Here's a New York Times story from last week, reporting a very high prevalence of financial ties to industry among experts on NIH panels drafting guidelines on hypertension, obesity and cholesterol. (As the article notes, the panels were seated in 2008, before the current more rigorous guidelines on COI were put into place.) 20 members of the three panels, including some co-chairs, have been told they ought to recuse themselves from voting on crucial issues. 8 of 19 obesity panel members have ties to industry, as do 7 of 16 cholesterol panel members. Worryingly, 5 of 17 hypertension panel members have taken industry money since the panel was seated.
And government panels are among the least worrying on the COI issue. This piece from BMJ last month finds that, among 7 panels working on diabetes and 7 on hyperlipidaemia guidelines between 2000 and 2010, most panel members and half of all panel chairs had COI, and that the COI prevalence was lowest on government sponsored panels. It was highest on panels sponsored by specialty societies. It's time for a hard look, not only at standards but at remedies. Mere disclosure and self-recusal from voting doesn't help much, if the panelist has had the chance to frame the discussion. One panelist in the Times story is quoted as saying he severed his ties with industry in order to serve--but if he had the ties before, and will be free to have them again afterwards, what does the current severing really do to secure his independence? The best solution is probably the one used by NICE in the UK: no one who's received industry money in the last year is permitted to serve.