A National Survey of Provisions in Clinical-Trial Agreements between Medical Schools and Industry Sponsors
Kevin A. Schulman, M.D., Damon M. Seils, M.A., Justin W. Timbie, B.A., Jeremy Sugarman, M.D., M.P.H., Lauren A. Dame, J.D., M.P.H., Kevin P. Weinfurt, Ph.D., Daniel B. Mark, M.D., M.P.H., and Robert M. Califf, M.D.
Background Concerned about threats to the integrity of clinicaltrials in a research environment increasingly controlled byprivate interests, the International Committee of Medical JournalEditors (ICMJE) has issued revised guidelines for investigators'participation in the study design, access to data, and controlover publication. It is unclear whether research conducted atacademic institutions adheres to these new standards.
Methods From November 2001 through January 2002, we interviewedofficials at U.S. medical schools about provisions in theirinstitutions' agreements with industry sponsors of multicenterclinical trials. A subgroup of the respondents were also askedabout coordinating-center agreements for such trials.
Results Of the 122 medical schools that are members of the Associationof American Medical Colleges, 108 participated in the survey.The median number of site-level agreements executed per institutionin the previous year was 103 (interquartile range, 50 to 210).Scores for compliance with a wide range of provisions from ensuring that authors of reports on multicenter trialshave access to all trial data (1 percent [interquartile range,0 to 21]) to addressing the plan for data collection and monitoring(10 percent [interquartile range, 1 to 50]) demonstratedlimited adherence to the standards embodied in the new ICMJEguidelines. Scores for coordinating-center agreements were somewhathigher for most survey items.
Conclusions Academic institutions routinely engage in industry-sponsoredresearch that fails to adhere to ICMJE guidelines regardingtrial design, access to data, and publication rights. Our findingssuggest that a reevaluation of the process of contracting forclinical research is urgently needed.
Source Information
From the Center for Clinical and Genetic Economics (K.A.S., D.M.S., J.W.T., K.P.W.), the Outcomes Research and Assessment Group (D.B.M.), Duke Clinical Research Institute (R.M.C.), and the Center for the Study of Medical Ethics and Humanities (J.S., L.A.D.), Duke University Medical Center; and the Duke University School of Law (L.A.D.) all in Durham, N.C.
Address reprint requests to Dr. Schulman at the Center for Clinical and Genetic Economics, Duke Clinical Research Institute, P.O. Box 17969, Durham, NC 27715, or at kevin.schulman{at}duke.edu.
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