Patient Outcomes Research Teams (PORTS) Managing Conflict of Interest (1991) / Chapter Skim
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5 Managing Conflicts of Interest: General Models and Approaches
5 Managing Conflicts of Interest: General Models and Approaches
Pages 61-68
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From page 61... ...
We call this model "disclosure and peer review." l"VVO MODELS OF CONFLICT-OF-INTEREST MANAGEMENT Prohibition Model The prohibition model discourages any arrangement, particularly financial, that might create a conflict of interest unless that arrangement provides a sufficiently countervailing social benefit. Implementing this approach requires that those who advocate it establish a framework within which certain conflicts of interest may be acceptable.
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From page 62... ...
Disclosure and Peer Rewew Model The disclosure and peer review model holds that conflicts of interest are unavoidable and that financial conflicts of interest are only the most visible and perhaps the least scientifically dangerous. Acknowledging potential sources of bias promotes an awareness of different points of view and the possibility of developing some kind of balance within PORTs—provided also that a strong peer-review process is in place and that there are opportunities for secondary data analysis.
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From page 63... ...
Seemingly, both the prohibition and the disclosure and peer review models would permit PORT studies to continue despite real or apparent conflicts of interest. Where they significantly differ is in their underlying presumptions and in where they draw the line between prohibition and management, though not necessarily in the means used to deal with conflicts of interest.
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From page 64... ...
Financial Distancing Regarding financial conflicts of interest, one possible method of reducing the influence of corporate money on research is to establish financial pools or mechanisms that increase the distance (real or perceived) between the funding source and the PORT or its members.
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From page 65... ...
When I was talking before about the Mega Foundation's money, I was thinking of it as grants that were coming into very specific people for very specific research projects, but coming in as grants through the university. That is not a laundering phenomenon.
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From page 66... ...
It would only affect personal financial gain, however, not prevent biased research, and it is the latter that reflects the intent of financial distancing. For instance, a blind trust would not provide a solution for the investigator who has a substantial holding in a closely held company whose product is involved in PORT studies (or is competitive with such a product)
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From page 67... ...
Defining Categories of Unacceptable Activities and Implementing Prohibitions Although differing in their presumptions, both the prohibition and the disclosure and review models recognize that when ameliorative approaches are insufficient to ensure adequate conflict-of-interest protection for researchers, prohibition may be required. Consequently, several schemes have been proposed to delineate permissible from impermissible activities.
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From page 68... ...
Institutions also sometimes apply sanctions. For example, the Harvard University Faculty of Medicine's approach to conflicts of interest specifies the following sanctions in rough order of severity: formal admonition; inclusion in a personnel file of a letter from the Office of the Dean that an individual's good standing as a member of the faculty has been called into question; ineligibility for grant applications, institutional review board approval, or supervision of graduate students; nonrenewal of appointment; and dismissal from the faculty.
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