Conflict of Interest in Medical Research, Education, and Practice

by Lo, Bernard

• ISBN13: 9780309131889
• ISBN10: 030913188X
• Edition: 1st
• Format: Hardcover
• Copyright: 2009-09-01
• Publisher: NATL ACADEMY OF SCIENCE

Summary

Presents report of the Committee on Conflict of Interest in Medical Research, Education, and Practice. Offers principles to inform the design of policies to identify, limit, and manage conflicts of interest without damaging constructive collaboration with industry. For medical ethicists. DNLM: Conflict of interest.

Table of Contents

Summary	p. 1
Introduction	p. 23
Overview and Themes of the Report	p. 27
Historical and Policy Context	p. 33
Organization of Report	p. 43
Principles for Identifying and Assessing Conflicts of Interest	p. 44
What Is a Conflict of Interest?	p. 45
What Are the Purpose of Conflict of Interest Policies?	p. 48
Why Not Examine the Motives of the Decision Maker or the Validity of the Decision?	p. 50
Should Policies Also Require That Professionals Avoid the ôAppearance of Conflict of Interestö?	p. 52
How Can Conflicts of Interest Be Assessed?	p. 52
How Can Conflict of Interest Policies Be Evaluated?	p. 56
Conclusion	p. 60
Policies on Conflict of Interest: Overview and Evidence	p. 62
Overview of Conflict of Interest Policies	p. 64
Disclosure: An Essential but Insufficient Element of Policy	p. 67
Prohibiting or Eliminating Conflicts of Interest	p. 79
Evaluating and Managing Conflicts of Interest	p. 80
Recommendations	p. 87
Conflicts of Interest in Biomedical Research	p. 97
Collaboration and Discovery in Biomedicine	p. 98
Industry Funding and Relationships in Biomedical Research	p. 101
Concerns About Relationships with Industry	p. 102
Responses to Concerns About Conflicts of Interest in Research	p. 110
Recommendations	p. 116
Conflicts of Interest in Medical Education	p. 122
Background and COntext	p. 124
Learning Environments in Medical Schools and Residency Programs	p. 127
The Learning Environment in Accredited Continuing Medical Education	p. 140
Ghostwriting, Speakers Bureaus, and Independence of Publications and Presentations	p. 153
Recommendations	p. 157
Conflicts of Interest and Medical Practice	p. 166
The Broader Context: Physician Payment, Self-Referral, and Conflicts of Interest in Medical Practice	p. 167
Industry Promotional Activities and Practicing Physicians	p. 170
Responses to Concerns About Industry Relationships and Conflicts of Interest in Community Practice	p. 175
Recommendations	p. 183
Conflicts of Interest and Development of Clinical Practice Guidelines	p. 189
Background and Context	p. 190
Groups That Develop Clinical Practice Guidelines	p. 196
Financial Relationships in Guideline Development	p. 198
Policies on Conflicts of Interest in Clinical Practice Guideline Development	p. 204
Recommendations	p. 210
Institutional Conflicts of Interest	p. 216
What Are Institutional Conflicts of Interest?	p. 218
Extent of Institutional Relationships with Industry	p. 219
Responses to Institutional Conflicts of Interest	p. 221
Special Challenges in Managing Institutional Conflicts of Interest	p. 224
Recommendations	p. 226
Role of Supporting Organizations
How Supporting Organizations Can Influence Medical Institutions	p. 232
Recommendations	p. 235
References	p. 240
Appendixes
Study Activities	p. 285
U.S. Public Health Service Regulations: Objectivity in Research (42 CFR 50)	p. 295
Conflict of Interest in Four Professions: A Comparative Analysis	p. 302
How Psychological Research Can Inform Policies for Dealing with Conflicts of Interest in Medicine	p. 358
The Pathway from Idea to Regulatory Approval: Examples for Drug Development	p. 375
Model for Broader Disclosure	p. 384
Committee Biographies	p. 392
Index	p. 401
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