Collaborations Beneficial, but Limits Needed
Here are some of the recommendations in the Institute of Medicine's report“ Conflicts of Interest in Medical Research, Education, and Practice.” It is posted at<www.iom.edu/CMS/3740/47464/65721.aspx>.
General policy
Adopt and implement conflict-of-interest policies. | |||||
Strengthen disclosure policies. | |||||
Standardize disclosure content and formats. | |||||
Create a national program for the reporting of company payments to affected parties. | |||||
Primary affected actors: institutions that carry out medical research and education, clinical care, and clinical practice guideline development; U.S. Congress; pharmaceutical, medical device, and biotechnology companies.
Medical education and research
Restrict participation of researchers with conflicts of interest. | |||||
Reform relationships with industry in medical education. | |||||
Provide education on conflict of interest. | |||||
Reform financing system for continuing medical education. | |||||
Primary affected actors: Academic medical centers, teaching hospitals, and research institutions; medical researchers; faculty, students, residents, and fellows; professional societies; organizations that created the accrediting program for continuing medical education and other organizations interested in high-quality, objective education.
Medical practice
Reform financial relationships with industry for community physicians. | |||||
Reform industry interactions with physicians. | |||||
Primary affected actors: Community physicians; professional societies; hospitals and other health care providers; pharmaceutical, medical-device, and biotechnology companies.
Clinical practice guidelines
Restrict industry funding and conflicts in clinical practice guideline development. | |||||
Create incentives for reducing conflicts in clinical practice guideline development. | |||||
Primary affected actors: Institutions that develop clinical practice guidelines; accrediting and certification bodies, formulary committees, health insurers, public agencies, and other organizations with an interest in objective, evidence-based clinical practice guidelines.
Institutional conflict-of-interest policies
Create board-level responsibility for institutional conflicts of interest. | |||||
Revise Public Health Service regulations to require policies on institutional conflicts of interest. | |||||
Primary affected actors: Institutions that carry out medical research and education, clinical care, and clinical practice guideline development; National Institutes of Health.
Oversight and administrative agencies
Provide additional incentives for institutions to adopt and implement policies. | |||||
Develop research agenda on conflict of interest. | |||||
Primary affected actors: Oversight bodies and other groups that have a strong interest in or reliance on medical research, education, clinical care, and practice guideline development; National Institutes of Health, Agency for Healthcare Research and Quality, and other agencies of the U.S. Department of Health and Human Services. ▪
