The Future of Conflicts of Interest: A Call for Professional Standards

Journal of Law, Medicine and Ethics

Volumn 40, Issue 3, 2012, Pages 441-451

  Lo, Bernard ^a,b  

^a Greenwall Foundation   (United States)

^b UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CONFLICT OF INTEREST; ECONOMICS; ETHICS; FINANCIAL MANAGEMENT; HUMAN; INDUSTRY; INTERPERSONAL COMMUNICATION; LEGAL ASPECT; PERSONNEL; PHYSICIAN; POLICY; PUBLIC-PRIVATE PARTNERSHIP; UNITED STATES;

CONFLICT OF INTEREST; DISCLOSURE; HUMANS; INDUSTRY; PHYSICIANS; PUBLIC POLICY; PUBLIC-PRIVATE SECTOR PARTNERSHIPS; RESEARCH PERSONNEL; RESEARCH SUPPORT AS TOPIC; UNITED STATES;

EID: 84867621203     PISSN: 10731105     EISSN: 1748720X     Source Type: Journal    
DOI: 10.1111/j.1748-720X.2012.00677.x     Document Type: Article

References (72)

1. E. G. Campbell, S. R. Rao, C. M. DesRoches, L. I. Iezzoni, C. Vogeli, and D. Bolcic-Jankovic et al., "Physician Professionalism and Changes in Physician-Industry Relationships from 2004 to 2009, " Archives of Internal Medicine 170, no. 20 (2010): 1820-1826.
2. The Patient Protection and Affordable Care Act, P.L. 111-148, 23 March 2010. See also the Department of Health and Human Services, "Responsibility of Applicants for Promoting Objectivity in Research for which Public Health Service Funding Is Sought and Responsible Prospective Contractors, "available at (last visited July 30, 2012).
3. J. E. Bekelman, Y. Li, and C. P. Gross, "Scope and Impact of Financial Conflicts of Interest in Biomedical Research: A Systematic Review, " JAMA 289, no. 4 (2003): 454-465
4. J. Lexchin, L. A. Bero, B. Djulbegovic, and O. Clark, "Pharmaceutical Industry Sponsorship and Research Outcome and Quality: Systematic Review, " BMJ 326, no. 7400 (2003): 1167-1170
5. V. Yank, D. Rennie, and L. A. Bero, "Financial Ties and Concordance between Results and Conclusions in Meta-Analyses: Retrospective Cohort Study, " BMJ 335, no. 7631 (2007): 1202-1205.
6. P. A. Ubel, C. Jepson, and D. A. Asch, "Misperceptions about Beta-Blockers and Diuretics: A National Survey of Primary Care Physicians, " Journal of General Internal Medicine 18, no. 12 (2003): 977-983
7. R. F. Adair and L. R. Holmgren, "Do Drug Samples Influence Resident Prescribing Behavior? A Randomized Trial, " American Journal of Medicine 118, no. 8 (2005): 881-884.
8. J. Kaiser, "Private Money, Public Disclosure, " Science 325, no. 5936 (2009): 28-30.
9. C. J. Whittington, T. Kendall, P. Fonagy, D. Cottrell, A. Cotgrove, and E. Boddington, "Selective Serotonin Reuptake Inhibitors in Childhood Depression: Systematic Review of Published Versus Unpublished Data, " The Lancet 363, no. 9418 (2004):1341-1345
10. E. H. Turner, A. M. Matthews, E. Linardatos, R. A. Tell, and R. Rosenthal, "Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy, " New England Journal of Medicine 358, no. 3 (2008): 252-260
11. D. Healy, "Did Regulators Fail Over Selective Serotonin Reuptake Inhibitors?" BMJ 333, no. 7558 (2006): 92-95; L. Gibson, "GlaxoSmithKline to Publish Clinical Trials After US Lawsuit, " BMJ 328, no. 7455 (2004): 1513
12. L. Gibson, "GlaxoSmithKline to Publish Clinical Trials After US Lawsuit, " BMJ 328, no. 7455 (2004): 1513
13. J. J. Kastelein, F. Akdim, E. S. Stroes, A. H. Zwinderman, M. L. Bots, and A. F. Stalenhoef et al., "Simvastatin With or Without Ezetimibe in Familial Hypercholesterolemia, " New England Journal of Medicine 358, no. 14 (2008): 1431-1443
