Evidence-based recommendations of hemato-oncological guidelines: quality assessment and the role of industry-sponsored trials

Guidelines in clinical practice play a fundamental role in applying evidence-based medicine or professional guidance to clinical practice. An increasing financial conflict of interest in clinical trials in general medicine has been illustrated in recent literature. Pharmaceutical-funded clinical drug trials yield positive outcomes for company products more frequently than independent trials do. In this line, we aimed to identify whether there is a role of conflict of interest (COls) in the hemato-oncology field. Thus, we searched hemato-oncological guidelines (April 1st, 2007 and March 31st, 2017) from the selected transnational societies by the experts in the field of hemato-oncology. Clinical practice guidelines (CPGS) and consensus statements complying with the inclusion and exclusion criteria were included in the study and analysed the proportion of reported clinical trials funded by industry and non-industry for each guideline. Quality assessments were performed with the Appraisal of Guidelines for Research and Evaluation II (AGREE-11) tool. We identified 110 guidelines, of which 57 were excluded; 53 guidelines included were developed by 7 transnational societies. Overall, we identified 927 treatment recommendations made by 507 trial citations, of which 255 (50.3%) were industry and 252 (49.7%) non-industry sponsored. The AGREE-ll overall assessment score was less for specialised oncology developers (33.5%) than general guideline developers (52.8%). Of those six AGREE-Il domains, the applicability domain scored (19.8%) less for the oncology specialised concerning general guideline developers (41.0%). Concluding, we identified that the guidelines produced by ESMO, ELN and NCCN societies are driven to make recommendations by a greater proportion of industry-sponsored trials. The very low-quality score is reported in the guidelines established by the ELN, ESMO and NCCN society. Whereas AHS and BSH, medium-quality scores are registered. While the guidelines developed by CCO and NICE societies, higher quality scores are registered.