To 1) evaluate payments from industry (i.e. pharmaceutical and medical device companies) to physician-authors of the ºÃÉ«ÏÈÉú's (AAN) internally developed Clinical Practice Guidelines (CPGs) published between August 2014 and July 2019, using the Open Payments Database (OPD); and 2) to compare completeness of author-disclosed payments to OPD-listed payments

Clinical practice guidelines shape clinical practice. Therefore, the relationships between CPG authors and Industry must be transparent to CPG readers.

This cross-sectional analysis examined industry payments to physician authors of AAN CPGs using OPD. Authors extracted data from included CPGs one year before and after the date of publication. Payments received from OPD were compared to disclosure statements from the AAN authors. A board-certified neurologist then assessed each payment for relevancy to the CPG. All data collection was performed in a duplicate and blinded manner by two investigators.

101 of 209 physician authors (48.3%) of 22 AAN CPGs received 3018 payments totaling roughly $12 million. 8 of 101 physician authors (7.9%) fully disclosed all payments received. Relevancy could be judged for 39.7% of payments ($4,799,661), of which 45.1% ($2,162,387) were from companies selling products directly relevant to the CPG.

The majority of physician authors of AAN CPGs had no Industry-related financial relationships, but many authors received substantial payments – most of which were not disclosed. Rules governing mandatory reporting of Industry-related financial relationships must be strengthened in order to ensure trust in the medical profession and the objectivity of the medical literature.