Institute of Medicine (IOM), Guidelines International Network (G-I-N)\u306eCOI\u306b\u95a2\u3059\u308b\u89e3\u8aac\u3001COI\u3078\u306e\u5bfe\u51e6\u6cd5\u306a\u3069\u306b\u3064\u3044\u3066\u3001\u91cd\u8981\u306a\u7b87\u6240\u306e\u539f\u6587\u3068\u65e5\u672c\u8a9e\u8a33\u3067\u3059\u3002\u3053\u308c\u3092\u8aad\u3080\u3068COI\u306b\u3064\u3044\u3066\u306e\u7406\u89e3\u304c\u6df1\u307e\u308a\u3001\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u306b\u304a\u3051\u308bCOI\u3078\u306e\u5bfe\u51e6\u6cd5\u304c\u7406\u89e3\u3067\u304d\u308b\u3068\u601d\u3044\u307e\u3059\u3002<\/p>\n\n\n\n
\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d\uff0d<\/p>\n\n\n\n
Institute of Medicine 2009\u5e74\u306e\u5b9a\u7fa9<\/strong><\/p>\n\n\n\n \u201cA set of circumstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by a secondary interest\u201d (IOM, 2009, p. 46).<\/p>\n\n\n\n \u300c\u3082\u3063\u3068\u3082\u91cd\u8981\u306a\u4e00\u6b21\u7684\u5229\u5bb3\u306b\u95a2\u3059\u308b\u5c02\u9580\u7684\u5224\u65ad\u3042\u308b\u3044\u306f\u884c\u52d5\u304c\u4e8c\u6b21\u7684\u5229\u5bb3\u306b\u4e0d\u5f53\u306b\u5f71\u97ff\u3092\u53d7\u3051\u308b\u30ea\u30b9\u30af\u3092\u751f\u3058\u308b\u4e00\u9023\u306e\u72b6\u6cc1\u300d<\/p>\n\n\n\n Clinical Practice Guidelines We Can Trust<\/a> 2011\u5e74\u306b\u5f15\u7528\u3055\u308c\u3066\u3044\u308b\u3002<\/p>\n\n\n\n <\/p>\n\n\n\n \u3055\u3089\u306bIOM\u306e\u8ffd\u52a0\u7684\u8aac\u660e\uff1acomplementary descriptions of COI: \u201cA divergence between an individual\u2019s private interests and his or her professional obligations such that an independent observer might reasonably question whether the individual\u2019s professional actions or decisions are motivated by personal gain, such as financial, academic advancement, clinical revenue streams, or community standing\u201d <\/p>\n\n\n\n \u300c\u72ec\u7acb\u3057\u305f\u89b3\u5bdf\u8005\u304c\u3001\u500b\u4eba\u306e\u5c02\u9580\u7684\u884c\u52d5\u3042\u308b\u3044\u306f\u6c7a\u65ad\u304c\u7d4c\u6e08\u7684\u3001\u30a2\u30ab\u30c7\u30df\u30c3\u30af\u306a\u6607\u9032\u3001\u81e8\u5e8a\u7684\u53ce\u5165\u306e\u6d41\u308c\u3042\u308b\u3044\u306f\u793e\u4f1a\u7684\u5730\u4f4d\u306e\u3088\u3046\u306a\u500b\u4eba\u7684\u7372\u5f97\u5229\u76ca\u306b\u52d5\u6a5f\u3065\u3051\u3089\u308c\u3066\u3044\u308b\u304b\u3069\u3046\u304b\u306b\u3064\u3044\u3066\u7591\u554f\u3092\u62b1\u304f\u304b\u3082\u3057\u308c\u306a\u3044\u3088\u3046\u306a\u3001\u500b\u4eba\u306e\u79c1\u7684\u5229\u5bb3\u3068\u305d\u306e\u5c02\u9580\u5bb6\u3068\u3057\u3066\u306e\u7fa9\u52d9\u306e\u9593\u306e\u76f8\u9055\u300d<\/p>\n\n\n\n \u3055\u3089\u306bSch\u00fcnemann HJ,\u3089\u306e\u89e3\u8aac\uff1a<\/p>\n\n\n\n \u201cA financial or intellectual relationship that may impact an individual\u2019s ability to approach a scientific question with an open mind\u201d (Sch\u00fcnemann et al., 2009, p. 565).<\/p>\n\n\n\n \u300c\u958b\u304b\u308c\u305f\u5fc3\u3067\u79d1\u5b66\u7684\u7591\u554f\u306b\u30a2\u30d7\u30ed\u30fc\u30c1\u3059\u308b\u500b\u4eba\u306e\u80fd\u529b\u306b\u5f71\u97ff\u3092\u4e0e\u3048\u308b\u304b\u3082\u3057\u308c\u306a\u3044\u7d4c\u6e08\u7684\u3042\u308b\u3044\u306f\u77e5\u7684\u95a2\u4fc2\u300d<\/p>\n\n\n\n \u3055\u3089\u306b\u77e5\u7684COI\u306b\u3064\u3044\u3066\u306e\u8aac\u660e\uff1a<\/p>\n\n\n\n intellectual COIs specific to CPGs are defined as \u201cacademic activities that create the potential for an attachment to a specific point of view that could unduly affect an individual\u2019s judgment about