Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new onset epilepsy: Report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society

To the Editor:

I was surprised that recently published practice parameters did not contain conflict of interest disclosure statements.1,2⇓ Authors of American Academy of Neurology (AAN) practice parameters should disclose their potential conflicts of interests. This is particularly relevant for practice parameters that review pharmaceutical agents or procedures in which the authors have a potential financial conflict of interest. The disclosures should be broad and include all types of relationships with sponsoring companies including equity holdings, contracted research, and various consulting relationships. Given the stature of the practice parameters in influencing practice across multiple specialties, consideration should be given for a non-zero limit required for disclosure.

In addition, donation of remuneration from a potentially conflicting sponsor to a not-for-profit organization (e.g., charitable organization, university discretionary account, or equivalent) should not preclude the need to disclose. Disclosure statements should also be considered for authors whose salaries are directly linked to the volume of procedures or devices that they are reviewing. Although not well studied, one would speculate that under such circumstances, “self-serving” bias might influence how an author seeks, interprets, and reports available evidence, as likely occurs with gifts.3

Consideration should also be given to the AAN itself to disclose its potential financial conflicts of interest when the sponsors of reviewed drugs or procedures have donated substantial amounts to the organization, even if only as unrestricted educational grants. The AAN has already made the list of not-for-profit organizations that have substantial ties to industry4 and, I suspect, wants to avoid the negative publicity that could result from an inquisitive investigative journalist.5

As the public demands more accountability of the scientific enterprise, and financial conflicts of interest receive continued attention at the national level, including the recently issued guidance statement by the Department of Health and Human …