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Discordance Between Self-Reported COI and CMS Open Payment Database Among Gastroenterology Guideline Authors


Shah, Raj MD1; Numan, Laith MD2; Chandar, Apoorva K. MD, MPH1; Maruggi, Chiara MD1; Alabdulwahhab, Motib MD1; Chauhan, Mahak MD2; Davitkov, Perica MD3; Falck-Ytter, Yngve MD3

doi: 10.14309/01.ajg.0000594144.95973.3a

1University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH;

2University of Missouri, Kansas City, MO;

3Case Western Reserve University School of Medicine, Cleveland, OH.

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The 2011 IOM Standards of developing trustworthy guidelines emphasizes transparency and mitigating conflict of interest. This study aims to assess the transparency of reported conflict of interest in gastroenterology guidelines using the “Sunshine” CMS Open Payment Database for comparison.

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Guidelines using GRADE methodology and guideline authors from American Association for the Study of Liver Disease, American College of Gastroenterology, American Gastroenterology Association, and American Society of Gastrointestinal Endoscopy societies from 2013 to October 15, 2018, were abstracted. We reviewed conflict of interest disclosure statements for each author on all guidelines, even if they had no conflict of interest. We analyzed the Sunshine data for each author for the year the guideline was published and the year prior.

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In guideline documents, 222/823 (26.6%) authors self-reported conflict of interest. Out of 823 authors, 510 (61.9%) of them were reviewed on the Sunshine database, and the remaining authors were not found on the database. 172 of the 510 (33.7%) self-reported at least one conflict of interest. However, 338 (66.2%) did not disclose any conflict of interest. Out of the 338, 325 (96.1%) and 220 (65%) authors did receive general payments in the same year the guideline was published and the year prior, respectively. Out of those who received payments, 213 (65.5%) and 147 (66.8 %) had general payment amounts above $500 in the same year the guideline was published and the year prior, respectively.

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There is a discordance between guideline self-disclosures and the sunshine database. Two-thirds of all guideline authors with CMS reported payments on the sunshine database do not seem to report conflict of interest on the guideline they published during the same time period. We encourage authors to frequently check this publically accessible database to ensure accuracy in its reporting. Additionally, authors and guideline societies should strive to increase conflict of interest reporting to allow for an even further transparent guideline development process.

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