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One society required Board review, but not approval. The approval process was not reported by 2 (6%) of the specialty societies. CONCLUSIONS Most medical specialty societies in the U.S. require approval of guidelines by a board that represents the society as whole. Since medical specialty societies have loyalties to the patients they serve and to their physician members, and because the interests of those two groups may differ, such an approval process introduces a potential conflict of interest into the guideline development process.M
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