ESC Guidelines for the management of atrial fibrillation, engl.

Evaluation by Leitlinienwatch

29.01.17

PTs.	Criterion
2	Transparency A detailed list of each author’s potential conflicts of interest is published on the ESC homepage (http://www.escardio.org/static_file/Escardio/Guidelines/DOI/DOI_Summary_2016_AFIB.pdf).
0	Composition of the Guideline Working Group 15 out of 17 authors in the guideline working group declare financial conflicts of interest, the majority of which are directly connected to the subject of the guideline. This means that these authors have financial relationships with manufacturers of anticoagulants or manufacturers of interventional therapy devices for atrial fibrillation.
0	Independence of the Coordinators/Chairs/Lead AuthorsUnabhängigkeit der Vorsitzenden/federführenden Autoren Both leading authors declare conflicts of interest.
0	Abstention from Voting The documentation does not provide any information regarding abstention from voting or rules regarding abstention.
0	External Review of the Guideline The documentation does not indicate that external consulting on the guidelines took place.
1	Bonus Points According to the recommendations for drawing up guidelines on the ESC homepage (http://www.escardio.org/static_file/Escardio/Guidelines/ESC%20Guidelines%20for%20Guidelines%20Update%202010.pdf, Section 4.4), a comprehensive internal review process is conducted that can also involve experts from outside the ESC as needed.

Explanations to the evaluation criteria

Comment

European Society of Cardiology (ESC) guidelines outside the German AWMF guideline register, drawn up with the involvement of the European Association for Cardio-Thoracic Surgery (EACTS) and the European Stroke Association (ESO). Based on the standard practices of the Deutsche Gesellschaft für Kardiologie (German Society of Cardiology, DGK), we assume that the DGK will soon publish an adapted version of these guidelines in German. The latest official German version (as of January 2017) published by the DGK, “Fokus Update,” is the 2012 version of the document.
As with the other ESC guidelines we have evaluated, the problem here is that nearly all the guideline authors – including the lead authors – have relevant financial conflicts of interest.
A specific guideline report is not available. The ESC only published general recommendations for drawing up guidelines (http://www.escardio.org/static_file/Escardio/Guidelines/ESC%20Guidelines%20for%20Guidelines%20Update%202010.pdf). Study evaluation methods are not apparent in these recommendations. Conflicts of interest are transparently disclosed, but any consequences derived from these disclosures – such as rules regarding abstention from voting – are not indicated.
Furthermore, the regulation of ESC guideline authors’ conflicts of interest urgently requires comprehensive reform. The current recommendations from the Guideline International Network and the AWMF could serve as a model here. Important aspects of a reform would include the recruitment of independent authors and measures to effectively regulate the existing and often substantial conflicts of interest of the guideline authors.