Transparency and open communication are key to a healthy relationship
Medical practice these days is influenced to a large extent by clinical practice guidelines. Usually sponsored by professional bodies, these compendia of advice should be produced by groups of experts with broad representation and credibility. These experts are expected to follow clearly defined processes1 to arrive at recommendations that are based on evidence, and which are unadulterated by other influences, such as commercial considerations. Strict adherence to this framework underpins the authority and acceptability of the guideline. But these standards are sometimes not met, and there have been calls for reform to ensure reliability of guidelines, and thereby offer patients protection from treatment based on guidelines whose content may be affected by extraneous influences.2-4
The full article is accessible to AMA members and paid subscribers. Login to read more or purchase a subscription now.
Please note: institutional and Research4Life access to the MJA is now provided through Wiley Online Library.
- Medical Journal of Australia, Sydney, NSW.
- 1. National Health and Medical Research Council. A guide to the development, implementation and evaluation of clinical practice guidelines. Canberra: NHMRC, 1999. http://www.nhmrc.gov.au/publications/synopses/cp30syn.htm (accessed Mar 2009).
- 2. Sniderman AD, Furberg CD. Why guideline-making requires reform. JAMA 2009; 301: 429-431.
- 3. Stembrook R. Guidance for guidelines. N Engl J Med 2007; 356: 331-333.
- 4. Shaneyfelt TM, Centor RM. Reassessment of clinical practice guidelines: go gently into that good night [editorial]. JAMA 2009; 301: 868-869.
- 5. Millar JA. Genesis of medical thromboprophylaxis guidelines in Australia: a need for transparency and standardisation in guideline development. Med J Aust 2009; 190: 446-450. <MJA full text>
- 6. Australia and New Zealand Working Party on the Management and Prevention of Venous Thromboembolism. Prevention of venous thromboembolism: best practice guidelines for Australia and New Zealand. 4th ed. Sydney: Health Education and Management Innovations, 2007.
- 7. Godlee F. Doctors, patients and the drug industry [editor’s choice]. BMJ 2009; 338: b463.
- 8. Wager E. How to dance with porcupines: rules and guidelines on doctors' relations with drug companies. BMJ 2003; 326: 1196-1198.
- 9. DeAngelis CD, Fontanarosa PB. Impugning the integrity of medical science [editorial]. JAMA 2008; 299: 1833-1835.
- 10. Royal College of Physicians of London. Innovating for health: patients, physicians, the pharmaceutical industry and the NHS. Report of a working party. London: RCP, 2009.
- 11. Royal Australasian College of Physicians. Guideline for ethical relationship between physicians and industry. 3rd ed. Sydney: RACP, 2006. http://www.racp.edu.au/page/publications-and-communications (accessed Mar 2009).
- 12. Steinbrook R. Physician–industry relations — will fewer gifts make a difference? N Engl J Med 2009; 360: 557-559.
- 13. Hébert PC, Stanbrook MB, Sibbald B, et al. The need for an institute of continuing health education. CMAJ 2008; 178: 805-806, 809-810.
- 14. Grouse L. Physicians for sale: how medical professional organizations exploit their members. Medscape J Med 2008; 10: 169.
- 15. Gilmore I. Build bridges with the drugs industry — but keep patients in mind. BMJ 2009; 338: b439.