BMJ reports on conflicts of interest in medical guidelines

The report also includes reasons and evidence that doctors are inclined to follow the guidelines despite known conflicts of interest, lack of supporting evidence, and their own perceptions of what might be best for their patients:

Doctors who are sceptical about the scientific basis of clinical guidelines have two choices: they can follow guidelines even though they suspect doing so will cause harm, or they can ignore them and do what they believe is right for their patients, thereby risking professional censure and possibly jeopardising their careers. This is no mere theoretical dilemma; there is evidence that even when doctors believe a guideline is likely to be harmful and compromised by bias, a substantial number follow it…

Guidelines are usually issued by large panels of authors representing specialty and other professional organisations… A recent survey found that 71% of chairs of clinical policy committees and 90.5% of co-chairs had financial conflicts…

“We like to stick within the standard of care, because when the shit hits the fan we all want to be able to say we were just doing what everyone else is doing—even if what everyone else is doing isn’t very good.”

Unfortunately the full text is now behind a paywall. However a search for the article’s title “Why we can’t trust clinical guidelines” may turn up sites hosting the content in accordance with fair use.

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