Hams Marcia, Wilkinson Wells G, Zentner Lynn, Schmidt Cory, Dweik Raed A, Karafa Matthew, Rose Susannah L
Community Catalyst, Boston, MA, United States of America.
Office of Institutional Compliance at the University of Minnesota, Minneapolis, MN, United States of America.
PLoS One. 2017 Mar 15;12(3):e0172472. doi: 10.1371/journal.pone.0172472. eCollection 2017.
A majority of academic medical centers (AMCs) have now adopted conflict of interest policies (COI) to address relationships with pharmaceutical and device industries that can increase the risk of bias in patient care, education and research. However, AMCs may have little information on the impact of their policies. This paper provides a new method, which is a free, publicly-available survey, to fill this information gap and improve COI programs at AMCs.
METHODS & FINDINGS: The survey, piloted in three AMCs and designed in collaboration with national conflicts of interest policy experts, covers a range of universal compliance-related concerns, which allows institutions to tailor questions to align with their own policies and culture. The survey was low-burden, and provided important data for these AMCs to evaluate their policies. A descriptive analysis of the pooled pilot site data (n = 1578) was performed, which found that a majority of respondents did not have financial ties with industry and a majority was satisfied with specific COI policies at their institutions. The analysis also showed that the survey is sensitive to differences that AMCs will find meaningful. For instance, individuals with industry ties were significantly more likely than individuals without ties to think that COI policies unnecessarily hindered interactions with industry (p = .004), were ineffective at reducing harm to patients (p < .001), and were ineffective in reducing bias in medical education (p>.001).
The survey is now free and publicly available for use by any institution. AMCs can use the results to update and refine policies, and to provide ongoing education regarding existing policies.
大多数学术医疗中心(AMC)现已采用利益冲突政策(COI),以处理与制药和器械行业的关系,这些关系可能增加患者护理、教育和研究中出现偏差的风险。然而,AMC可能对其政策的影响了解甚少。本文提供了一种新方法,即一项免费的、可公开获取的调查,以填补这一信息空白,并改进AMC的COI计划。
该调查在三家AMC进行了试点,并与国家利益冲突政策专家合作设计,涵盖了一系列与普遍合规相关的问题,使机构能够根据自身政策和文化调整问题。该调查负担较轻,为这些AMC评估其政策提供了重要数据。对汇总的试点站点数据(n = 1578)进行了描述性分析,发现大多数受访者与行业没有财务关系,并且大多数人对其机构的特定COI政策感到满意。分析还表明,该调查对AMC认为有意义的差异很敏感。例如,与行业有联系的个人比没有联系的个人更有可能认为COI政策不必要地阻碍了与行业的互动(p = .004),在减少对患者的伤害方面无效(p < .001),并且在减少医学教育中的偏差方面无效(p>.001)。
该调查现已免费并可供任何机构公开使用。AMC可以利用这些结果来更新和完善政策,并就现有政策提供持续教育。