The question of independence of decision making from financial benefits in medicine and other areas of healthcare remains an ongoing problem. It exists, it is being more exposed, it is insidious and it affects important decision making processes. No discipline is free of the pernicious influence of commercial pressure – how this translates into risk Vs benefit is a more complex question.
In a recent study out in the NEJM, the authors analysed the reports of payments made to physicians by five manufacturers of total hip and knee prostheses in 2007. For each payment recipient who was an author of a presentation or served as a committee member or board member at the 2008 annual meeting of the American Academy of Orthopaedic Surgeons, the disclosure statement was reviewed to determine whether the payment had been disclosed.
Conclusions In this study of self-reported conflict-of-interest disclosure by physicians at a large annual meeting, the rate of disclosure was 79.3% for directly related payments and 50.0% for indirectly related payments.
Kanu Okike, Mininder S. Kocher, Erin X. Wei, Charles T. Mehlman, and Mohit Bhandari Accuracy of Conflict-of-Interest Disclosures Reported by Physicians N. Engl. J. Med., Oct 2009; 361: 1466 – 1474 View Full Paper
The first paragraph of the article is presented below.
Financial conflict of interest in biomedical research has been associated with a number of potential pitfalls, including an increased likelihood of positive (pro-industry) conclusions,[1-25} the suppression of negative results,[26-30] restrictions on the behavior of the investigators, and the use of biased study designs. Although some academic medical centers have sought to manage the financial relationships of their investigators, most interested parties — including the U.S. government, professional organizations, and medical journals — have required only that potential conflicts of interest, including those that were present at the time of publication or presentation of the research, be fully disclosed. Historically, these disclosures have nearly always been reported by physicians, and there have been no means of confirmation or verification. However, there is reason to believe that this policy may change in the near future, since there is legislation currently pending in the U.S. Congress that would require companies to publicly disclose payments made to physicians.
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