a specific recommendation\u201d (Guyatt et al., 2010, p. 739)<\/p>\n\n\n\n \u300c\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306b\u7279\u7570\u7684\u306a\u77e5\u7684COI\u306f\u3001\u7279\u7570\u7684\u306a\u63a8\u5968\u306b\u95a2\u3059\u308b\u500b\u4eba\u306e\u5224\u65ad\u306b\u4e0d\u5f53\u306b\u5f71\u97ff\u3057\u3046\u308b\u7279\u7570\u7684\u306a\u898b\u89e3\u3078\u306e\u57f7\u7740\u306e\u53ef\u80fd\u6027\u3092\u751f\u307f\u51fa\u3059\u30a2\u30ab\u30c7\u30df\u30c3\u30af\u306a\u6d3b\u52d5\u3068\u5b9a\u7fa9\u3055\u308c\u308b\u300d<\/p>\n\n\n\n G-I-N 2016\u306e\u5b9a\u7fa9<\/strong><\/p>\n\n\n\n G-I-N 2016\u306e\u5b9a\u7fa9\u306fIOM\u306e\u8ffd\u52a0\u7684\u8aac\u660e\u3068\u540c\u3058\u5185\u5bb9\u3067\u3042\u308b\uff1a<\/p>\n\n\n\n \u201cA divergence between an individual\u2019s private interests and his or her professional obligations such that an independent observer might reasonably question whether the individual\u2019s professional actions or decisions are motivated by personal gain, such as direct financial, academic advancement, clinical revenue streams, or community standing.\u201d<\/p>\n\n\n\n \u30fc\u30fc\u30fc\u30fc\u30fc \u7b2c4\u7ae0\uff0875\uff5e107\u30da\u30fc\u30b8\uff09<\/p>\n\n\n\n 1. Establishing Transparency <\/p>\n\n\n\n 1.1 The processes by which a CPG is developed and funded should be detailed explicitly and publicly accessible.<\/p>\n\n\n\n 2. Management of Conflict of Interest (COI) <\/p>\n\n\n\n 2.1 Prior to selection of the guideline development group (GDG), individuals being considered for membership should declare all interests and activities potentially resulting in COI with development group activity, by written disclosure to those convening the GDG: <\/p>\n\n\n\n \u2022 Disclosure should reflect all current and planned commercial (including services from which a clinician derives a substantial proportion of income), noncommercial, intellectual, institutional, and patient\u2013public activities pertinent to the potential scope of the CPG. <\/p>\n\n\n\n 2.2 Disclosure of COIs within GDG: <\/p>\n\n\n\n \u2022 All COI of each GDG member should be reported and discussed by the prospective development group prior to the onset of his or her work. <\/p>\n\n\n\n \u2022 Each panel member should explain how his or her COI could influence the CPG development process or specific recommendations. <\/p>\n\n\n\n 2.3 Divestment <\/p>\n\n\n\n \u2022 Members of the GDG should divest themselves of financial investments they or their family members have in, and not participate in marketing activities or advisory boards of, entities whose interests could be affected by CPG recommendations. <\/p>\n\n\n\n 2.4 Exclusions <\/p>\n\n\n\n \u2022 Whenever possible GDG members should not have COI. <\/p>\n\n\n\n \u2022 In some circumstances, a GDG may not be able to perform its work without members who have COIs, such as relevant clinical specialists who receive a substantial portion of their incomes from services pertinent to the CPG.<\/p>\n\n\n\n \u2022 Members with COIs should represent not more than a minority of the GDG. <\/p>\n\n\n\n \u2022 The chair or cochairs should not be a person(s) with COI. <\/p>\n\n\n\n \u2022 Funders should have no role in CPG development.