Understanding conflicts of interest

Excerpt

In the era of evidence-based medicine, clinical decisions about diagnosis and treatment should be informed by best current evidence integrated with clinical expertise and patient values, preferences and experiences [1]. However, conflicts of interest (COIs) could have a detrimental effect on the synthesis, interpretation and application of evidence in the field of intensive care medicine and in healthcare in general [2, 3]. These effects can be complex and difficult to characterise; therefore, better understanding is crucial. Indeed, evidence is open for interpretation. For example, the design, execution, or interpretation of randomised clinical trials (RCTs) and systematic reviews can be affected by various types of COIs (e.g., financial COIs). Similarly, recommendations in clinical practice guidelines can be highly influenced by unmanaged COIs [4‐6]. Furthermore, COIs may affect decision making in daily clinical practice and in quality improvement initiatives, e.g. through flawed performance measures [7]. Also, non-transparent declaration and management of COIs could result in erosion of trust at governmental, institutional, and individual levels. …