Background: The identification and appropriate management of conflicts of interest (COI) are essential for assuring trustworthy guidelines.
Objectives: We aimed to examine the declaration of interests (DOI), management of COI, and the funders for World Health Organization (WHO) guidelines.
Methods: We examined all Guidelines Review Committee (GRC)-approved WHO guidelines published in English from 2007 (inception of the GRC) to November 2016. We obtained a list of all such guidelines from the GRC Secretariat, and downloaded the documents from the WHO website. Characteristics of each guideline including funders’ and contributors’ DOI and COI were independently extracted by two researchers. Binary logistic regression was used to assess the associations between declarations and the number of developers.
Results: 178 WHO guidelines fulfilled inclusion criteria, encompassing 14 clinical or public health fields. Funding sources were reported in 73% of guidelines: the most common funders were governments. DOI for external contributors were reported in 89% of the guidelines, of which 48% indicated no contributors with COI, 36% reported one or more contributors with COI, and 16% reported collecting DOI but not whether COI existed. Financial COI were reported more frequently than nonfinancial COI. The difference of DOI reporting between guidelines developed solely by WHO and co-developed with other organisations was insignificant (91% versus 79%, P=0.05).
Conclusions: WHO guidelines generally reported their funding sources, and the DOI and COI of external contributors However, the role of funders, declaration processes, and how COI were assessed and managed were often not provided. WHO and the guideline community in general need to continue to look for more efficient and effective approaches for identifying, quantifying and minimising potential sources of bias in guideline development.