<\/p>\n\n\n\n 3. Guideline Development Group Composition <\/p>\n\n\n\n 3.1 The GDG should be multidisciplinary and balanced, comprising a variety of methodological experts and clinicians, and populations expected to be affected by the CPG. <\/p>\n\n\n\n 3.2 Patient and public involvement should be facilitated by including (at least at the time of clinical question formulation and draft CPG review) a current or former patient, and a patient advocate or patient\/consumer organization representative in the GDG. <\/p>\n\n\n\n 3.3 Strategies to increase effective participation of patient and consumer representatives, including training in appraisal of evidence, should be adopted by GDGs.<\/p>\n\n\n\n 4. Clinical Practice Guideline\u2013Systematic Review Intersection <\/p>\n\n\n\n 4.1 Clinical practice guideline developers should use systematic reviews that meet standards set by the Institute of Medicine\u2019s Committee on Standards for Systematic Reviews of Comparative Effectiveness Research. <\/p>\n\n\n\n 4.2 When systematic reviews are conducted specifically to inform particular guidelines, the GDG and systematic review team should interact regarding the scope, approach, and output of both processes.<\/p>\n\n\n\n 1. \u900f\u660e\u6027\u306e\u78ba\u4fdd<\/p>\n\n\n\n 1.1 CPG\u306e\u4f5c\u6210\u3068\u8cc7\u91d1\u8abf\u9054\u306e\u904e\u7a0b\u306f\u660e\u78ba\u3001\u8a73\u7d30\u3067\u516c\u8846\u304c\u30a2\u30af\u30bb\u30b9\u3067\u304d\u308b\u3088\u3046\u306b\u3059\u3079\u304d\u3067\u3042\u308b\u3002<\/p>\n\n\n\n 2. \u5229\u76ca\u76f8\u53cd\uff08COI\uff09\u306e\u7ba1\u7406<\/p>\n\n\n\n 2.1 \u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u30b0\u30eb\u30fc\u30d7\uff08GDG\uff09\u306e\u9078\u4efb\u306b\u5148\u7acb\u3061\u3001\u53c2\u52a0\u3092\u8003\u616e\u4e2d\u306e\u500b\u4eba\u306f\u4f5c\u6210\u30b0\u30eb\u30fc\u30d7\u306e\u6d3b\u52d5\u3068COI\u3092\u751f\u3058\u3046\u308b\u3059\u3079\u3066\u306e\u5229\u76ca\u3068\u6d3b\u52d5\u3092\u62db\u96c6\u8005\u306b\u66f8\u9762\u3067\u7533\u544a\u3059\u3079\u304d\u3067\u3042\u308b\u3002<\/p>\n\n\n\n \u30fb\u7533\u544a\u306f\u73fe\u5728\u306e\u3001\u305d\u3057\u3066\u8a08\u753b\u3055\u308c\u3066\u3044\u308b\u3001CPG\u306e\u60f3\u5b9a\u3055\u308c\u308b\u30b9\u30b3\u30fc\u30d7\u306b\u95a2\u9023\u3059\u308b\u5546\u696d\u7684\uff08\u305d\u3053\u304b\u3089\u53ce\u5165\u306e\u304b\u306a\u308a\u306e\u90e8\u5206\u3092\u5f97\u3066\u3044\u308b\u696d\u52d9\u30fb\u30b5\u30fc\u30d3\u30b9\u3082\u542b\u3080\uff09\u3001\u975e\u5546\u696d\u7684\u3001\u77e5\u7684\u3001\u60a3\u8005\u2010\u516c\u8846\u306b\u95a2\u3059\u308b\u6d3b\u52d5\u306e\u3059\u3079\u3066\u3092\u53cd\u6620\u3059\u3079\u304d\u3067\u3042\u308b\u3002<\/p>\n\n\n\n 2.2 GDG\u5185\u3067\u306eCOI\u306e\u7533\u544a\uff1a<\/p>\n\n\n\n \u30fbGDG\u30e1\u30f3\u30d0\u30fc\u306e\u3059\u3079\u3066\u306eCOI\u306f\u305d\u306e\u4ed5\u4e8b\u3092\u958b\u59cb\u3059\u308b\u524d\u306b\u5831\u544a\u3055\u308c\u3001\u5c06\u6765\u306e\u4f5c\u6210\u30b0\u30eb\u30fc\u30d7\u306b\u3088\u3063\u3066\u8b70\u8ad6\u3055\u308c\u308b\u3079\u304d\u3067\u3042\u308b\u3002<\/p>\n\n\n\n \u30fb\u5404\u30d1\u30cd\u30eb\u30e1\u30f3\u30d0\u30fc\u306f\u305d\u306eCOI\u304c\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u30d7\u30ed\u30bb\u30b9\u3042\u308b\u3044\u306f\u500b\u5225\u63a8\u5968\u306b\u3069\u306e\u3088\u3046\u306b\u5f71\u97ff\u3057\u3046\u308b\u304b\u3092\u8aac\u660e\u3059\u3079\u304d\u3067\u3042\u308b\u3002<\/p>\n\n\n\n 2.3 \uff08\u682a\u5f0f\u306a\u3069\u306e\uff09\u51e6\u5206<\/p>\n\n\n\n \u30fbGDG\u30e1\u30f3\u30d0\u30fc\u306f\u5404\u81ea\u304a\u3088\u3073\u5bb6\u65cf\u304c\u4fdd\u6709\u3059\u308b\u7d4c\u6e08\u7684\u6295\u8cc7\u3092\u81ea\u3089\u58f2\u5374\u30fb\u51e6\u5206\u3059\u3079\u304d\u3067\u3001\u305d\u306e\u5229\u76ca\u304c\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306e\u63a8\u5968\u306b\u3088\u308a\u5f71\u97ff\u3092\u53d7\u3051\u3046\u308b\u4f01\u696d\u4f53\u306e\u30de\u30fc\u30b1\u30c6\u30a3\u30f3\u30b0\u3042\u308b\u3044\u306f\u30a2\u30c9\u30d0\u30a4\u30b6\u30ea\u30fc\u30dc\u30fc\u30c9\u306b\u53c2\u52a0\u3059\u3079\u304d\u3067\u306f\u306a\u3044\u3002<\/p>\n\n\n\n 2.4 \u9664\u5916\u898f\u5b9a<\/p>\n\n\n\n \u30fb\u53ef\u80fd\u306a\u9650\u308aGDG\u30e1\u30f3\u30d0\u30fc\u306fCOI\u3092\u6709\u3059\u308b\u3079\u304d\u3067\u306f\u306a\u3044\u3002 3. \u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u30b0\u30eb\u30fc\u30d7\u306e\u69cb\u6210<\/p>\n\n\n\n 3.1 GDG\u306f\u65b9\u6cd5\u8ad6\u306e\u5c02\u9580\u5bb6\u3001\u81e8\u5e8a\u5bb6\u3001\u305d\u3057\u3066\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3067\u5f71\u97ff\u3092\u53d7\u3051\u308b\u3067\u3042\u308d\u3046\u96c6\u56e3\u306a\u3069\u3055\u307e\u3056\u307e\u306a\u4eba\u3005\u304b\u3089\u69cb\u6210\u3055\u308c\u3001\u591a\u304f\u306e\u5c02\u9580\u5206\u91ce\u306e\u30d0\u30e9\u30f3\u30b9\u304c\u3068\u308c\u305f\u69cb\u6210\u306b\u3059\u3079\u304d\u3067\u3042\u308b\u3002<\/p>\n\n\n\n 3.2 \u60a3\u8005\u3068\u516c\u8846\u306e\u53c2\u753b\u306f\u73fe\u5728\u306e\u60a3\u8005\u3042\u308b\u3044\u306f\u75be\u60a3\u7d4c\u9a13\u8005\u3001\u60a3\u8005\u652f\u63f4\u8005\u3042\u308b\u3044\u306f\u60a3\u8005\u30fb\u533b\u7642\u5229\u7528\u8005\u56e3\u4f53\u306e\u4ee3\u8868\u8005\u3092GDG\u306b\u542b\u3080\u3053\u3068\u3067\uff08\u5c11\u306a\u304f\u3068\u3082\u30af\u30ea\u30cb\u30ab\u30eb\u30af\u30a8\u30b9\u30c1\u30e7\u30f3\u4f5c\u6210\u6642\u70b9\u3068\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u8349\u7a3f\u306e\u30ec\u30d3\u30e5\u30fc\u306e\u6642\u70b9\u3067\uff09\u5f37\u5316\u3059\u3079\u304d\u3067\u3042\u308b\u3002<\/p>\n\n\n\n 3.3 \u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u6279\u5224\u7684\u541f\u5473\u306e\u30c8\u30ec\u30fc\u30cb\u30f3\u30b0\u3092\u542b\u3080\u3001\u60a3\u8005\u3068\u533b\u7642\u5229\u7528\u8005\u306e\u4ee3\u8868\u306e\u52b9\u679c\u7684\u306a\u53c2\u52a0\u3092\u5897\u3084\u3059\u6226\u7565\u304cGDG\u306b\u3088\u308a\u63a1\u7528\u3055\u308c\u308b\u3079\u304d\u3067\u3042\u308b\u3002<\/p>\n\n\n\n 4. \u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3-\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u306e\u4ea4\u5dee<\/p>\n\n\n\n 4.1 \u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u8005\u306fInstitute of Medicine\u306e\u6bd4\u8f03\u52b9\u679c\u7814\u7a76\u306e\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u306e\u30b9\u30bf\u30f3\u30c0\u30fc\u30c9\u306b\u3088\u308a\u8a2d\u5b9a\u3055\u308c\u305f\u57fa\u6e96\u3092\u6e80\u305f\u3059\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u3092\u7528\u3044\u308b\u3079\u304d\u3067\u3042\u308b\u3002<\/p>\n\n\n\n 4.2 \u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u304c\u7279\u5b9a\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306b\u60c5\u5831\u3092\u4e0e\u3048\u308b\u305f\u3081\u306b\u7279\u7570\u7684\u306b\u5b9f\u65bd\u3055\u308c\u308b\u6642\u306f\u3001GDG\u3068\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u30c1\u30fc\u30e0\u306f\u4e21\u8005\u306e\u30b9\u30b3\u30fc\u30d7\u3001\u30a2\u30d7\u30ed\u30fc\u30c1\u3001\u305d\u3057\u3066\u30a2\u30a6\u30c8\u30d7\u30c3\u30c8\u306b\u3064\u3044\u3066\u5354\u50cd\u3059\u3079\u304d\u3067\u3042\u308b\u3002<\/p>\n\n\n\n \u6587\u732e<\/p>\n\n\n\n IOM. 2009. Conflict of interest in medical research, education, and practice. Edited by B. Lo and M. J. Field. Washington, DC: The National Academies Press, USA.