Conflicts of interest common among panel members of guidelines that expand disease definitions

Main Category: Regulatory Affairs / Drug Approvals
Article Date: 13 Aug 2013 - 14:00 PDT Current ratings for:
Conflicts of interest common among panel members of guidelines that expand disease definitions

An assessment of expert members of panels making decisions about definitions or diagnostic criteria for common conditions in the US, which were published in guidelines used by physicians and other healthcare professionals caring for patients, found that most members had ties to industry. The assessment was made in a study from Ray Moynihan of Bond University, Queensland, Australia, and colleagues published in this week's issue of PLOS Medicine.

Of the 16 expert panel publications appearing between 2000 and April 2013 that met the authors' criteria of changing disease definitions, 10 proposed changes widening disease definitions and one narrowed a definition. Conditions being expanded included high blood pressure, Alzheimer disease and rheumatoid arthritis. Among the 14 panels with disclosure sections, the average proportion of members with industry ties was 75%.Twelve panels were chaired by people with industry ties. For members with ties, the median number of companies to which they were tied was seven. Companies with the highest proportions of ties manufactured drugs used to treat the disease.

In 2009, a US Institute of Medicine (IOM) report recommended that professional societies and other organizations drafting clinical practice guidelines should "generally exclude as panel members individuals with conflicts of interest," and in 2011 another IOM report recommended furthermore that panel chairs should be free of conflicts. To assess the potential impact of these recommendations, the authors compared panel publications released in 2012 with those released earlier and found no difference--guidelines published in 2012 had an average of 76% of members with ties, vs 74% before 2012.

The authors state, "This study did not investigate the merits of the proposed changes to the conditions identified. However, findings that diagnostic thresholds are being lowered by panels dominated by those with financial ties to multiple companies which may benefit directly from those decisions, raises questions about current processes of disease definition."

A limitation of the study is that the authors did not compare their results with guidelines that did not change disease definitions to determine whether industry ties were more common among panelists of guidelines that changed definitions compared with those that did not. Furthermore, the authors state, "As both [IOM] reports make clear, there are financial as well as non-financial or intellectual conflicts such as academic advancement, and there should be no assumption that having a conflict is unethical, or 'that any particular professional will necessarily let financial gain influence his or her judgment'."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our regulatory affairs / drug approvals section for the latest news on this subject.

Funding: NHMRC Screening and Test Evaluation Program Grant. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: RM, JD, and PG are involved in planning an international conference called Preventing Overdiagnosis. GC is a board member of General Practice Education and Training, Ltd; a registrar for the Medical Administration of the Princess Alexandra Hospital in Brisbane, Australia; and a former board member of the Royal Australian College of General Practitioners. SH is a member of the PLOS Medicine editorial board and chairs the Australian Pharmaceutical Benefits Advisory Committee, an independent advisory body for the Australian government. LB declares that no competing interests exist.

Expanding Disease Definitions in Guidelines and Expert Panel Ties to Industry: A Crosssectional Study of Common Conditions in the United States.

PLoS Med 10(8): e1001500. doi:10.1371/journal.pmed.1001500

Moynihan RN, Cooke GP, Doust JA, Bero L, Hill S, et al.

PLOS Medicine

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People likely to safeguard common goods when they trust in leaders, have a sense of belonging

Main Category: Psychology / Psychiatry
Also Included In: Public Health
Article Date: 28 Jul 2013 - 0:00 PDT Current ratings for:
People likely to safeguard common goods when they trust in leaders, have a sense of belonging

Every day, people donate to charities, volunteer to clean up city parks, or scale back their driving to curb air pollution. But some take these public goods for granted and ride free on the efforts of others. They watch public television but never make a donation to fund it. Or they run their lawn sprinklers during a drought while their neighbors follow government pleas to limit water consumption.

A new report in Psychological Science in the Public Interest, a journal of the Association for Psychological Science, examines more than 25 years' worth of studies on the use and support of public goods ranging from radio broadcasts to drinking water. Psychological researcher Craig Parks (Washington State University, Pullman) and his co-authors emphasize the urgent need to broaden thoughtful use of public goods, noting that charitable contributions are at historic lows, fossil fuel reserves are shrinking, and climate change threatens the planet's future.

In the report, the researchers discuss a variety of scientific findings on conditions that foster cooperative use of common resources, including:

Strong group identity

People are more likely to act cooperatively when they have a strong sense of belonging to a collective. A 2003 European study showed that fishermen who were strongly connected in their communities were more judicious with fishing stocks than were their counterparts in more loosely connected communities.

Smaller community size

Cooperation is likely to be stronger in smaller groups, particularly when one's contribution is easily identified. Psychological research suggests that cooperation decreases in large groups because people feel less influential, less identifiable, and less responsible for the group's welfare.

High trust in leaders

Citizens are more willing to help out in urgent situations when their government leaders act in transparent and trustworthy ways. A study of people's behavior during a 1991 water shortage in California showed that residents exercised more constraint on their water consumption if they felt local authorities were rationing water fairly.

The article also cites factors that lead to incongruous use of resources, including:

Intergroup conflicts

People often try to prevent those in an opposing group from benefiting from a good or resource in order to advance their own groups' interests. Parks and his co-authors cite as an example the 2011 debate in the U.S. Congress over the nation's debt ceiling. The Obama administration wanted to raise the debt ceiling to support such public goods as Social Security and the military. Republicans who fought the increase drew anger from many Americans, but in doing so helped enhance the GOP's reputation as a party of fiscal watchdogs.