14. J. Avorn, "Dangerous Deception - Hiding the Evidence of Adverse Drug Effects, " New England Journal of Medicine 355, no. 21 (2006): 2169-2171
15. Citizens for Responsible Care and Research, "The Polyheme Trial Part 1. 2008, "available at (last visited July 30, 2012)
16. E. E. Moore, F. A. Moore, T. C. Fabian, A. C. Bernard, G. J. Fulda, and D. B. Hoy et al., "Human Polymerized Hemoglobin for the Treatment of Hemorrhagic Shock When Blood Is Unavailable: The USA Multicenter Trial, " Journal of the American College of Surgeons 208, no. 1 (2009): 1-13
17. B. M. Psaty, C. D. Furberg, W. A. Ray, and N. S. Weiss, "Potential for Conflict of Interest in the Evaluation of Suspected Adverse Drug Reactions: Use of Cerivastatin and Risk of Rhabdomyolysis, " JAMA 292, no. 21 (2004): 2622-2631
18. K. Lee, P. Bacchetti, and I. Sim, "Publication of Clinical Trials Supporting Successful New Drug Applications: A Literature Analysis, " PLoS Medicine 5, no. 9 (2008): e191
19. G. Harris, "Diabetes Drug Maker Hid Test Data, Files Indicate, " available at (last visited August 8, 2012)
20. A. Berenson, "Disparity Emerges in Lilly Data on Schizophrenia Drug, " available at (last visited August 8, 2012).
21. A. Berenson, "Evidence in Vioxx Suits Shows Intervention by Merck Officials, " New York Times, available at (last visited August 8, 2012)
22. G. D. Curfman, S. Morrissey, and J. M. Drazen, "Expression of Concern Reaffirmed, " New England Journal of Medicine 354, no. 11 (2006): 1193.
23. J. Woodcock, J. M. Sharfstein, and M. Hamburg, "Regulatory Action on Rosiglitazone by the U.S. Food and Drug Administration, " New England Journal of Medicine 363, no. 16 (2010): 1489-1491.
24. S. W. Lagakos, "Time-to-Event Analyses for Long-Term Treatments - the APPROVe Trial, " New Engand Journal of Medicine 355, no. 2 (2006): 113-117;
25. C. D. DeAngelis and P. B. Fontanarosa, "Ensuring Integrity in Industry-Sponsored Research: Primum Non Nocere, Revisited, " JAMA 303, no. 12 (2010): 1196-1198
26. J. B. Hrachovec and M. Mora, "Reporting of 6-month vs 12-Month Data in a Clinical Trial of Celecoxib, " JAMA 286, no. 18 (2001): 2398, 2399-2400
27. J. M. Wright, T. L. Perry, K. L. Bassett, and G. K. Chambers, "Reporting of 6-month vs 12-Month Data in a Clinical Trial of Celecoxib, " JAMA 286, no. 19 (2001): 2398-2400
28. S. S. Vedula, L. Bero, R. W. Scherer, K. Dickersin, "Outcome Reporting in Industry-Sponsored Trials of Gabapentin for Off-Label Use, " New England Journal of Medicine 361, no. 20 (2009): 1963-1971
29. C. S. Landefeld and M. A. Steinman, "The Neurontin Legacy - Marketing through Misinformation and Manipulation, " New England Journal of Medicine 360, no. 2 (2009): 103-106
30. J. S. Ross, K. P. Hill, D. S. Egilman, and H. M. Krumholz, "Guest Authorship and Ghostwriting in Publications Related to Rofecoxib: A Case Study of Industry Documents from Rofecoxib Litigation, " JAMA 299, no. 15 (2008): 1800-1812
31. K. P. Hill, J. S. Ross, D. S. Egilman, and H. M. Krumholz, "The ADVANTAGE Seeding Trial: A Review of Internal Documents, " Annals of Internal Medicine 149, no. 4 (2008): 251-258
32. M. A. Steinman, L. A. Bero, M. M. Chren, and C. S. Landefeld, "Narrative Review: The Promotion of Gabapentin: An Analysis of Internal Industry Documents, " Annals of Internal Medicine 145, no. 4 (2006): 284-293;