<\/p>\n\n\n\n Guyatt G, Akl EA, Hirsh J, Kearon C, Crowther M, Gutterman D, Lewis SZ, Nathanson I, Jaeschke R, Sch\u00fcnemann H: The vexing problem of guidelines and conflict of interest: a potential solution. Ann Intern Med 2010;152:738-41. PMID: 20479011<\/a><\/p>\n\n\n\n Sch\u00fcnemann HJ, Osborne M, Moss J, Manthous C, Wagner G, Sicilian L, Ohar J, McDermott S, Lucas L, Jaeschke R, ATS Ethics and Conflict of Interest Committee and the Documents Development and Implementation Committee: An official American Thoracic Society Policy statement: managing conflict of interest in professional societies. Am J Respir Crit Care Med 2009;180:564-80. PMID: 19734351<\/a><\/p>\n\n\n\n G-I-N\u306e9\u3064\u306e\u539f\u5247<\/p>\n\n\n\n 1\uff0e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u8005\u306f\u76f4\u63a5\u7684\u306aCOI\u3042\u308b\u3044\u306f\u95a2\u9023\u306e\u3042\u308b\u9593\u63a5\u7684COI\u3092\u6709\u3059\u308b\u8005\u3092\u30e1\u30f3\u30d0\u30fc\u306b\u542b\u307e\u306a\u3044\u305f\u3081\u306b\u53ef\u80fd\u306a\u9650\u308a\u52aa\u529b\u3059\u3079\u304d\u3067\u3042\u308b\u3002 \u88dc\u8db3\uff1a<\/p>\n\n\n\n 1-\uff0eG-I-N\u306f\u305d\u308c\u304c\u5b9f\u969b\u7684\u3067\u306a\u3044\u5834\u5408\u306b\u3001\u4f8b\u5916\u304c\u5fc5\u8981\u306a\u3053\u3068\u3092\u8a8d\u8b58\u3057\u3066\u3044\u308b\u304c\u3001\u305d\u306e\u3088\u3046\u306a\u554f\u984c\u304c\u3053\u306e\u539f\u5247\u306e\u91cd\u8981\u6027\u3092\u6e1b\u5c11\u3055\u305b\u308b\u3082\u306e\u3067\u306f\u306a\u3044\u3002\u30d1\u30cd\u30eb\u30e1\u30f3\u30d0\u30fc\u304cCOI\u3092\u6709\u3059\u308b\u5834\u5408\u3001COI\u3092\u6709\u3059\u308b\u30e1\u30f3\u30d0\u30fc\u304c\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u30d1\u30cd\u30eb\u3067\u5c11\u6570\u6d3e\u306b\u306a\u308b\u3088\u3046\u306b\u3001\u305d\u3057\u3066\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u8005\u306fCOI\u3092\u6709\u3059\u308b\u30e1\u30f3\u30d0\u30fc\u3092\u542b\u3081\u308b\u7406\u7531\u306b\u3064\u3044\u3066\u305d\u3057\u3066COI\u306e\u7ba1\u7406\u306b\u3064\u3044\u3066\u900f\u660e\u6027\u3092\u78ba\u4fdd\u3059\u3079\u304d\u3067\u3042\u308b\u3002 \u6587\u732e\uff1a<\/p>\n\n\n\n Sch\u00fcnemann HJ, Al-Ansary LA, Forland F, Kersten S, Komulainen J, Kopp IB, Macbeth F, Phillips SM, Robbins C, van der Wees P, Qaseem A, Board of Trustees of the Guidelines International Network: Guidelines International Network: Principles for Disclosure of Interests and Management of Conflicts in Guidelines. Ann Intern Med 2015;163:548-53. PMID: 26436619<\/a><\/p>\n\n\n\n \u4f4e\u3044\u30ec\u30d9\u30eb\u306eCOI \uff08\u6392\u9664\u306a\u3057\uff09<\/strong><\/p>\n\n\n\n \u76f4\u63a5\u7684\u306a\u7d4c\u6e08\u7684COI\u306a\u3057 \u5bfe\u5fdc\uff1a\u5168\u9762\u7684\u53c2\u753b<\/u><\/p>\n\n\n\n \u4e2d\u7b49\u5ea6\u306e\u30ec\u30d9\u30eb\u306eCOI \uff08\u90e8\u5206\u7684\u6392\u9664\uff09<\/strong><\/p>\n\n\n\n \u76f4\u63a5\u7684\u7d4c\u6e08\u7684COI \u500b\u4eba\u7684\u306a\u7d4c\u6e08\u7684COI \u76f4\u63a5\u7684\u77e5\u7684COI \u5bfe\u5fdc\uff1a\u8b70\u8ad6\u306b\u306f\u53c2\u52a0\u3059\u308b\u304c\u3001\u30d1\u30cd\u30eb\u3001\u8457\u8005\u3001\u6295\u7968\u306b\u306f\u53c2\u52a0\u3057\u306a\u3044\u3002<\/u><\/p>\n\n\n\n \u9ad8\u3044\u30ec\u30d9\u30eb\u306eCOI\uff08\u5b8c\u5168\u6392\u9664\uff09<\/strong><\/p>\n\n\n\n \u76f4\u63a5\u7684\u306a\u7d4c\u6e08\u7684COI<\/p>\n\n\n\n -\u8b1b\u6f14\u3001\u682a\u5f0f\u3001\u30dc\u30fc\u30c9\u30e1\u30f3\u30d0\u30fc \u5bfe\u5fdc\uff1a\u62d2\u7d76<\/u><\/p>\n\n\n\n 