Category: Conflict of interest. Conflict of interest represents an outside influence, usually financial, that has the potential to upset the balance of impartiality that is important in credible research. Articles are arranged by date with the most recent entries at the top. You can find the theme and closely related categories and other resources at the bottom of this page.

Stats: Reforming conflict of interest statements (November 12, 2007). In a recent talk, I was asked to disclose any conflicts of interest. I did so, but I also commented that the organization I was speaking to, as well as most other organizations have a poorly thought out conflict of interest policy. The problem with most of these policies is that they make it hard to disclose conflicts and easy to pretend that no conflicts exist. I believe that rather than having an easy box to check, make the statement of no conflict a more detailed one.

Stats: Does promoting your book constitute a conflict of interest? (August 13, 2007). I give lots of talks and I usually put in a plug for my book, Statistical Evidence in Medical Trials. I even promote my book in the signature file that I put at the bottom of all my emails. My philosophy is that if you don't promote yourself, who will? I got an interesting email from someone associated with the Continuing Medical Education (CME) department of a site where I will be giving a talk that very politely called me to task for this self-promotion.

 Stats: Need for a conflict of interest policy (August 9, 2007). I attended a very interesting session at the Joint Statistical Meetings last week on conflict of interest. I asked a question during the session that seemed quite obvious to me at the time, but which was apparently not thought of by any of the speakers. Why did no one in that session formally declare whether they had a conflict of interest?

Stats: Conflict of interest in the Wakefield MMR study (July 26, 2007). An interesting case study in conflict of interest (perhaps a bit too complex to be described fairly in this brief weblog entry) involves a controversial paper. The lead author of this paper, Wakefield A; Murch S, Anthony A, Linnell J, Casson D, Malik M, Berelowitz M, Dhillon A, Thomson M, Harvey P, Valentine A, Davies S, Walker-Smith J (February 28 1998). Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children 637-641. The Lancet - Vol. 351, Issue 9103. DOI:10.1016/S0140-6736(97)11096-0, is Andrew Wakefield. Dr. Wakefield has alleged on the basis of twelve children referred to his clinic that there was a link between the MMR vaccine and the development of autism.

Stats: Conflict of interest list (July 18, 2007). I was asked to fill out a conflict of interest form for a talk I will be giving in December. While I have not gotten any money directly from drug companies recently, I do have some financial support outside the hospital that might be considered a conflict of interest in some contexts. These sources of support do not relate directly or indirectly to the topic I will be discussing in December (or any of the topics that I plan to discuss), but it it better to disclose too much rather than too little. I will try to update this page as new sources of support appear.

Stats: Manipulation of peer-review publications by pharmaceutical companies (March 9, 2007). This weblog entry provides some discussion points that I want to share in a seminar: Stats #72: Manipulation of peer-review publications by pharmaceutical companies

Stats: PharmedOUT website (March 2, 2007). In response to educational resources in medicine that are dominated by drug company support, a  new website, PharmedOUT, has been formed, www.pharmedout.org/index.htm.

Stats: When can a conservative trust a liberal information source (and vice versa) (July 10, 2006). I have a brother-in-law who loves to debate politics and religion. He always takes an aggressively conservative stand (I'm a flaming liberal, but try not to mention politics too much on this weblog). Often he will cite a "liberal" source, such as the New York Times to support his arguments, and although he does not trust most of what is published in these liberal sources, he will still cite them when they make a point in favor of a conservative viewpoint. His rationale is when a liberal source cites data supporting a conservative cause, they only do it grudgingly and because the facts are too overwhelming to ignore. I suppose I do the same thing myself, but with the politics reversed. But this is a dangerous approach to take for several reasons.

Stats: What constitutes a conflict of interest? (May 4, 2006). I am a member of a committee that helps researchers set up Data Safety and Monitoring Boards (DSMBs) for research projects at Kansas University Medical Center (KUMC). The typical study that we would help set up DSMBs for would be small scale single center trials. We recommended that the typical DSMB have two specialists in the medical area of the research and a statistician. We ask the principal investigator to nominate the two specialists. Some debate ensued about whether the specialists nominated by the principal investigator would have a conflict of interest because they presumably would know and would have worked with the principal investigator.

Stats: Taking charges of conflicting interest too far (June 4, 2005). You should always be aware of potential conflicts of interest. Sometimes researchers allow a financial incentive to influence their research and end up skewing  the data to achieve a particular outcome. More uncertain is the belief that researchers working in an area will try to obtain findings that encourage greater research funding in the area they work in. This might manifest itself in a tendency to exaggerate the importance of a particular disease and to overstate the number of people affected. One author commented that having an NIH grant is the biggest conflict of interest of all.

