JAMA Shines Spotlight on Conflicts of Interest in Healthcare

Renowned medical journal JAMA Internal Medicine has published a collection of articles about conflicts of interest in healthcare. HealthNewsReview — one of our favorite health journalism websites — provides an excellent summary.

Many of these same issues are at play in nutrition research as well as between dietitians and companies that largely produce and market foods and beverages that contribute to a variety of public health ills.

Highlights:

• “Researchers wanted to know if the doctors involved in writing guidelines for the management of cholesterol and hepatitis C had any conflicts of interest.”

• “In 2011, the Institute of Medicine (IOM) published standards for what they believed constituted conflict of interest (COI). The IOM standards call for no commercial COI among guideline committee chairs and co-chairs. Commercial COI should exist in less than 50% of regular committee members. This study found that both groups — the chairs and co-chairs, as well as the regular committee members — not only had conflicts of interest that they disclosed, but also conflicts of interest they did not disclose (but were revealed in other publications).”

• “Patient advocacy organizations (PAO’s) receive extensive industry funding. Two-thirds of those surveyed reported receiving industry funding, with just over 1-in-10 of this group receiving more than half of their funding from industry. Conflicts of interest with patient advocacy groups are particularly disconcerting because of the potential to directly misguide patients. These groups now have — for better and for worse — an extended reach and influence on the Internet. They also can author and dictate guidelines, fundraise, sponsor research, influence and guide media coverage, and shape public policy and perception.”

• “The authors looked for potential conflicts of interest among 634 hematologist-oncologists who use Twitter. Using the open payments website, they found that about 80 percent of these tweeting doctors had at least one documented financial conflict of interest. Roughly half of the hematologist-oncologists were recipients of research funding. Nearly 3 out of 4 received personal payments (ie. checks made out personally to them and not tied to their employer).”

• “There were really two motivations for looking into this,” says Dr. Vinay Prasad, a hematologist-oncologist from Portland, Oregon who co-authored the study. “I would see these doctors tweeting about cancer drugs who were only giving the upside to drugs I knew were not necessarily the safest or most affordable option. When I would bring this up they would tweet ‘it’s not a problem’ or ‘it’s not our concern.’ I’d then look them up and they usually had FCOI. So they’re tweeting about drugs and not telling people they get money.”

• “The concrete examples of conflicts of interest in this special issue of JAMA Internal Medicine make it clear that the problem is pervasive, worrisome, and clearly has the potential to not only change healthcare delivery, but impact those who receive it.”