A study of nearly 500 individuals who helped craft treatment guidelines for heart conditions found that more than half reported financial conflicts of interest involving drug companies and medical technology firms.
Study: Many top doctors have conflicts
More than half of the heart specialists who helped write treatment guidelines had conflicts of interest with drug or med-tech firms.
March 30, 2011 at 1:37AM
The most common conflict involved doctors serving as paid consultants to drug or medical device companies, such as Fridley-based Medtronic Inc., according to a report this week in an American Medical Association journal.
The study in the Archives of Internal Medicine also found doctors and researchers receiving research grants from companies or speaking on their behalf, as well as owning stock in firms selling or developing drugs or devices.
"Imagine if the Twins were playing the Yankees, and the umpires are stockholders for the Yankees," said Dr. Eric Campbell, one of the study's authors, who is an associate professor at Harvard Medical School.
A total of 277 of the 498 individuals involved in crafting 17 clinical practice guidelines for the American Heart Association and the American College of Cardiology reported a conflict.
The panels that create these guidelines include experts who evaluate scientific evidence and then recommend how to treat heart conditions. The guidelines may ultimately influence how patients are treated, including what drugs or devices are deployed and whether insurance will pay for their use.
On a broader scope, guidelines are used to craft government policies regarding heath care.
An editorial accompanying the study, written by Dr. Steven Nissen, chair of the cardiovascular medicine department at the Cleveland Clinic, said the study raises "troubling concerns that must be urgently addressed." In order for guidelines "to be truly independent and respected, even the appearance of impropriety must be avoided."
But in a statement, Medtronic spokesman Christopher Garland defended consulting relationships between doctors and the med-tech giant, noting that "collaboration with physicians is vital to innovation."
Relationships with Medtronic were frequently cited by those crafting guidelines, as well as with drugmakers Pfizer and Merck. Garland said that makes sense, since Medtronic is the world's largest med-tech company with devices treating many kinds of heart conditions.
However, one of the biggest surprises unearthed in the study was the number of guideline writers -- about 44 percent -- who reported no financial conflicts, according to Dr. James Kirkpatrick, one of the study's authors.
This debunks the widely held view that there aren't enough experienced experts to serve on guideline panels who are independent of industry ties, said Kirkpatrick, an assistant professor of cardiovascular medicine at the University of Pennsylvania.
Researchers also found that 81 percent of the panels' leaders reported a conflict. Medtronic's Garland said this may indicate that those with more involvement with industry are frequently recognized by medical societies as being experts, and thus well-suited to serve on guideline committees.
Janet Moore • 612-673-7752
There were no optimal outcomes. But there was also a lot of good work, and change that made sense.