2015\u5e74Guidelines International Network \uff08G-I-N\uff09\u3067\u306e\u30d7\u30ec\u30ca\u30ea\u30fc\u30bb\u30c3\u30b7\u30e7\u30f3\u3067\u306eGRADE working group\u306eHolger Schunemann\u3068American College of Phyisicians (ACP)\u306eAmir Quaseem\u306e\u767a\u8868\u30b9\u30e9\u30a4\u30c9\u3002<\/p>\n\n\n\n <\/p>\n","protected":false},"excerpt":{"rendered":" Institute of Medicine (IOM), Guidelines International Network (G-I-N)\u306eCOI\u306b\u95a2\u3059\u308b\u89e3\u8aac\u3001COI\u3078\u306e\u5bfe\u51e6\u6cd5\u306a\u3069\u306b\u3064\u3044\u3066\u3001\u91cd\u8981\u306a\u7b87\u6240\u306e\u539f\u6587\u3068\u65e5\u672c\u8a9e\u8a33\u3067\u3059 … “Conflict of Interest (COI) \u5229\u76ca\u76f8\u53cd” \u306e<\/span>\u7d9a\u304d\u3092\u8aad\u3080<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[],"class_list":["post-1531","post","type-post","status-publish","format-standard","hentry","category-cpg"],"_links":{"self":[{"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/posts\/1531","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1531"}],"version-history":[{"count":1,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/posts\/1531\/revisions"}],"predecessor-version":[{"id":1532,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/posts\/1531\/revisions\/1532"}],"wp:attachment":[{"href":"https:\/\/info.zanet.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1531"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1531"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1531"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\u30fb\u3044\u304f\u3064\u304b\u306e\u72b6\u6cc1\u3067\u306f\u3001\u30e1\u30f3\u30d0\u30fc\u306f\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306b\u95a2\u9023\u306e\u3042\u308b\u30b5\u30fc\u30d3\u30b9\u304b\u3089\u53ce\u5165\u306e\u304b\u306a\u308a\u306e\u90e8\u5206\u3092\u5f97\u3066\u3044\u308b\u95a2\u9023\u306e\u3042\u308b\u81e8\u5e8a\u5c02\u9580\u5bb6\u306e\u3088\u3046\u306a\u3001COI\u3092\u6709\u3059\u308b\u30e1\u30f3\u30d0\u30fc\u306a\u3057\u3067\u305d\u306e\u4ed5\u4e8b\u3092\u9042\u884c\u3067\u304d\u306a\u3044\u304b\u3082\u3057\u308c\u306a\u3044\u3002
\u30fbCOI\u3092\u6709\u3059\u308b\u30e1\u30f3\u30d0\u30fc\u306fGDG\u306e\u5c11\u6570\u6d3e\u306b\u3068\u3069\u3081\u308b\u3079\u304d\u3067\u3042\u308b\u3002
\u30fb \u8b70\u9577\u3042\u308b\u3044\u306f\u526f\u8b70\u9577\u306fCOI\u3092\u6709\u3059\u308b\u8005\u3067\u3042\u3063\u3066\u306f\u306a\u3089\u306a\u3044\u3002
\u30fb\u8cc7\u91d1\u63d0\u4f9b\u8005\u306fCPG\u4f5c\u6210\u3067\u4f55\u3089\u304b\u306e\u5f79\u5272\u3092\u6301\u3063\u3066\u306f\u306a\u3089\u306a\u3044\u3002<\/p>\n\n\n\n
\n\n\n\n
2\uff0eCOI\u306e\u5b9a\u7fa9\u3068\u305d\u306e\u7ba1\u7406\u306f\u3001\u5c02\u9580\u6027\u3042\u308b\u3044\u306f\u4ee3\u8868\u3057\u3066\u3044\u308b\u30b9\u30c6\u30fc\u30af\u30db\u30eb\u30c0\u306b\u95a2\u308f\u3089\u305a\u3001\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u30b0\u30eb\u30fc\u30d7\u306e\u5168\u54e1\u306b\u9069\u7528\u3055\u308c\u3001\u3053\u308c\u306f\u30d1\u30cd\u30eb\u304c\u69cb\u6210\u3055\u308c\u308b\u524d\u306b\u6c7a\u3081\u3089\u308c\u308b\u3079\u304d\u3067\u3042\u308b\u3002
3. \u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u30b0\u30eb\u30fc\u30d7\u306f\u5229\u5bb3\u7533\u544a\u306b\u6a19\u6e96\u5316\u3055\u308c\u305f\u30d5\u30a9\u30fc\u30e0\u3092\u7528\u3044\u308b\u3079\u304d\u3067\u3042\u308b\u3002
