AP-HP, Hôpital Robert Debré, Unité d'Épidémiologie Clinique, Paris, France.
PLoS One. 2012;7(4):e35247. doi: 10.1371/journal.pone.0035247. Epub 2012 Apr 9.
Peer review is the most widely used method for evaluating grant applications in clinical research. Criticisms of peer review include lack of equity, suspicion of biases, and conflicts of interest (CoI). CoIs raise questions of fairness, transparency, and trust in grant allocation. Few observational studies have assessed these issues. We report the results of a qualitative study on reviewers' and applicants' perceptions and experiences of CoIs in reviews of French academic grant applications.
We designed a qualitative study using semi-structured interviews and direct observation. We asked members of assessment panels, external reviewers, and applicants to participate in semi-structured interviews. Two independent researchers conducted in-depth reviews and line-by-line coding of all transcribed interviews, which were also subjected to Tropes® software text analysis, to detect and qualify themes associated with CoIs. Most participants (73/98) spontaneously reported that non-financial CoIs predominated over financial CoIs. Non-financial CoIs mainly involved rivalry among disciplines, cronyism, and geographic and academic biases. However, none of the participants challenged the validity of peer review. Reviewers who felt they might be affected by CoIs said they reacted in a variety of ways: routine refusal to review, routine attempt to conduct an impartial review, or decision on a case-by-case basis. Multiple means of managing non-financial CoIs were suggested, including increased transparency throughout the review process, with public disclosure of non-financial CoIs, and careful selection of independent reviewers, including foreign experts and methodologists.
Our study underscores the importance of considering non-financial CoIs when reviewing research grant applications, in addition to financial CoIs. Specific measures are needed to prevent a negative impact of non-financial CoIs on the fairness of resource allocation. Whether and how public disclosure of non-financial CoIs should be accomplished remains debatable.
同行评议是评估临床研究资助申请最广泛使用的方法。同行评议的批评包括缺乏公平性、怀疑存在偏见以及利益冲突（CoI）。CoI 引发了公平性、透明度和对资助分配的信任问题。很少有观察性研究评估过这些问题。我们报告了一项关于评审员和申请人对法国学术资助申请评审中 CoI 的看法和经验的定性研究结果。
我们使用半结构化访谈和直接观察设计了一项定性研究。我们邀请评估小组成员、外部评审员和申请人参加半结构化访谈。两名独立研究人员对所有转录访谈进行了深入审查和逐行编码，并使用 Tropes®软件文本分析来检测和定性与 CoI 相关的主题。大多数参与者（73/98）自发报告称，非财务 CoI 比财务 CoI 更为普遍。非财务 CoI 主要涉及学科之间的竞争、裙带关系以及地域和学术偏见。然而，没有参与者质疑同行评议的有效性。认为自己可能受到 CoI 影响的评审员表示，他们会以各种方式做出反应：例行拒绝评审、例行试图进行公正评审或根据具体情况做出决定。提出了多种管理非财务 CoI 的方法，包括在整个评审过程中提高透明度，公开披露非财务 CoI，并谨慎选择独立评审员，包括外国专家和方法学家。
我们的研究强调了在评审研究资助申请时，除了财务 CoI 之外，还需要考虑非财务 CoI。需要采取具体措施来防止非财务 CoI 对资源分配公平性产生负面影响。公开披露非财务 CoI 是否以及如何进行仍存在争议。
