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Financial Conflicts of Interest in Biomedical Research Project Findings. Josephine Johnston The Hastings Center Garrison, New York. Project Purpose. Review nature and extent of financial conflicts of interest Consider existing rules and guidelines Compare with other professions
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Financial Conflicts of Interest in Biomedical ResearchProject Findings Josephine Johnston The Hastings Center Garrison, New York
Project Purpose • Review nature and extent of financial conflicts of interest • Consider existing rules and guidelines • Compare with other professions • Isolate areas of concern in present management • Recommend changes
Prevalence Financial interests are pervasive • Individual researchers • 1/3 have ties to industry • Research Institutions • Equity in companies sponsoring research
Benefits of Financial Interests • Benefits – knowledge transfer, additional finances. We focused on the risks • Financial interests can conflict with other interests or duties
Conflicting Interests • Conflict of primary and secondary interests – actual or apparent • Term = description of situation ≠ moral judgment • “Yellow flag”
Risks “Human nature” creates risks: • Bias • Carelessness • Secrecy • Delay in publication • Loss of public interest scientists • Loss of public trust
Questions • What do about these situations? • What must be preserved and protected? • Which mechanisms already work well? • What new measures are necessary?
Existing Rules and Guidelines • Institutions, professional societies, federal regulations, journals. • Complex, variable, misunderstood, resented, avoided, relaxed, not enforced. • Over-reliance on disclosure.
Recommendation Changes to existing rules • Simplification • Unification • Education • Enforcement
Existing Culture • Lack of understanding of risks of financial interests • Lack of support for rules • Resentment • Comparison with other professions
Recommendation Promote recognition of the problem through: • Education • Professional discussion Aim for: • “Buy in” • Culture of embarrassment
Other Recommendations • Firewalls to separate research and finance. • Support public clinical trials registry. • Presumption against conflicted investigators in human subject research (AAMC). • Reduce reliance on disclosure. • Publicize best practices. • Continue public discussion.