Stats: More on conflicts of interest (March 23, 2005). I need to write up something on my very incomplete page on Intellectual conflict of interest. A review in JAMA of the report, Complementary and Alternative Medicine in the United States, which I commented on in a January 24, 2005 weblog entry, has an interesting quote about conflict of interest.

Stats: Intellectual conflict of interest [Incomplete] (November 24, 2004). Here are some web pages that discuss the concept of an intellectual conflict of interest.

Stats: Conflict of interest (July 20, 2004). Does having a commercial interest in the results of a drug trial cause a problem for the people running the trial? If it does, then much of the research that we rely on could be flawed. A recent article in the British Medical Journal raises some serious concerns: Efficacy and safety of antidepressants for children and adolescents. Jureidini JN, Doecke CJ, Mansfield PR, Haby MM, Menkes DB, Tonkin AL. Bmj 2004: 328(7444); 879-83.

Stats: Conflict of Interest (February 25, 2004). The New York Review of Books has a extensive review written by Richard Horton of the book Science in the Private Interest: Has the Lure of Profits Corrupted Biomedical Research? by Sheldon Krimsky. The review has an extensive bibliography, and cites some good work about problems with the quality and conclusions of corporate sponsored research.

Theme and closely related categories:

• Theme: Evidence based medicine
• Category: Corroborating evidence
• Category: Fraud in research

Other resources:

• Academic freedom in clinical research Description: This article summarizes the Nancy Oliveri case. Dr. Olivieri was a researcher who was determined to present information about safety problems with a drug she was studying, in violation of a confidentiality agreement with the drug company that sponsored the research. This case illustrates the need to avoid agreements with drug companies that allow those companies to completely bar publication of unfavorable results.
• Academic Relationships with Industry: A New Model for Biomedical Research. Description: This article proposes several general principles for managing the increasingly complex financial ties between academic research institutions and industry.
• Academic-corporate ties in biotechnology: a quantitative study Description: Coming soon!
• All Gifts Large and Small - Toward an Understanding of the Ethics of Pharmaceutical Industry Gift-Giving Description: This article notes that even gifts of negligible value can influence behavior and recommends that arbitrary value limits for reporting are inappropriate.
• Assessing faculty financial relationships with industry: A case study Description: This article summarizes the financial relationships that faculty members at the University of California, San Francisco have with external sponsors of clinical research. This occurs about 8% of the time. The finncial relationships typically involve paid speaking engagements and consulting agreements. A smaller proportion involved equity holding or participation on an advisory board.
• Association between competing interests and authors' conclusions: epidemiological study of randomised clinical trials published in the BMJ. Description: This article notes that publications noting financial competing interests led to different reporting results compared to publications reporting no competing interests. This effect could not be explained by methodological quality or other factors. Interestingly, publications reporting other types of competing interests did not differ in reporting results.
• Association of funding and conclusions in randomized drug trials: a reflection of treatment effect or adverse events? Description: This article notes that industry funded studies are more likely to recommend the experimental drug. This result apears to be associated not with any particular finding of better efficacy or better safety, but rather a biased interpretation of trial results.
• Association between industry funding and statistically significant pro-industry findings in medical and surgical randomized trials Description: This article provides evidence that randomized trials sponsored by industry are more likely to report results favorable to the sponsoring company and compares these results to other studies looking at this issue.
• Avoiding conflicts of interest in drug research Description: Coming soon!
• Being a modern pharmaceutical company: involves making information available on clinical trial programmes Description: This article highlights the policy at GlaxoWellcome to register information on all the clinical trials that it conducts.
• Beyond conflict of interest. Transparency is the key [editorial] Description: This article presents the case that conflict of interest is more than a theoretical concern and outlines changes in the conflict of interest policy at BMJ.
• Bias in analytic research Description: Coming soon!
• Blood lead levels, scientific misconduct and the Needleman case. 3. A reply from Scarr and Ernhart Description: Coming soon!
• Conflict of interest and cost-effectiveness analysis Description: This article reviews the viewpoints for and against disclosing financial conflicts of interest. Then the author summarizes a research publication of the influence of financial support in studies of cost effectiveness.
• Conflict of interest and the American Journal of Bioethics Description: Coming soon!
• Conflict of interest and the physician-researcher Description: This article suggests that indirect research support may undermine the investigator's role to serve first as an advocate for his/her patient.
• Conflict of interest and the public trust Description: This article summarizes an issue of JAMA devoted to conflict of interest issues. The authors note the problems with industry support of research, but argue that it is untenable to simply ban industry funding.
• Conflict of interest in the debate over calcium-channel antagonists Description: This article reviews a series of publications examining the safety of calcium channel antogonists. Authors were more likely to have a financial ties if their articles were positive towards calcium-channel antagonists than those neutral or critical.
• Does the type of competing interest statement affect readers' perceptions of the credibility of research? Randomised trial Excerpt: Financial relationships among industry and academic institutions are diverse and common.1 These interests can influence authors' conclusions2 and readers' perceptions of published studies.3 We report the effects on reader perceptions of different statements of competing interests for two manuscripts.
• Journal Policies on Conflict of Interest: If This Is the Therapy, What's the Disease? Description: This article criticizes the policies that most journals have for reporting conflicts of interest.

