Etain Bruno, Guittet Lydia, Weiss Nicolas, Gajdos Vincent, Katsahian Sandrine
AP-HP, Hôpitaux Universitaires Henri Mondor, Creteil, France.
INSERM U1086 Cancers & Preventions, CHU de Caen, Caen, France.
PLoS One. 2014 Mar 26;9(3):e92858. doi: 10.1371/journal.pone.0092858. eCollection 2014.
Following recent health scandals in France, the French parliament adopted law n°2011-2012 to regulate ties between physicians and the pharmaceutical industry. The law also requires pharmaceutical companies to publicize financial and other benefits given to medical students. In this context, we administered a survey to medical students in France, in an effort to identify priorities for future education regarding conflicts of interest (COI). This web-based survey encompassed knowledge about, training on, personal exposure to, and opinions on COI among preclinical and clinical students as well as residents. Two thousand one hundred and one (2,101) students participated. Although most students (64.6%) believed that they are able to define what a COI is, they failed to correctly identify several situations as COI (receiving a gift, being offered a meal, being invited to a conference). Most students reported feeling inadequately educated about COI (85.2%). Compared to other class levels, residents were more exposed to pharmaceutical sales representatives. This exposure is highly associated to receipt of gifts (OR 14.51, 95% CI 11.67-18.05). Medical students were aware of potential bias induced by COI with respect to drug prescriptions and research, but felt personally immune towards COI. In our survey, personal research performed by students was more likely to be associated with perception of potential bias on prescription for self (but not for others) than attending a lecture on COI. Promulgating laws that regulate ties between physicians/students and the pharmaceutical industry is a mandatory first step. However, complementary strategies should be implemented within medical schools, in particular, specific training about COI in early medical education.
在法国近期发生健康丑闻之后，法国议会通过了第2011 - 2012号法律，以规范医生与制药行业之间的关系。该法律还要求制药公司公布给予医学生的经济及其他利益。在此背景下，我们对法国的医学生进行了一项调查，旨在确定未来关于利益冲突（COI）教育的重点。这项基于网络的调查涵盖了临床前和临床学生以及住院医师对利益冲突的了解、相关培训、个人接触情况及看法。2101名学生参与了调查。尽管大多数学生（64.6%）认为自己能够界定什么是利益冲突，但他们未能正确识别一些属于利益冲突的情况（收受礼物、接受宴请、受邀参加会议）。大多数学生表示感觉自己在利益冲突方面接受的教育不足（85.2%）。与其他年级相比，住院医师与制药行业销售代表的接触更多。这种接触与收受礼物高度相关（比值比14.51，95%可信区间11.67 - 18.05）。医学生意识到利益冲突可能会在药物处方和研究方面导致潜在偏差，但觉得自己个人不会受到利益冲突的影响。在我们的调查中，学生自己进行的个人研究比参加关于利益冲突的讲座更有可能与对自身（而非他人）处方潜在偏差的认知相关。颁布规范医生/学生与制药行业关系的法律是必不可少的第一步。然而，医学院校应实施补充策略，特别是在医学早期教育中开展关于利益冲突的专项培训。