33. E. J. Carragee, E. L. Hurwitz, and B. K. Weiner, "A Critical Review of Recombinant Human Bone Morphogenetic Protein-2 Trials in Spinal Surgery: Emerging Safety Concerns and Lessons Learned, " Spine Journal 11, no. 6 (2011): 471-491.
34. E. J. Carragee, A. J. Ghanayem, B. K. Weiner, D. J. Rothman, and C. M. Bono, "A Challenge to Integrity in Spine Publications: Years of Living Dangerously with the Promotion of Bone Growth Factors, " Spine Journal 11, no. 6 (2011): 463-468.
35. J. R. Ingelfinger, "Through the Looking Glass: Anemia Guidelines, Vested Interests, and Distortions, " Clinical Journal of the American Society of Nephrology 2, no. 3 (2007): 415-417.
36. D. J. Graham, D. Campen, R. Hui, M. Spence, C. Cheetham, and G. Levy et al., "Risk of Acute Myocardial Infarction and Sudden Cardiac Death in Patients Treated with Cyclo-Oxygenase 2 Selective and Non-Selective Non-Steroidal Anti-Inflammatory Drugs: Nested Case-Control Study, " The Lancet 365, no. 9458 (2005): 475-481.
37. United States Department of Justice, "Five Companies in Hip and Knee Replacement Industry Avoid Prosecution by Agreeing to Compliance Rules and Monitoring, " available at (last visited July 30, 2012).
38. K. Okike, M. S. Kocher, E. X. Wei, C. T. Mehlman, and M. Bhandari, "Accuracy of Conflict-of-Interest Disclosures Reported by Physicians, " New England Journal of Medicine 361, no. 15 (2009): 1466-1474.
39. R. Steinbrook, "Online Disclosure of Physician-Industry Relationships, " New England Journal of Medicine 360, no. 4 (2009): 325-327
40. R. Steinbrook "Disclosure of Industry Payments to Physicians, " New England Journal of Medicine 359, no. 6 (2008): 559-561
41. J. S. Ross, L. E. Lackner, P. Lurie, C. P. Gross, S. Wolfe, and H. M. Krumholz, "Pharmaceutical Company Payments to Physicians: Early Experiences with Disclosure Laws in Vermont and Minnesota, " JAMA 297, no. 11 (2007):1216-1223
42. T. A. Brennan and M. M. Mello, "Sunshine Laws and the Pharmaceutical Industry, " JAMA 297, no. 11 (2007): 1255-1257.
43. G. Harris, "Top Psychiatrist Didn't Report Drug Makers' Pay, " available at (last visited August 8, 2012
44. G. Harris and B. Carey, "Researchers Fail to Reveal Full Drug Pay, " available at (last vistied August 8, 2012)
45. Editorial, "Expert or Shill, "New York Times, available at (last visited July 31, 2012).
46. ProPublica, "Dollars for Docs: How Industry Dollars Reach Your Doctors, " available at (last visited July 31, 2012).
47. B. Lo and M. Field, "Conflict of Interest in Medical Research, Education, and Practice, " available at (last visited July 31, 2012).
48. R. Saver, "Is It Really All about the Money? Reconsidering Non-Financial Interests in Medical Research, " Journal of Law Medicine & Ethics 40, no. 3 (2012): 517-531.
49. E. J. Emanuel and D. F. Thompson, "The Concept of Conflicts of Interest, " E. J. Emanuel, C. Grady, R. A. Crouch, R. K. Lie, F. G. Miller, and D. Wendler, eds., The Oxford Textbook of Clinical Research Ethics ( New York : Oxford University Press, 2008): 758-766.
50. T. P. Stossel, "Regulation of Financial Conflicts of Interest in Medical Practice and Medical Research: A Damaging Solution in Search of a Problem, " Perspective Biological Medicine 50, no. 1 (2007): 54-71.
51. J. Lewin and T. E. Arend Jr., "Industry and the Profession of Medicine: Balancing Appropriate Relationships with the Need for Innovation, " Journal of Vascular Surgergy 54, no. 3, Supp. (2011): 47S-49S.
