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Perceptions of conflict of interest: surgeons, internists, and learners compared
Christopher J de Gara1, Kim C Rennick, John Hanson
1Department of Surgery, University of Alberta, 2-590 Edmonton Clinic Health Academy, 11405 87 Ave NW, Edmonton, Alberta, Canada T6G 1C9. cdegara@ualberta.ca
Background:
Making a conflict of interest declaration is now mandatory at continuing medical education CME accredited events. However, these declarations tend to be largely perfunctory. This study sought to better understand physician perceptions surrounding conflict of interest.
Methods:
The same PowerPoint (Microsoft, Canada) presentation (http://www.youtube.com/watch?v=mQSOvch7Yg0&feature=g-upl) was delivered at multiple University of Alberta and Royal College CME-accredited events to surgeons, internists, and learners. After each talk, the audience was invited to complete an anonymous, pretested, and standardized 5-point Likert scale (strongly disagree to strongly agree) questionnaire.
Results:
A total of 136 surveys were analyzed from 31 surgeons, 49 internists, and 56 learners. In response to the question regarding whether by simply making a declaration, the speaker had provided adequate proof of any conflicts of interest, 71% of surgeons thought so, whereas only 35% of internists and 39% of learners agreed or strongly agreed (P = .004). Further probing this theme, the audience was asked whether a speaker must declare fees or monies received from industry for consulting, speaking, and research support. Once again there was a variance of opinion, with only 43% of surgeons agreeing or strongly agreeing with this statement; yet, 80% of internists and 71% of learners felt that such a declaration was necessary (P = .013). On the topic of believability (a speaker declaration makes him or her and the presentation more credible), the 3 groups were less polarized: 50% of surgeons, 41% of internists, and 52% of learners (P = .2) felt that this was the case. Although two thirds of surgeons (68%) and learners (66%) and nearly all internists (84%) felt that industry-sponsored research was biased, these differences were not significant (P = .2).
Conclusions:
Even when they are completely open and honest, conflict of interest declarations do not negate the biases inherent in a speaker's talk or research when it is industry sponsored. The larger issue is how best to manage these conflicts.
Insights
Physician perceptions of conflict of interest (COI) declarations vary significantly by specialty. While surgeons often find declarations sufficient, internists and learners emphasize the need for explicit disclosure of industry funding to ensure transparency in medical education.
Area of Science:
- Medical Education
- Professional Ethics
- Conflict of Interest Disclosure
Background:
- Conflict of interest (COI) declarations are mandatory for continuing medical education (CME) events.
- Current declarations are often perceived as perfunctory.
- Physician perceptions of COI are not well understood.
Purpose of the Study:
- To investigate physician perceptions of conflict of interest disclosures in CME.
- To explore differences in perceptions among surgeons, internists, and learners.
Main Methods:
- A standardized presentation was delivered at multiple CME-accredited events.
- Anonymous surveys using a 5-point Likert scale were administered post-presentation.
- Data were collected from surgeons, internists, and learners.
Main Results:
- Surgeons were more likely than internists and learners to consider a simple declaration adequate proof of COI (71% vs. 35-39%).
- Internists (80%) and learners (71%) were more likely than surgeons (43%) to believe speakers must declare industry funding.
- Believability of presentations and bias in industry-sponsored research showed less significant differences across groups.
Conclusions:
- Conflict of interest declarations alone do not eliminate inherent biases in industry-sponsored content.
- Managing conflicts of interest in medical education remains a significant challenge.
- Understanding physician perceptions is crucial for improving COI management strategies.
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