Disclosure of industry relationships by anesthesiologists: is the conflict of interest resolved?

Anesthesiologists are flooded with requests that they themselves reveal their associations with industry and other external sources of financial support and also with stories about adverse outcomes related to poorly managed conflict of interest (COI) in research, education, and clinical practice. Guidelines for evaluating COI in these areas are needed and provision of such guidelines is the goal of this review.

The medical literature and lay press provide ample publications outlining the extent of the COI problem and recent efforts to manage COI with numerous opinions on how to best accomplish COI management. The Institute of Medicine has provided significant guidance with a recent exhaustive review with recommendations. The central theme of managing COI is disclosure. However, there remains an unsettling void in this simple approach, which is reviewed. Moreover, there is a rising chorus of opposing views suggesting that not all collaborations with industry constitute a conflict.

A balanced review of the pros and cons of industry collaboration in research, education, and clinical practice is presented along with recommendations for evaluating potential COI in anesthesia practice. Current guidelines generally call for simple disclosure of the presence of COI and for sponsoring professional societies and institutions to evaluate and manage COIs. However, for the anesthesiologist reading an article or chapter or attending an oral presentation by a conflicted author or presenter, in attempting to ascertain the possibility of bias simple disclosure seems inadequate to enable reliable assessment of potential bias. Information should be made available regarding the extent of industry involvement in the activity and the actual amounts of remuneration rendered to supported authors and speakers.