4\uff0e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u30b0\u30eb\u30fc\u30d7\u306f\u3059\u3079\u3066\u306e\u76f4\u63a5\u7684\u306a\u7d4c\u6e08\u7684\u304a\u3088\u3073\u9593\u63a5\u7684COI\u542b\u3080\u5229\u5bb3\u3092\u516c\u958b\u3059\u3079\u304d\u3067\u3001\u3053\u308c\u3089\u306f\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u5229\u7528\u8005\u304c\u5bb9\u6613\u306b\u95b2\u89a7\u3067\u304d\u308b\u3088\u3046\u306b\u3059\u3079\u304d\u3067\u3042\u308b\u3002
5\uff0e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u30b0\u30eb\u30fc\u30d7\u306e\u3059\u3079\u3066\u306e\u30e1\u30f3\u30d0\u30fc\u306f\u30b0\u30eb\u2015\u30d7\u306e\u4f1a\u8b70\u306e\u305f\u3073\u306b\u305d\u3057\u3066\u5b9a\u671f\u7684\u306b\uff08\u4f8b\u3048\u3070\u3001\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u30b0\u30eb\u30fc\u30d7\u306e\u306b\u3044\u308b\u9593\u306f1\u5e74\u3054\u3068\u306b\uff09\u5229\u5bb3\u306e\u5909\u66f4\u306b\u3064\u3044\u3066\u7533\u544a\u3057\u66f4\u65b0\u3059\u3079\u304d\u3067\u3042\u308b\u3002
6\uff0e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u30b0\u30eb\u30fc\u30d7\u306e\u8b70\u9577\u306f\u76f4\u63a5\u7684\u3042\u308b\u3044\u306f\u95a2\u9023\u306e\u3042\u308b\u9593\u63a5\u7684COI\u3092\u6709\u3059\u308b\u3079\u304d\u3067\u306f\u306a\u3044\u3002\u8b70\u9577\u306e\u76f4\u63a5\u7684\u3042\u308b\u3044\u306f\u9593\u63a5\u7684COI\u304c\u907f\u3051\u3089\u308c\u306a\u3044\u5834\u5408\u3001\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u30d1\u30cd\u30eb\u3092\u30ea\u30fc\u30c9\u3059\u308bCOI\u306e\u306a\u3044\u526f\u8b70\u9577\u3092\u4efb\u547d\u3059\u3079\u304d\u3067\u3042\u308b\u3002
7\uff0e\u95a2\u9023\u306e\u3042\u308bCOI\u3068\u7279\u7570\u7684\u306a\u77e5\u8b58\u3042\u308b\u3044\u306f\u5c02\u9580\u6027\u3092\u6301\u3064\u5c02\u9580\u5bb6\u306f\u500b\u3005\u306e\u30c8\u30d4\u30c3\u30af\u306e\u8b70\u8ad6\u3078\u306e\u53c2\u52a0\u3092\u8a31\u53ef\u3057\u3046\u308b\u304c\u3001\u610f\u898b\u3092\u6c42\u3081\u3089\u308c\u308b\u59d4\u54e1\u306e\u9593\u3067\u9069\u5207\u306a\u30d0\u30e9\u30f3\u30b9\u304c\u3068\u3089\u308c\u308b\u3079\u304d\u3067\u3042\u308b\u3002
8\uff0e\u63a8\u5968\u306e\u65b9\u5411\u3068\u5f37\u3055\u3092\u6c7a\u3081\u308b\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u30b0\u30eb\u30fc\u30d7\u306e\u30e1\u30f3\u30d0\u30fc\u306f\u8ab0\u3082\u76f4\u63a5\u7684\u306a\u7d4c\u6e08\u7684COI\u3092\u6709\u3059\u308b\u3079\u304d\u3067\u306f\u306a\u3044\u3002
9\uff0e\u7d71\u62ec\u59d4\u54e1\u4f1a\u306fCOI\u306b\u95a2\u9023\u3057\u305f\u898f\u5247\u306e\u4f5c\u6210\u3068\u5b9f\u884c\u306b\u8cac\u4efb\u3092\u6301\u3064\u3079\u304d\u3067\u3042\u308b\u3002<\/p>\n\n\n\n
4-\uff0eCOI\u306f\u3055\u307e\u3056\u307e\u306a\u8a2d\u5b9a\u306e\u3055\u307e\u3056\u307e\u306a\u30ec\u30d9\u30eb\u3067\u8d77\u304d\u308b\u306e\u3067\u3001\u3053\u306e\u958b\u793a\u306e\u90e8\u5206\u3067\u306f\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u30b0\u30eb\u30fc\u30d7\u306f\u3059\u3079\u3066\u306e\u7279\u7570\u7684\u306a\u91d1\u92ad\u7684\u4fa1\u5024\u306e\u3042\u308b\u3082\u306e\u3092\u958b\u793a\u3059\u3079\u304d\u3067\u3042\u308b\u3002\u3082\u3057\u308f\u304b\u308b\u306e\u3067\u3042\u308c\u3070\u3001\u5b9f\u969b\u306e\u3042\u308b\u306f\u304a\u304a\u3088\u305d\u306e\u91d1\u984d\u3092\u5831\u544a\u3059\u308b\u3053\u3068\u306f\u900f\u660e\u6027\u3092\u9ad8\u3081\u308b\u3002\u958b\u793a\u306e\u30ec\u30b8\u30b9\u30c8\u30ea\u30fc\u3092\u4f7f\u3046\u3053\u3068\u304c\u53ef\u80fd\u3067\u3042\u308b\u3002
