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Toward Evidence-Based Conflicts of Interest Training for Physician-Investigators

Published online by Cambridge University Press:  01 January 2021


In recent years, the government, advocacy organizations, the press, and the public have pressured universities, academic medical centers, and physicianinvestigators to do more to ensure that their financial interests and relationships do not conflict with their duties to conduct high-quality research and protect the safety and welfare of clinical trial participants. A number of factors underlie the increased focus. First, private sector funding of clinical research has grown both in absolute terms and as a proportion of overall funding. In 2008, the pharmaceutical, medical device, and biotechnology industries’ domestic research and development expenditures constituted approximately 60.9% of funding for biomedical research in the United States; the next largest funder, the National Institutes of Health, funded 27.9%. Private industry spent $58.6 billion on research in 2007, up from $40 billion in 2003, an increase of 25% after adjusting for inflation.

Copyright © American Society of Law, Medicine and Ethics 2012

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The Institute of Medicine defines a conflict of interest as “a set of circumstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by a secondary interest.” Lo, B. Field, M., eds., Conflict of Interest in Medical Research, Education, and Practice (Washington, D.C.: National Academies Press, 2009): At46. The primary interests of physician-investigators include advancing the scientific goals of their research and protecting the rights and well-being of research participants. Investigators may have a host of secondary interests as well, including career advancement, intellectual stimulation, and financial gain. Importantly, there is nothing inherently wrong with these secondary interests. As the IOM defines it, and as it is used here, the term “conflict of interest” does not equate to compromised judgment or action but to the risk of such compromisekk.Google Scholar
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