Ideology/values

Individuals may withhold support for a public good that they see as useless or objectionable. Examples of this are environmentalists who fight a highway expansion, or political conservatives who reject public radio as too left-leaning.

Cognitive disconnection

Threats to some common resources are so vast or abstract that people struggle to comprehend the consequences. The most salient example is people's struggle to envision the impact that climate change will have on future generations.

Parks and his colleagues propose some policy steps that could promote better care of public resources. Research shows, for example, that people tend to act for the benefit of those who are powerless or helpless. Framing future generations in that light (e.g., talking about the more-hostile climate that we stand to leave for our great-grandchildren) can spark people today to be more diligent about reducing their carbon footprint, they suggest.

The researchers also argue that policymakers, in promoting optimal use of public goods, must concentrate on building the public's trust in order to garner cooperation.

"Sincere and concerted attempts to collect public input and a general 'let's work together' approach will do much to enhance group identity," they write. "Toleration of a certain amount of deviation from policy, at least in the early stages of implementation, will show that policy makers are forgiving. And last, a policy that gives citizens more than they might have expected - a more well-developed public good and broader access to it - will convey an image of generosity."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Co-authors on the article are Jeff Joireman of Washington State University, Pullman, and Paul A.M. Van Lange of Vrije Universiteit, Amsterdam.

Association for Psychological Science

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Association for Psychological Science. "People likely to safeguard common goods when they trust in leaders, have a sense of belonging." Medical News Today. MediLexicon, Intl., 28 Jul. 2013. Web.
29 Jul. 2013. APA

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'People likely to safeguard common goods when they trust in leaders, have a sense of belonging'

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Oral Health For Children - Common Dental Problems And Solutions

Oftentimes, grown ups miss out on the significance of oral health for children. Incidents where argue that it's all right for kids to possess rotten teeth. They are saying kid's teeth are temporary ones and can undergo an all natural or self-fix once permanent teeth begin to grow. That's in some way true. But the truth is half the fight of adult dental problems is won when teeth and nicotine gums are correctly looked after in early years.

Surprisingly, cavities can happen the moment nursing years. This problem is known as the infant bottle cavities. The nicotine gums and teeth of the baby reaches risk when it's in constant connection with sugars which are contained in the breast milk, formulas, fruit drinks and plain water with sugar. The sugars during these substances remain in the babies' mouths for any very long time. Later on, bacteria feast upon the sugar deposits plus they eventually damage the nicotine gums and teeth. Cavities may cause discomfort and discomfort to children. Much more, it may cause the imbalance of permanent which grow some years later.

Included in oral health for children, parents and first care providers of kids are encouraged to clean the newborn's mouth having a small bit of cotton dabbed in water that is clean after bottle feeding periods. Avoid pacifying or putting the infant to rest by bottle feeding him with milk. Rather possess a pacifier ready sometimes such as this. The moment the infant turns into a toddler, lessen his utilization of feeding bottles. Train him using cups with straws.

When small children come to be young children, another threat which comes their strategy is early teeth loss. While cavities is one reason with this, small accidents throughout a tough play also make children loose one or a few teeth. Similar to the above-pointed out, this could lead to misaligned teeth. When the positioning from the concerned teeth isn't remedied, the problem can result in related dental joint pain.

The need for oral health should be trained to kids the moment they acquire the opportunity to understand. Including constant practice too. Parents and first care givers should be determined to do this understanding since the motivation from the kids will rely on them. To start with, discipline children to consume regular foods per day with no snacks among. Besides providing them with definite time for you to eat, make sure that their foods are healthy. You are able to research online for a listing of meals that are great for one's teeth. Next, encourage children to clean their teeth after every meal. Whenever possible, allow them to use tooth paste that's wealthy in fluoride.

Oral health for children could be best accomplished with the aid of a dental professional. Train children that the dental professional is really a friend who'll take care of their teeth. Schedule regular dental check-ups in order to eliminate potential fear inside them. Possess the dental professional discuss dental hygiene and also the miracles of sealants in combating cavities.

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Health Tips & Info : The End of Common Diseases.

This picture presents the latest available statistics of the World Health Organization regarding the main causes of death in Europe, the United States, and other industrialized countries at the end of the twentieth century. Every year 12 million people worldwide die of the results of atherosclerosis, heart infarctions, and strokes. These are by far the most common causes of death of our time. 
Cellular Medicine has already found an answer to this epidemic: atherosclerosis and its consequences, heart infarction and stroke are early forms of scurvy. Based on this knowledge, coronary heart disease will be reduced to a fraction of the current figures over the next decades. The second-largest common disease is cancer—malignant tumors. Coronary disease and cancer together are responsible for over 80% of all deaths in industrialized countries. Incidences of cancer keep increasing on a global scale. There is only one plausible explanation for this: conventional medicine does not know the causes for cancer nor how this disease spreads. Because of this there is no effective cancer therapy available and the disease can keep expanding on a global scale. The most common diseases and causes of death in developing countries are infectious diseases, including the AIDS epidemic. These serious infectious diseases can only continue spreading the way they do because the knowledge of cellular health has been not efficiently used. This book will also provide the solution for the control of these diseases.From : Cellular Health Series Cancer Book. By Matthias Rath, M.D.

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