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Views & Reviews Personal View

NICE’s recommendations for thromboembolism are not evidence based

BMJ 2011; 343 doi: (Published 07 December 2011) Cite this as: BMJ 2011;343:d6452

Rapid Response:

Re: NICE’s recommendations for thromboembolism are not evidence based

We operate under the principle that ‘we need clinical experts in the field to develop guidelines’. But because of the pervasive and persuasive nature of contact between these experts and pharma – ‘food, flattery and friendship’ plus funding – we risk getting expert opinion based, instead of evidence based guidelines.

If there are no uncompromised experts in the relevant field we may be better served if guideline developers were only method experts, with or without uncompromised clinicians in a different specialty from the guideline. The real clinical experts could then make their input during the public consultation phase, at which time their views would be subject to scrutiny of their argument, not respect for their opinion.

Requiring a conflict of interest be declared does not remove its potential bias. It simply shifts its burden to the end user. Quite unhelpful.

Competing interests: No competing interests

09 December 2011
Peter Grant
Sydney, Australia