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Conflict of Interest in Medical Research, Education, and Practice
TABLE 7-2 Number of Clinical Practice Guidelines in the National Guideline Clearinghouse by Selected Types of Sponsors, as of March 16, 2009
Type of Sponsor
Number of Guidelines
Medical specialty society (U.S. and other)
Professional association (U.S. and other; mostly nonphysician or mixed groups)
Government agency (non-U.S.)
Federal/state/local government agency
Independent expert panel
Academic institution (U.S. and other)
Disease-specific society (U.S. and other)
Hospital/medical center (U.S. and other)
Managed care organization
Total, all guidelines, all sponsors
NOTE: Some guidelines are developed collaboratively by more than one type of sponsor. For example, a guideline may list as developers one or more professional societies and one or more disease-specific societies. The National Guideline Clearinghouse (NGC) search option does not generate unduplicated counts by category of sponsor. The unduplicated count presented here was provided by NGC staff. Nineteen of the 26 guidelines from a hospital or medical center were submitted by a single institution.
SOURCE: Personal communication, Mary Nix, Health Scientist Administrator, National Guideline Clearinghouse, March 22, 2009.
Public agencies also develop practice guidelines. U.S. federal and state agencies and public agencies from other countries accounted for more than 500 of the guidelines in the National Guideline Clearinghouse.
Some groups involved in guideline development have sought partners. For example, the American College of Cardiology and the American Heart Association have collaborated in their guideline development program since the 1980s (ACC/AHA, 2009). Several groups are investigating an international collaboration to develop guidelines for the care of respiratory diseases (personal communication, Holger Schunemann, M.D., Ph.D., chair, Department of Clinical Epidemiology and Biostatistics, McMaster University, February 19, 2009). Compared with the complexity of simply adding individuals with different professional and other backgrounds to a guideline development panel, the management of partnerships between and among agencies tends to be more complicated because each partner usually has, for example, its own policies and procedures. Nevertheless, the