Fear and loathing of pharmaceutical statistics

Operating the smokescreen

Is academic medicine for sale?

Cholesterol lowering trials in coronary heart disease: frequency of citation and outcome

Conflict-of-interest policies for investigators in clinical trials

Conflict of interest policies in science and medical journals: editorial practices and author disclosures

Declaring financial competing interests: survey of five general medical journals

Deficits in psychologic and classroom performance of children with elevated dentine lead levels

Disclosure and Disinterest

Disclosure policies for gifts from industry to academic faculty

Disclosure of Authors' Conflicts of Interest: A Follow-up

Does the type of competing interest statement affect readers' perceptions of the credibility of research? Randomised trial

Economic incentives in clinical investigation

Editorials and Conflicts of Interest

Efficacy and safety of antidepressants for children and adolescents

Environmental lead and children's intelligence

Ethics issues in academic-industry relationships in the life sciences: the continuing debate

Evaluation of conflict of interest in economic analyses of new drugs used in oncology

Financial Associations of Authors

Financial interest and its disclosure in scientific publications

Financial interests of authors in scientific journals: a pilot study of 14 publications

Financial Conflict-of-Interest Policies in Clinical Research: Issues for Clinical Investigators

Funding source, trial outcome and reporting quality: are they related? Results of a pilot study

Get-the-lead-out guru challenged

How can research ethics committees protect patients better?

Influences on the Quality of Published Drug Studies

Institutions, Contracts, and Academic Freedom

Journal Policies on Conflict of Interest: If this Is the Therapy, What's the Disease?

Lung cancer and passive smoking. Turning over the wrong stone

National office of drug safety is needed, experts say in JAMA

New England Journal loosens its rules on conflict of interest

Nonfinancial conflicts of interest in research

Of whistleblowers, investigators, and judges

On being a whistleblower: the Needleman case

Operating the smokescreen

Participation of life-science faculty in research relationships with industry

Pharmaceutical industry sponsorship and research outcome and quality: systematic review

Policies on faculty conflicts of interest at US universities

Potential solutions to the problem of conducting systematic reviews of new health technologies

Print media coverage of research on passive smoking

Problem is greater than editorial indicates

The publication of sponsored symposiums in medical journals

The Quality of Drug Studies Published in Symposium Proceedings

Reanalysis of epidemiological evidence on lung cancer and passive smoking

Relationships between academic institutions and industry in the life sciences--an industry survey

Reference bias in reports of drug trials

Relationships between authors of clinical practice guidelines and the pharmaceutical industry

Reply to Ernhart, Scarr, and Geneson

A reply to Scarr and Ernhart

Review of the quality of studies on the economic effects of smoke-free policies on the hospitality industry

Salem comes to the National Institutes of Health: notes from inside the crucible of scientific integrity

Scientific journals and their authors' financial interests: a pilot study

Scope and impact of financial conflicts of interest in biomedical research: a systematic review

Source of funding and outcome of clinical trials

Sponsorship, Authorship and Accountability

A Study of Manufacturer-Supported Trials of Nonsteroidal Anti-inflammatory Drugs in the Treatment of Arthritis

Systematic reviews and meta-analyses on treatment of asthma: critical evaluation

Tobacco Industry Efforts to Defeat the Occupational Safety and Health Administration Indoor Air Quality Rule

Tobacco industry research: collaboration, not confrontation, is the best approach

The uncertainty principle and industry-sponsored research

Uneasy Alliance - Clinical Investigators and the Pharmaceutical Industry

What scientists funded by the tobacco industry believe about the hazards of cigarette smoking

When commitments and interests conflict. "There's probably no greater conflict of interest than an NIH grant"

Why Review Articles on the Health Effects of Passive Smoking Reach Different Conclusions

[Return to full topic list] [Read current weblog entries]

This webpage was written by Steve Simon on 2007-06-11, edited by Steve Simon, and was last modified on 2008-07-14. Send feedback to ssimon at cmh dot edu or click on the email link at the top of the page.