Conflict-of-Interest.net

Its the Thanksgiving long weekend in Canada, and I really should also be doing other work alongside getting out to enjoy some of the gorgeous Fall colours with my family. So here’s a quick list of interesting COI stories:

• Doctors’ disclosure list less complete than industry’s
• Conflict-of-Interest Disclosure Remains Thorny Issue
• Paranoid Perceptions of Peer Perfidy
• Opinion: Health care reform from a surgeon’s perspective
• Coke partners with doctors’ group

Here’s an interesting story that is particularly appropriate for this blog – FTC to bloggers: Fess up or pay up. The US Federal Trade Commission is requiring that independent bloggers disclose any interests (especially financial) that they might have in the stories they produce, particularly if this involves reviews or evaluations of products. As the story notes, the FTC is trying to deal with an issue that has long been a challenge in the media and public press. (See also: FTC Drops the Banhammer on Undisclosed Reviews | Infusionsoft Blog)

As a Canadian blogging about academic COI, this move by the FTC has no impact on my behaviour. But it does raise an interesting issue that is more generally of concern to academic presentations and publications, including the growing number of science blogs.

• Blogs are often completely independent from academic or other professional entities and so are essentially free from oversight like peer review.
• Its not clear whether academic blogs should be thought of as “merely” individual opinion, academic self-promotion, or more formal publication (e.g., like at a conference presentation).
• Nor is it very clear that there are (or even could be) widely shared norms about the ethics of blogging given the diversity of people that blog and the types of blogs that exist.
• Yet that doesn’t mean that certain blogging communities, such as academic bloggers, couldn’t try to create locally relevant and accepted norms – its what we academics have done with peer review, debates about declaring COI in publications, grant reviews, etc.

So in the name of transparency:

• this blog is hosted on a private web server, paid for out of my pocket, and my solely responsibility;
• I receive no income from this blog, and if I do I review a product (e.g., a book), I’ll be transparent about whether I received  a free copy of the book;
• the blog is a front page (and thus publicity) for my ongoing research programme on COI that recently received grant funding from the Quebec (FQRSC) and Canadian (CIHR) funding councils.

The University of Wisconsin appears to have made a rather bizarre distinction in their new COI rules. As the following story notes (Speaking fee ban riles UW doctors), the COI rules allow

orthopedic surgeons and other doctors who implant devices to earn large sums of money making presentations for medical device companies. The new policy would keep in place a ban on UW doctors giving talks about medications for drug companies.

And,

If implemented, the policy essentially would create two classes of doctors, those who can’t supplement their income speaking for drug companies and those who can, making presentations for device companies.

But why favour medical devices (and by extension their manufacturers) over drugs (and drug companies)? You would think that the issue of COI relating to physicians working as promotional speakers (and opinion leaders) for medical technologies would be a serious concern, regardless of what type of company or technology was involved. MDs consulting with the Drug Industry has received much attention in recent years (see the AMSA PharmaFree ranking that I blogged on in July); my concern, though, is that too much attention in COI policies on Big Pharma as the Bad Guys marginalises other type of industrial sectors, and non-financial COIs more generally.