Introduction
Over the past three decades, clinical practice guidelines (CPGs) have increasingly played instrumental roles in standardizing the diagnostic and treatment processes based on the best available evidence. CPGs are now essential tools for endorsing evidence-based medicine in clinical practice.1,2 However, the trustworthiness of CPGs could be compromised by conflicts of interest (COIs) between CPG authors and the pharmaceutical industry. Over the past decade, accumulating evidence has shown prevalent financial relationships between CPG authors and the healthcare industry.3-9 While not all financial interactions necessarily lead to problematic relationships or harmful influences on patients and physicians’ clinical practice, some can introduce bias into CPG recommendations, potentially compromising patient-centered care.2,10,11 A recent systematic review indicated that CPGs and advisory committee reports with COIs were more likely to make favorable recommendations for pharmaceutical companies.12
To mitigate concerns about the undue influence of the healthcare industry on CPG recommendations, many national and international professional organizations have implemented strict COI management policies for trustworthy CPG development.1,2,5,11,13-15 Given the significant impact of CPGs on patients, clinicians, and other stakeholders, stringent COI management—including full disclosure, minimization of COIs among authors and organizations, and the appointment of COI-free chairpersons for CPGs—is essential. This approach could foster reliable CPGs and advances patient-centered care in the field of neurology and beyond.2,3,5,11,16-18 Nevertheless, the extent of financial COIs among neurology CPG authors has not been thoroughly investigated to date. Utilizing a publicly accessible database containing payments to physicians from pharmaceutical companies, this study aims to evaluate the potential financial COIs among neurology CPG authors in Japan.