52. D. E. Zinner, D. Bjankovic, B. Clarridge, D. Blumenthal, and E. G. Campbell, "Participation of Academic Scientists in Relationships with Industry, " Health Affairs (Millwood) 28, no. 6 (2009): 1814-1825.
53. H. Moses and J. B. Martin, "Academic Relationships with Industry: A New Model for Biomedical Research, " JAMA 285, no. 7 (2001): 933-935.
54. Committee on a Framework for Development a New Taxonomy of Disease; National Research Council, "Toward Precision Medicine: Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease, " available at (visited July 30, 2012).
55. G. Lee and L. Studer, "Induced Pluripotent Stem Cell Technology for the Study of Human Disease, " Nature Methods 7, no. 1 (2010): 25-27.
56. K. P. Weinfurt, D. M. Seils, J. P. Tzeng, L. Lin, K. A. Schulman, and R. M. Califf, "Consistency of Financial Interest Disclosures in the Biomedical Literature: The Case of Coronary Stents, " PLoS ONE 3, no. 5 (2008): e2128
57. T. L. Forbes, "Author Disclosure of Conflict of Interest in Vascular Surgery Journals, " Journal of Vascular Surgergy 54, no. 3, Supp. (2011): 55S-58S.
58. J. Dana, "How Psychological Research Can Inform Policies for Dealing with Conflicts of Interest in Medicine, " in B. Lo and M. Field, eds., Conflict of Interest in Medical Research, Education, and Practice ( Washington, D.C. : National Academies Press, 2009): at 358-374
59. J. Dana and G. Loewenstein, "A Social Science Perspective on Gifts to Physicians from Industry, " JAMA 290, no. 2 (2003): 252-255.
60. R.H. Thaler and C. R. Sunnstein, Nudge ( New Haven : Yale University Press, 2008).
61. V. Hughes, "Sunshine on Conflicts, " Nature Biotechnology 28, no. 7 (2010): at 641-643.
62. International Committee of Medical Journal Editors, "Uniform Requirements for Manuscripts Submitted to Biomedical Journals, " available at (last visited July 30, 2012).
63. R. Graham, M. Mancher, D. M. Wolman, S. Greenfield, and E. Steinberg, "Clinical Practice Guidelines We Can Trust, " available at (last visited July 30, 2012);
64. N. Singh, R. Bush, M. Dalsing, and C. K. Shortell, "New Paradigms for Physician-Industry Relations: Overview and Application for SVS Members, " Journal of Vascular Surgergy 54, no. 3, Supp. (2011): 26S-30S.
65. D. J. Rothman and S. Chimonas, "Academic Medical Centers' Conflict of Interest Policies, " JAMA 304, no. 20 (2010): 2294-2295.
66. T. P. Stossel, "Regulating Academic-Industrial Research Relationships - Solving Problems or Stifling Progress?" New England Journal of Medicine 353, no. 10 (2005): 1060-1065
67. T. P. Stossel and L. K. Stell, "Time to 'Walk the Walk' about Industry Ties to Enhance Health, " Nature Medicine 17, no. 4 (2011): 437-438
68. K. J. Rothman, "Conflicts of Interest: The New McCarthyism in Science, " JAMA 269, no. 21 (1993): 2782-2784.
69. B. Lo, "Serving Two Masters - Conflicts of Interest in Academic Medicine, " New England Journal of Medicine 362, no. 8 (2010): 669-671.
70. B. Lo, "Conflict of Interest Policies: An Opportunity for the Medical Profession to Take the Lead, " Academic Medicine 85, no. 1 (2010): 9-11.
71. J. A. Freischlag, "Academic Medical Centers Write Their Own Rules, " Journal of Vascular Surgery 54, no. 3, Supp. (2011): 19S-21S
72. N. B. Kahn Jr. and A. S. Lichter, "The New CMSS Code for Interactions with Companies Managing Relationships to Minimize Conflicts, " Journal of Vascular Surgergery 54, no. 3, Supp. (2011): 34S-40S.