Feature

Commentary: How the BMJ selects guideline summaries for publication

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f5536 (Published 17 September 2013) Cite this as: BMJ 2013;347:f5536
  1. Mabel Chew, practice editor, BMJ
  1. mchew{at}bmj.com

There is little doubt that financial conflicts of interest among guideline developers can influence guideline recommendations, as well as external perceptions of their credibility.1 Some guideline bodies, such as the US Preventive Services Task Force (USPSTF) and the UK’s National Institute for Health and Care Excellence (NICE) have moved to minimise such conflicts of interest, but it is clear that many still fall short, despite calls from the Institute of Medicine and others to do better.1 2 Lenzer and colleagues are to be commended for working to improve matters with their proposed list of questions, intended for publication with guidelines, to help determine if guidelines are likely to be affected by financial bias.3

At the BMJ, we have opted to screen guidelines at an earlier stage. Although we no longer publish full guidelines, we do publish summaries of selected guidelines. These have to meet specific criteria as part of a checklist, with some similarities to criteria proposed by Lenzer and colleagues (www.bmj.com/about-bmj/resources-authors/article-types/practice, www.bmj.com/about-bmj/resources-authors/article-types/clinical-management-guidelines). This helps us to determine if systematic, transparent methods—including efforts to safeguard against conflicts of interest—were used to develop guideline recommendations. For instance, was there a sufficiently multidisciplinary guideline development group; were there clearly described and adequate methods for taking into account potential biases or competing interests among guideline developers; did the guideline group take into account preferences of the target population and seek views of interested parties not in the group?

We decline to publish summaries of guidelines that don’t meet these criteria. Where funding sources are not mentioned, we ask how the guidelines were funded and what the role of the funding body was in developing the guidelines and in the decision to submit the article for publication. We avoid publishing summaries of guidelines that received industry funding for their development, even if this was partial and unrestricted, as we believe it would be difficult for readers to perceive the guidance as being truly independent.

By publishing summaries of good quality guidelines that rigorously try to minimise conflicts of interest, we hope to help patients and doctors make better decisions about care. We also hope such endorsement encourages more guideline developers to make better decisions in handling competing interests.

Notes

Cite this as: BMJ 2013;347:f5536

References

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