Impact of pharmaceutical industry involvement in the external review of clinical practice guidelines-A case study.

Participation of professional societies, patients, and the general public in the external review of the 2016 European acne guideline was unacceptably low. This is in concordance with reports of low participation of these groups in other European dermatology guidelines. While involving the pharmaceutical industry in the review substantially increased the number of comments received, many of these sought changes that would have put companies' own products in a more favourable light. Our findings underscore the need to manage reviewer comments in a robust and transparent fashion. Solutions to encourage participation of all relevant stakeholders are needed.