Background There is substantial concern that financial conflictsof interest on the part of investigators conducting clinicaltrials may compromise the well-being of research subjects.
Methods We analyzed policies governing conflicts of interestat the 10 medical schools in the United States that receivethe largest amount of research funding from the National Institutesof Health. These institutions are Baylor College of Medicine,Columbia University College of Physicians and Surgeons, HarvardMedical School, Johns Hopkins University School of Medicine,the University of Pennsylvania School of Medicine, the Universityof California at Los Angeles School of Medicine, the Universityof California at San Francisco School of Medicine, the Universityof Washington School of Medicine, Washington University Schoolof Medicine at St. Louis, and Yale University School of Medicine.
Results All 10 universities required that faculty members disclosefinancial interests to university officials. Only four requireddisclosure by all members of the research staff. Five universitiesrequired disclosure of all financial interests, even thoughfederal regulations specify a threshold for disclosure. Sixuniversities required disclosure to the institutional reviewboard as well as to a committee on conflicts of interest ora university official. Four universities had stricter requirementsfor investigators conducting clinical trials than required byfederal regulations. One university prohibited investigatorsfrom having stock, stock options, consulting agreements, ordecision-making positions involving a company that sponsoredthe research. A second university prohibited researchers fromtrading stock or stock options in a company that sponsored theresearch or sold the product or device under study. Two universitiesordinarily did not allow faculty members to participate in clinicalresearch if they had what federal regulations refer to as a"significant" financial interest in the company owning the productor device being studied, but exceptions were allowed.
Conclusions Policies governing conflicts of interest at leadingmedical schools in the United States vary widely. We suggestthat university-based investigators and research staff be prohibitedfrom holding stock, stock options, or decision-making positionsin a company that may reasonably appear to be affected by theresults of their clinical research. Of the 10 medical schoolswe studied, only 1 had a policy that was close to this standard.
Source Information
From the Program in Medical Ethics (B.L., L.E.W.), the Center for AIDS Prevention Studies (B.L., L.E.W.), the Division of General Internal Medicine (B.L., L.E.W.), and the Office of Student Affairs (A.B.), University of California at San Francisco, San Francisco.
Address reprint requests to Dr. Lo at bernie{at}medicine.ucsf.edu.
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