Sat, 26 Jul 2008 04:36:44 BST CiteULike: Tag conflict_of_interest http://www.citeulike.org/tag/conflict_of_interest CiteULike.org en-gb Copyright © 2004-2008 citeulike.org http://www.citeulike.org/user/wandall/article/1417968 <i>Acad Med, Vol. 76, No. 2. (February 2001), pp. 209-214.</i><br /><br />Investigator's and institutions' financial conflicts of interest in clinical research raise serious questions about the objectivity of such research, the safety of human subjects, and the threat to public trust in the integrity of clinical research. Yet the author makes clear that a conflict of interest is a state of affairs, not a behavior, and therefore not automatically a manifestation of improper actions. Indeed, conflicts of interest are quite common in complex settings such as those of academic medicine, and usually pose no problem, both because of the safeguards already in place and the integrity of most researchers. But it is clear that both non-financial conflicts of interest (e.g., career advancement, peer recognition, garnering grants and publications) and financial ones are double-edged: they can motivate individuals to do their best work but also can compromise judgment and undermine objectivity. In particular, conflicts of interest involving money, especially money from external sources, warrant special, targeted safeguards. And whether or not such conflicts of interest have actually created significant problems, academic medicine risks great peril if its leaders fail to respond to the growing perception that such problems exist. To foster public trust, the public needs to be better educated about how, with proper safeguards, limited financial incentives in the conduct of clinical research can benefit everyone. In addition, safeguards against the downsides of such financial incentives must be visibly strengthened. The author offers eight suggestions for what academic medicine's leaders might do in this regard (comply with existing full-disclosure requirements; establish principles governing institutional conflicts of interest; etc.). He closes by reiterating that the pursuit of clinical research depends entirely on the ability and willingness of the research community to merit public trust. Trust us to make a difference: ensuring public confidence in the integrity of clinical research. JJ Cohen Acad Med, Vol. 76, No. 2. (February 2001), pp. 209-214. 2007-06-27T21:25:59-00:00 2001 Acad Med 1040-2446 76 2 209 214 conflict_of_interest industry trust http://www.citeulike.org/user/wandall/article/298922 <i>Toxicological Sciences, Vol. 87, No. 1. (September 2005), pp. 11-14.</i> Workshop Proceedings: Managing Conflict of Interest in Science. A Little Consensus and A Lot of Controversy Jacques Maurissen Steven Gilbert Miriam Sander Tom Beauchamp Shelley Johnson Bernard Schwetz Merrill Goozner Craig Barrow doi:10.1093/toxsci/kfi240 Toxicological Sciences, Vol. 87, No. 1. (September 2005), pp. 11-14. 2005-08-20T02:05:21-00:00 2005 Toxicological Sciences 1096-6080 87 1 11 14 Oxford University Press conflict_of_interest toxicology http://www.citeulike.org/user/wandall/article/961168 <i>JAMA, Vol. 289, No. 4. (9 2003), pp. 454-465.</i><br /><br />CONTEXT: Despite increasing awareness about the potential impact of financial conflicts of interest on biomedical research, no comprehensive synthesis of the body of evidence relating to financial conflicts of interest has been performed. OBJECTIVE: To review original, quantitative studies on the extent, impact, and management of financial conflicts of interest in biomedical research. DATA SOURCES: Studies were identified by searching MEDLINE (January 1980-October 2002), the Web of Science citation database, references of articles, letters, commentaries, editorials, and books and by contacting experts. STUDY SELECTION: All English-language studies containing original, quantitative data on financial relationships among industry, scientific investigators, and academic institutions were included. A total of 1664 citations were screened, 144 potentially eligible full articles were retrieved, and 37 studies met our inclusion criteria. DATA EXTRACTION: One investigator (J.E.B.) extracted data from each of the 37 studies. The main outcomes were the prevalence of specific types of industry relationships, the relation between industry sponsorship and study outcome or investigator behavior, and the process for disclosure, review, and management of financial conflicts of interest. DATA SYNTHESIS: Approximately one fourth of investigators have industry affiliations, and roughly two thirds of academic institutions hold equity in start-ups that sponsor research performed at the same institutions. Eight articles, which together evaluated 1140 original studies, assessed the relation between industry sponsorship and outcome in original research. Aggregating the results of these articles showed a statistically significant association between industry sponsorship and pro-industry conclusions (pooled Mantel-Haenszel odds ratio, 3.60; 95% confidence interval, 2.63-4.91). Industry sponsorship was also associated with restrictions on publication and data sharing. The approach to managing financial conflicts varied substantially across academic institutions and peer-reviewed journals. CONCLUSIONS: Financial relationships among industry, scientific investigators, and academic institutions are widespread. Conflicts of interest arising from these ties can influence biomedical research in important ways. Scope and impact of financial conflicts of interest in biomedical research: a systematic review. JE Bekelman Y Li CP Gross JAMA, Vol. 289, No. 4. (9 2003), pp. 454-465. 