Methodologists and context experts disagreed regarding managing conflicts of interest of clinical practice guidelines panels.

Objective: A new strategy to manage conflicts of interests (COIs) of a clinical guideline's panelists gives primary responsibility to a methodologist, puts equal emphasis on intellectual and financial COIs, and excludes panelists with primary conflicts from drafting or voting on recommendations. We explored the views of the methodologists and content experts regarding the new strategy.

Study Design And Setting: Before the guidelines chapter panels initiated their work, we conducted semi-structured personal interviews with the methodologists and the lead content experts. We analyzed the data qualitatively.

Results: Twenty-four panelists participated. The methodologists thought that the new strategy increased their responsibility and authority. The lead content experts perceived their role label as unfair and reflecting a demotion. Whereas methodologists were concerned about potential conflicts with content experts, the lead content experts were uncomfortable with the "extra surveillance" by the methodologists. Whereas methodologists believed that the changes ensure more rigorous evidence-based guidelines, some lead content experts were worried that methodologists' lack of content expertise and content expert attrition could hurt the quality of the guidelines.

Conclusions: The methodologists and lead content experts were uneasy regarding their counterpart's role. They disagreed about the potential effect of the new strategy on the quality of the guideline.