McMaster opioid guideline ‘unbiased’: review
National standards for prescribing opioids led by McMaster University are “scientifically rigorous” and “unbiased” concludes a government-ordered review.
The financial conflicts of one voting panel member didn’t influence the 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain, found the Canadian Institute for Health Research in a report released Thursday.
“The 2017 Canadian Guideline was subject to many checks and balances in order to minimize undue influence on the final recommendation,” states the independent assessment. “It seems clear that the perceived COI (conflict of interest) of one individual on the voting guideline panel did not have any impact on the final recommendations.”
McMaster admitted “errors were made” in the process that was supposed to keep the new national opioid guideline COI-free in a letter dated May 19 to then federal health minister Jane Philpott.
The letter by professor Dr. Gordon Guyatt acknowledged one voting member had received income from opioid manufacturers. The CIHR review identifies Oakville physician Dr. Sol Stern.
As a result, Philpott directed CIHR to assess “what impact, if any, the potential conflict of interest had on the scientific rigour of the 2017 Canadian Guideline.”
The review concluded the recommendations “provide unbiased, evidence-based guidance to clinicians on opioid prescribing practice that is aligned with international comparators.”
Dr. Jason Busse, the lead author of the guideline, said the steering committee is “pleased” with the “strong conclusion.”
“The report speaks for itself,” said Busse, associate professor in the department of anesthesia at McMaster. “This is another independent review by a highly reputable organization. … It’s another document that I think will give stakeholders, clinicians and patients confidence in the rigor underlying the recommendations of the guideline.”
However, he doesn’t expect it will satisfy all of the guidelines’ critics.
“This is controversial topic,” said Busse. “It’s inevitable that there’s going to be some people that will feel our recommendations have gone too far, and others that believe they do not go far enough.”