Hi, Tom;
This is an interesting intersection between COI, bias, and knowledge base/expertise. COI are reasonably easy to ferret out (in terms of finances, board memberships, etc), but both COI and biases may play significant roles in content of med ed and review articles. How should we compare the expert (with one set of biases) to the well-educated (with another set)? Will the audience necessarily accept the material if the content is by a nonmember of that intellectual community?
This is of personal interest as I am a plastic surgeon who does not do breast reconstruction but am on a guideline development committee for breast reconstruction. I am able to evaluate the literature, but unless we are willing to say that the only knowledge that matters is that which is contained within the literature, we need experts to add in the less tangible items related to clinical expertise, personal knowledge of the investigators publishing in the field etc. I am quite sure that readers of the breast recon guideline would give it less credence if the committee were all nonsurgeons or even all non-breast plastic surgeons.
Thoughts?
Loree
Loree K. Kalliainen, MD, MA, FACS
Program Director, Hand Surgery Fellowship
Department of Plastic & Hand Surgery
Assistant Professor, Department of Surgery
Assistant Professor, Department of Orthopaedic Surgery
University of Minnesota
Mail Stop 11503 B
640 Jackson St.
St. Paul, MN 55101
651-254-4870
651-254-2808 (fax)
-----Original Message-----
From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Tom Yates
Sent: Wednesday, August 08, 2012 12:43 PM
To: [log in to unmask]
Subject: Re: can disclosure of financial conflicts of interest actually worsen bias?
Hi Ted,
Here are a few studies looking at trial/review article conclusion by
funding source...
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC34722/?tool=pubmed
http://www.nejm.org/doi/full/10.1056/NEJM199801083380206#t=articleMethods
http://archinte.ama-assn.org/cgi/reprint/154/2/157
http://www.bmj.com/content/340/bmj.c1344?view=long&pmid=20299696
http://www.ncbi.nlm.nih.gov/pubmed/12775614
My take on conflict of interest is that you can't really tell from the
statement whether someone's relationships are likely to affect their
conduct. For this reason, I think it is much better if medical
education and review articles (perhaps eventually trials) are
written/delivered by people without conflicts of interest.
CoI statement: I am currently trying to set up a scheme to accredit
medical education delivered without industry funding by people without
conflict of interest. I also work on a trial that has received some
funding from GSK.
Best wishes,
Tom
On 8 August 2012 15:44, Ted Harding <[log in to unmask]> wrote:
> On 08-Aug-2012 12:50:19 Dr. Carlos Cuello wrote:
>> Interesting question
>>
>> http://the-scientist.com/2012/08/07/opinion-bias-is-unavoidable/
>> --
>> Carlos A. Cuello-García, MD
>
> Interesting question indeed.
>
> My take on Conflict of Interest declarations is that they
> say what they say, no more, no less, neamly that X has
> received funding from Y.
>
> This does not imply that, by declaring the interest, X is
> implicitly declaring that conduct, interpretation and
> publication have not been influenced by the funding, and
> were entirely objective.
>
> Nor does it imply that, by accepting the funding, X has
> been influenced, or has been biased, in favour of any
> particular outcome.
>
> Either interpretation may be the correct one.
>
> The real question is: Which interpretation is the more probable?
>
> Which leads on to an EBH-question:
>
> What studies are there which compare the outcomes of funded
> trials with each other, with funding agency as predictive
> covariate, where such trials refer to outcomes for a particular
> condition and involve competing treatments?
>
> Best wishes to all,
> Ted.
>
> -------------------------------------------------
> E-Mail: (Ted Harding) <[log in to unmask]>
> Date: 08-Aug-2012 Time: 15:44:53
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