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 Physicians who serve on so-called institutional review boards (IRBs)
may also be providing biotechnology, drug and device companies with
services or expertise in return for payment.
“(IRBs) approve and oversee the studies which are often funded by
pharmaceutical companies,” said lead author Eric G. Campbell of
Massachusetts General Hospital in Boston. “People who serve on these
committees may have financial relationships with companies whose
research they oversee, and that has potential positive and potential
negative consequences.”
Having a relationship with the company funding the research may mean
you have more experience with the area of study and can be an expert
judge of whether a study protocol is safe and ethical, but it could
also bias your decision in favor of the company, Campbell told
Reuters Health by phone.
“It’s important to disclose their relationships and also to not vote
on protocols for which they have conflicts,” he said. “Universities
have gotten much better at disclosing conflicts,” but many
physicians still vote on protocols they have a relationship with, he
said.
For the new study, researchers replicated a 2005 survey of IRB
members, mailing surveys to 115 research-intensive medical schools
and teaching hospitals. They received responses from 493 members in
2014, slightly more than had answered in 2005.
About a third of IRB members had some kind of industry relationship
in 2005 and 2014, but the percentage who felt another member did not
properly disclose their financial relationships in the past year
decreased from 10.8 percent to 6.7 percent, the researchers reported
in JAMA Internal Medicine.
More than half of physicians in 2014 said their institution had a
formal written definition of a conflict of interest, compared to
fewer than half of those who responded in 2005.
The percentage who felt another IRB member had presented a protocol
in a biased manner because of their industry relationship decreased,
as did the percentage who felt pressure to approve a protocol they
felt was not ready.
But the percentage of members who voted on a study protocol with
which they had a conflict of interest did not decrease significantly
over time.
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Academic medical centers could still improve how they clarify and
publicize their conflict of interest policies, as many physicians
are still in the dark about their institution’s policy, Campbell
said.
Patients who enroll in clinical trials, whether they know it or not,
need to be able to trust an IRB to make sure the trial is ethical
and safe, he said.
“Clinical research is so important - there are so many serious
diseases and health conditions that we must understand to improve
the health of the public,” said Dr. Laura Weiss Roberts of Stanford
University School of Medicine in California, who wrote a commentary
on the new results. “For this reason, a strong IRB is really the
'best friend' to great clinical researchers.”
“Professionals should, in my view, engage in many different kinds of
activities that make the best use of their expertise in society,”
which generates potential conflicts, she told Reuters Health by
email.
Conflicts of interest should not be misunderstood or vilified, she
said.
“Some conflicts are incompatible with certain roles and activities,
but many role conflicts and resulting conflicts of interest can be
managed very effectively,” Roberts said.
SOURCE: http://bit.ly/1gw6t2d http://bit.ly/1USq2lc JAMA Internal
Medicine, July 13, 2015.
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