RT Journal
A1 Nissen SE
T1 THe proactive management of “relationship with industry” by acc/aha in the creation of our cardiovascular clinical practice guidelines—reply
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2011
FD September 26
VO 171
IS 17
SP 1598
OP 1600
DO 10.1001/archinternmed.2011.432
UL http://dx.doi.org/10.1001/archinternmed.2011.432
AB 
These questionable relationships were not limited to roles that might conceivably promote public good, such as provision of scientific advice to industry on development of innovative new therapies. In half of cases, industry relationships involved promotional speaking on behalf of companies, many directly affected by the guidelines. When a physician engages in speaking on behalf of industry that is not related to continuing medical education, he or she becomes a part-time employee of the sponsoring company. In the most egregious cases, committee participants were members of industry-funded “speakers' bureaus,” an activity that typically requires giving scripted talks using slides prepared by the company. Such roles are morally and ethically inconsistent with the responsibilities of an unbiased guideline writer—to independently assess the value of limitations of alternative therapeutic strategies. Other guideline writers held stock in affected companies. For both examples, promotional speaking and stock ownership, we must expect that such relationships bias the participant. As noted by the commonly quoted idiom, people do not “bite the hand that feeds them.”