Understanding Conflict of Interest in Professional Judgment
Learn about Conflict of Interest (COI) and its impact on professional judgment. Explore the types of COI, potential influences on study design, and individual and institutional sources of conflicts. Addressing COI is crucial to maintaining integrity and confidence in decision-making processes related to primary interests such as patient care and research validity.
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Presentation Transcript
Sequel Conflict of Interest (COI) A conflict of interest is a set of conditions in which professional judgment concerning a primary interest (such as a patient s welfare or the validity of the research) tends to be unduly influenced by a secondary interest (such as financial gain) 1
Why Address COI? 2 To maintain integrity of professional judgment (to minimize the influence of secondary interests, such as personal financial gain), that should be irrelevant to the merits of decisions about primary interests, such as the care of patient, conduct of research, or review. To maintain confidence in professional judgment
Types of Conflict of Interest Individual 3 Financial interests in outcome Professional advancement and recognition for personal achievement Working on a similar topic and with an interest in the outcome (positive or negative) Ideological position that biases decisions
Potential Influence of COI on Study Design 4 Which study approach to use Whether to have a control group Endpoints of the study Inclusion and exclusion criteria Which eligible patients will be enrolled Information made available in the informed consent form and process Whether a study will be stopped due to evidence from other studies
COI - Individual 5 Other sources of conflict are personal, political, academic and religious and we believe that those may be just as potent as financial conflicts
COI Institutional 6 When any of an institution s senior management or trustees or a department school or sub-unit or an affiliated foundation or organization has an external relationship or financial interest in a company that itself has a financial interest in a faculty research Ethics Committees may be subject to institutional pressures, to approve research activities in which the institution has a financial stake Commercial COI including journals approval processes, articles published, and editorials written
COI Review Processes 7 Peer review individual affiliations and interests Similar work in progress Personal affiliations etc. Financial or other stake holding
Managing COI 8 Prohibition--believes that any relationship presents a COI, therefore need to demonstrate a sufficient social benefit to override the prohibition model Disclosure and peer review--believes that COI are unavoidable and financial interests are the least scientifically dangerous
COI-What to Do 9 Thompson's view of COI reinforced the view that transparency the most prescribed remedy to COI in medicine was a necessary but insufficient tool to combat bias. Disclosing a COI drew attention to a potential source of bias. But it did not indicate what to do or how to proceed once a COI was disclosed. Nor did it indicate that a bias was necessarily present. One simply did not know.
Individual COIGuidelines 10 In informed consent forms Include the researchers sources of funds Researcher s affiliations Review processes Journals ask for COI statements to be filed Journals ask for sources of funds to be mentioned
Summary 11 COI can be financial, emotional, social, or legal COI they can be actual or perceived conflicts. COI can be at the level of the researcher and the institution Need to recognize, disclose and manage conflicts of interest of researchers and institutions COI cannot always be avoided, but they must be examined and minimized.
