The author's specialty and conflicts of interest contribute to conflicting guidelines for mammography screening
Journal of Clinical Epidemiology
Norris SL, Burda BU, Holmer HK, Ogden LA, Fu R, Bero L, Schünemann H, Deyo R.
To examine the relationship between the conflicts of interest of the members of the orientation group and the recommendations of the guidelines on mammography screening in asymptomatic middle-risk women aged between 40 and 49 years.
Study planning and setting: We searched the National Guideline Clearinghouse and MEDLINE for the relevant guidelines published between January 2005 and June 2011. We reviewed the information and specialties of the main and secondary authors of these guidelines, as well as the publications of the main authors.
Risultati: Twelve guidelines have been identified with a total of 178 medical authors from a wide range of specialties. Of the four guidelines that did not recommend routine screening, none had a member of the radiologist, while of the eight guidelines that recommended routine screening, five had a member of the radiologist (comparison of proportions, P = 0,05). A guideline with the authors of the radiologists was more likely to recommend routine screening (odds ratio = 6.05, 95% confidence interval = 0,57-∞, P = 0,14). The proportion of primary care physicians on panel of guidelines recommending routine versus non-routine screening was significantly different (38% versus 90% of authors, P = 0,01). The probabilities of a recommendation for routine screening were related to the number of recent publications on the diagnosis and treatment of breast disease of the reference author (P = 0.02).
Conclusion: Recommendations regarding mammography screening in this target population may reflect the special and intellectual interests of the authors of the guidelines.