2006-11-24T21:27:29-00:00 2003 JAMA 0098-7484 289 4 454 465 conflict_of_interest http://www.citeulike.org/user/wandall/article/1166131 <i>N Engl J Med, Vol. 329, No. 8. (19 August 1993), pp. 573-576.</i> Understanding financial conflicts of interest. DF Thompson N Engl J Med, Vol. 329, No. 8. (19 August 1993), pp. 573-576. 2007-03-15T21:36:10-00:00 1993 N Engl J Med 0028-4793 329 8 573 576 conflict_of_interest http://www.citeulike.org/user/wandall/article/1151399 <i>PLoS Medicine, Vol. 2, No. 8. (1 August 2005), e124.</i><br /><br />Summary There is increasing concern that most current published research findings are false. The probability that a research claim is true may depend on study power and bias, the number of other studies on the same question, and, importantly, the ratio of true to no relationships among the relationships probed in each scientific field. In this framework, a research finding is less likely to be true when the studies conducted in a field are smaller; when effect sizes are smaller; when there is a greater number and lesser preselection of tested relationships; where there is greater flexibility in designs, definitions, outcomes, and analytical modes; when there is greater financial and other interest and prejudice; and when more teams are involved in a scientific field in chase of statistical significance. Simulations show that for most study designs and settings, it is more likely for a research claim to be false than true. Moreover, for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias. In this essay, I discuss the implications of these problems for the conduct and interpretation of research. Why Most Published Research Findings Are False John Ioannidis doi:10.1371/journal.pmed.0020124 PLoS Medicine, Vol. 2, No. 8. (1 August 2005), e124. 2007-03-09T15:04:00-00:00 2005 PLoS Medicine 2 8 e124 conflict_of_interest expert_judgment false_positive judgement registry replication statistics uncertainty http://www.citeulike.org/user/wandall/article/938274 <i>N Engl J Med, Vol. 347, No. 10. (5 September 2002), pp. 759-761.</i> Nonfinancial conflicts of interest in research. NG Levinsky doi:10.1056/NEJMsb020853 N Engl J Med, Vol. 347, No. 10. (5 September 2002), pp. 759-761. 2006-11-09T20:08:03-00:00 2002 N Engl J Med 1533-4406 347 10 759 761 conflict_of_interest http://www.citeulike.org/user/wandall/article/1028940 <i>Journal of Clinical Epidemiology, Vol. 54, No. 12. (December 2001), pp. 1275-1275.</i> My actual beliefs Kenneth Rothman doi:10.1016/S0895-4356(01)00419-X Journal of Clinical Epidemiology, Vol. 54, No. 12. (December 2001), pp. 1275-1275. 2007-01-07T14:45:43-00:00 2001 Journal of Clinical Epidemiology 54 12 1275 1275 conflict_of_interest epidemiology objectivity publication http://www.citeulike.org/user/wandall/article/938275 <i>Kennedy Inst Ethics J, Vol. 15, No. 2. (June 2005), pp. 199-210.</i> Conflict-of-interest policy at the National Institutes of Health: the pendulum swings wildly. EG DeRenzo Kennedy Inst Ethics J, Vol. 15, No. 2. (June 2005), pp. 199-210. 2006-11-09T20:08:14-00:00 2005 Kennedy Inst Ethics J 1054-6863 15 2 199 210 conflict_of_interest http://www.citeulike.org/user/wandall/article/2203908 <i>Accountability in Research, Vol. 15, No. 1. (2008), pp. 1-29.</i><br /><br />This article argues that the three major elements of typical university conflict-of-interest (COI) policies (i.e., disclosure, management, and elimination of conflicts via divestiture or recusal) are likely to be insufficient for screening out many worrisome influences of financial COIs. Current psychological research challenges the effectiveness of disclosure, management plans are unlikely to address the wide range of ways that financial COIs can influence scientific judgment, and it is often impractical to eliminate conflicts. Identifying the limits of these policies highlights the importance of considering alternative strategies, such as encouraging more independently funded research, in order to maintain the integrity of science. Scientific Judgment and the Limits of Conflict-of-Interest Policies Kevin Elliott doi:10.1080/08989620701783725 Accountability in Research, Vol. 15, No. 1. (2008), pp. 1-29. 2008-01-07T14:28:15-00:00 2008 Accountability in Research 15 1 1 29 Taylor & Francis bias conflict_of_interest judgement judgment