6-\uff0e\u63a8\u5968\u306e\u5411\u304d\u3068\u5f37\u3055\u306b\u5f71\u97ff\u3059\u308b\u5834\u5408\u306f\u95a2\u9023\u306e\u3042\u308bCOI\u304c\u5b58\u5728\u3059\u308b\u3002\u305d\u306e\u3088\u3046\u306aCOI\u304c\u306a\u3044\u526f\u8b70\u9577\u306e\u4f8b\u306f\u63a8\u5968\u306e\u5411\u304d\u3068\u5f37\u3055\u306b\u95a2\u4fc2\u306e\u3042\u308b\u5229\u5bb3\u3092\u6301\u305f\u306a\u3044\u65b9\u6cd5\u8ad6\u5c02\u9580\u5bb6\u304c\u3042\u308b\u3002
-7\uff0e\u3044\u304f\u3064\u304b\u306e\u8a2d\u5b9a\u306b\u304a\u3044\u3066\u306f\u3001\u3053\u306e\u5f79\u5272\u3092\u6e80\u305f\u305b\u308b\u8005\u306f\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u30b0\u30eb\u30fc\u30d7\u306e\u6295\u7968\u3059\u308b\u3042\u308b\u3044\u306f\u6295\u7968\u3057\u306a\u3044\u30e1\u30f3\u30d0\u30fc\u3067\u306f\u306a\u3044\u5c02\u9580\u7684\u30a2\u30c9\u30d0\u30a4\u30b6\u30fc\u3068\u8003\u3048\u3066\u3082\u3088\u3044\u3002
-8\uff0e\u3053\u308c\u3089\u306e\u30e1\u30f3\u30d0\u30fc\u306f\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u306e\u6642\u70b9\u306b\u53c2\u52a0\u3059\u3079\u304d\u3067\u306f\u306a\u3044\u3002\u5f7c\u3089\u306f\u3001\u63a8\u5968\u306e\u65b9\u5411\u3068\u5f37\u3055\u306b\u95a2\u3059\u308b\u8b70\u8ad6\u306e\u5834\u306b\u306f\u3044\u306a\u3044\u3053\u3068\u3002
-9\uff0e\u7d71\u62ec\u59d4\u54e1\u4f1a\u306f\u8ad6\u4e89\u306b\u306a\u308b\u554f\u984c\u306b\u5bfe\u51e6\u3059\u3079\u304d\u3067\u3001\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u30b0\u30eb\u30fc\u30d7\u306e\u8b70\u9577\u306b\u8ab0\u304c\u6295\u7968\u3057\u3001\u3060\u308c\u304c\u6295\u7968\u3057\u306a\u3044\u30e1\u30f3\u30d0\u30fc\u304b\u3001\u305d\u3057\u3066\u5c02\u9580\u7684\u30a2\u30c9\u30d0\u30a4\u30b6\u30fc\u3068\u3057\u3066\u3060\u308c\u3092\u6307\u540d\u3059\u308b\u304b\u306b\u3064\u3044\u3066\u30a2\u30c9\u30d0\u30a4\u30b9\u3059\u3079\u304d\u3067\u3042\u308b\u3002<\/p>\n\n\n\n
\n\n\n\n
\u9593\u63a5\u7684\u306a\u7d4c\u6e08\u7684CO\u306a\u3057
\u76f4\u63a5\u7684\u306a\u77e5\u7684COI\u306a\u3057
-\u30c8\u30d4\u30c3\u30af\u9818\u57df\u3067\u63a8\u5968\u3092\u767a\u8868\u3057\u305f\u3053\u3068\u304c\u7121\u3044
-\u9055\u3046\u30c8\u30d4\u30c3\u30af\u9818\u57df\u3067\u306f\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u3092\u3057\u305f\u3053\u3068\u304c\u3042\u308b<\/p>\n\n\n\n
-\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3068\u95a2\u4fc2\u306e\u306a\u3044\u30c8\u30d4\u30c3\u30af\u9818\u57df\u3067\u96c7\u7528\u4e3b\u3078\u306e\u7814\u7a76\u8cbb\u3092\u4f01\u696d\u304b\u3089\u53d7\u3051\u3066\u3044\u308b
-\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306b\u76f4\u63a5\u95a2\u4fc2\u306e\u3042\u308b\u30c8\u30d4\u30c3\u30af\u9818\u57df\u3067\u975e\u55b6\u5229\u7d44\u7e54\uff08\u4f8b\u3048\u3070\u3001AHRQ\u3001NIH\u306a\u3069\uff09\u304b\u3089\u8cc7\u91d1\u3092\u53d7\u3051\u3066\u3044\u308b<\/p>\n\n\n\n
-\u88fd\u85ac\u4f01\u696d\u304b\u3089\u8fd1\u89aa\u8005\u304c\u8cc7\u91d1\u63d0\u4f9b\u3092\u53d7\u3051\u3066\u3044\u308b\u304c\u3001\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306e\u30c8\u30d4\u30c3\u30af\u3068\u306f\u95a2\u4fc2\u304c\u306a\u3044\u3002<\/p>\n\n\n\n
– \u5225\u306e\u7d44\u7e54\u306e\u305f\u3081\u306b\u540c\u3058\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u30c8\u30d4\u30c3\u30af\u3067\u4ed5\u4e8b\u3092\u3057\u305f\u3053\u3068\u304c\u3042\u308b<\/p>\n\n\n\n
-\u8fd1\u89aa\u8005\u304c\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306b\u76f4\u63a5\u95a2\u4fc2\u306e\u3042\u308b\u88fd\u54c1\u306b\u3064\u3044\u3066\u88fd\u85ac\u4f01\u696d\u304b\u3089\u91d1\u92ad\u3092\u53d7\u3051\u53d6\u308b\u3001\u3042\u308b\u3044\u306f\u53d7\u3051\u53d6\u3063\u305f\u3053\u3068\u304c\u3042\u308b<\/p>\n\n\n\n