Barnes Barbara E, Cole Jeanne G, King Catherine Thomas, Zukowski Rebecca, Allgier-Baker Tracy, Rubio Doris McGartland, Thorndyke Luanne E
University of Pittsburgh, Pittsburgh, PA 15213, USA.
J Contin Educ Health Prof. 2007 Fall;27(4):234-40. doi: 10.1002/chp.143.
Heightened concerns about industry influence on continuing medical education (CME) have prompted tighter controls on the management of commercial funding and conflict of interest. As a result, CME providers must closely monitor their activities and intervene if bias or noncompliance with accreditation standards is likely. Potential for industry influence can be difficult to assess at a stage in the planning process when mitigation strategies can assure balance and content validity. Few tools exist to aid providers in this regard.
A 12-item instrument was designed to assess risk for commercial influence on CME. To determine reliability and validity, a cohort of experienced CME professionals applied the tool to standardized "cases" representing CME activities in the early stages of planning. Results were compared with the experts' assignment of the same cases to one of four risk categories. A survey of study participants was conducted to ascertain usefulness and potential applications of the tool.
Analysis demonstrated strong intraclass correlation across cases (0.90), interrater reliability (94%), and correlation between assessment of risk with and without the tool (Spearman coefficient, 0.93, p < 0.01; weighted kappa, 0.59). Participants found the tool easy to use and of potential benefit to their CME office.
The Consortium for Academic Continuing Medical Education (CACME) risk stratification tool can help CME providers identify activities that must be closely monitored for potential industry influence, remain aware of factors that place programming at risk for noncompliance with accreditation standards, and substantiate the allocation of resources by the CME office.
对行业对继续医学教育（CME）影响的担忧加剧，促使对商业资金管理和利益冲突实施更严格的控制。因此，继续医学教育提供者必须密切监测其活动，并在可能存在偏见或不符合认证标准时进行干预。在规划过程的某个阶段，当缓解策略能够确保平衡和内容有效性时，行业影响的可能性可能难以评估。在这方面，几乎没有工具可以帮助提供者。
设计了一个包含12个条目的工具，用于评估商业对继续医学教育影响的风险。为了确定可靠性和有效性，一组经验丰富的继续医学教育专业人员将该工具应用于标准化的“案例”，这些案例代表了规划早期阶段的继续医学教育活动。将结果与专家对相同案例分配到四个风险类别之一的情况进行比较。对研究参与者进行了一项调查，以确定该工具的有用性和潜在应用。
分析表明，各案例之间的组内相关性很强（0.90），评分者间信度为94%，使用该工具和不使用该工具时风险评估之间的相关性（斯皮尔曼系数，0.93，p<0.01；加权卡帕系数，0.59）。参与者发现该工具易于使用，对他们的继续医学教育办公室可能有益。
学术继续医学教育联盟（CACME）风险分层工具可以帮助继续医学教育提供者识别那些必须密切监测是否存在潜在行业影响的活动，了解那些使项目有不符合认证标准风险的因素，并证实继续医学教育办公室资源的分配。
