FOR IMMEDIATE RELEASE ON June 19, 2013
AAN Issues Response to BMJ Article on Guideline Development
MINNEAPOLIS -
The American Academy of Neurology (AAN) wishes to describe its guideline author conflict of interest policy in response to the BMJ feature titled “Why we can’t trust clinical guidelines.” The AAN develops evidence-based, clinical practice guidelines for neurologists. The AAN has always strived to be at the forefront of clinical practice guideline development and the methodology for developing guidelines. This includes the process for managing conflicts of interest, which is always evolving and improving. The current process is discussed in detail in the Guideline development process manual (pages 23 and 24). Briefly, persons interested in authoring a guideline complete a conflict of interest form detailing potential financial and intellectual conflicts. The conflicts of potential authors are vetted by the AAN Guideline Development Subcommittee leadership to ensure that at least half the panel does not have substantial conflicts related to the guideline topic. Based on the specific circumstances, potential authors judged to have substantial financial or intellectual conflicts may be excluded altogether from the guideline panel or may be excluded from critical steps in the guideline development process. Relative to the guideline regarding the use of intravenous tPA for the treatment of acute stroke developed in collaboration with the American College of Emergency Physicians, the AAN selected two members of its guideline development committee to participate on the author panel. The selections were based upon the members’ interest and experience in acute stroke care and guideline development methodology. Both members disclosed that they had received honoraria for speaking on the secondary prevention of ischemic stroke. These activities were not judged to be substantial conflicts relative to a guideline regarding thrombolytics for the acute treatment of stroke. The AAN remains committed to developing unbiased evidence-based guidelines. It stands behind the recommendations for the use of intravenous tPA for the management of acute ischemic stroke. The AAN will be submitting a formal response to the article in the British Medical Journal. References: Why we can’t trust clinical guidelines. BMJ 2013;346 AAN (American Academy of Neurology). 2011. Clinical Practice Guideline Process Manual, 2011 Ed. St. Paul, MN: The American Academy of Neurology. Clinical policy: use of intravenous tPA for the management of acute ischemic stroke in the emergency department. Ann Emerg Med 2013;61:225-43.