Current guidelines regarding industry-sponsored continuing medical education

The relationship between industry and surgery

This article examines industry's involvement in medicine, particularly with respect to surgeons and clinical research, as well as continuing medical education. We describe some historical events involving industry and how these events have led to guidelines by various organizations to handle conflicts of interest. We also review the advantages and disadvantages of collaborating with industry and provide practical guides for interactions with industry in terms of clinical research, continuing medical education, and clinical practice. With careful consideration to protect all parties involved, collaboration with industry can be advantageous to surgeons, industry, and patients.

Low rates of reporting commercial bias by physicians following online continuing medical education activities

BACKGROUND

Concerns have been raised about bias in commercially supported continuing medical education (CME) activities, although the data are sparse about whether such bias exists, or if so, its extent.

METHODS

Postactivity CME evaluation surveys were analyzed to quantitate reporting rates of bias, overall and by funding source.

RESULTS

5Of 1,621,647 physicians who participated in online CME activities, 1,064,642 (65.7%) completed the evaluation surveys and 5.9% reported no opinion. The affirmative rates of physician perception of bias were 0.63% overall, a weighted average of 0.84% for activities developed with and 0.48% for those developed without commercial support, a difference of 0.36% (P <.001, 95% confidence interval, 0.33-0.39). Among the subgroup who strongly disagreed that there is no bias, the difference between commercial (0.17%) and noncommercial (0.11%) funding was 0.06% (P <.001, 95% confidence interval, 0.05-0.08, P <.05), smaller than the overall difference.

CONCLUSIONS

These data demonstrate that about 93% of physician participants affirmatively claim to perceive no commercial bias following online CME activities, over 99% if no opinion is included, overall and regardless of funding source.

The orthopaedic profession and the industry partnership

The partnership between the orthopaedic profession and industry has existed for more than half a century and has created advanced orthopaedic care and conflicting interest in the delivery of that care. The orthopaedic surgeon first initiated and controlled the relationship with industry as surgeon innovators strove to improve orthopaedic implants. Over time, the practice of orthopaedic surgery and the business of orthopaedic product supply have changed substantially, as has the environment within which each functions. The surgeon's scope of care has expanded enormously over the past decades. Today, orthopaedic care is delivered through a highly interdependent relationship of the orthopaedic profession, the products industry, healthcare providers, healthcare financers, and government agencies. In many ways the relative influence of the orthopaedic surgeon has diminished in this relationship as the influence of other parties has grown. This work outlines some of the current risks and opportunities for the beneficial delivery of patient care the orthopaedic profession and industry mutually face.

Impact of commercial support on continuing pharmacy education

INTRODUCTION

There is a serious debate over the involvement of the pharmaceutical industry in continuing education. Policies that govern the planning of continuing education for pharmacists center on the potential conflict of interest when there is commercial support for programs. The purpose of this study was to investigate the impact of commercial support on the provision and perceived outcomes of continuing pharmacy education.

METHODS

A survey was administered online to a national sample of accredited providers of continuing pharmacy education, resulting in 134 responses. The 64-item survey was developed to measure the planning practices of these providers and their perceptions of the educational and noneducational consequences of commercial support for continuing education.

RESULTS

One hundred thirty-four usable questionnaires (34%) were received from 386 leaders in pharmacy education. Approximately 86% of providers and 43% of programs received commercial support. Although the Accreditation Council for Pharmacy Education requires that providers review instructional content and materials for commercially supported programs before delivery, only 43% always did so. Commercial support was perceived to have consequences for provider organizations, pharmacists, and patients, such as increased cost and use of drugs and financial dependency of providers and participants on industry support.

DISCUSSION

The results of our study lead to the conclusions that commercial support of continuing education is widespread, affects continuing education programs, and is perceived to have significant educational and noneducational consequences. The profession should ensure that continuing education guidelines are unambiguous related to specific practices that are allowable and unallowable when receiving commercial support. Future research should study the consequences of commercial support behaviorally by examining the effects on pharmacy professionals' practice and pharmaceutical care.

Educational governance for the regulation of industry sponsored continuing medical education in interventional and device based therapies

The relationship between industry and clinicians in educational programmes needs to be regulated. Industry may be best placed to deliver educational programmes in "craft" related specialties and particularly in areas where device implantation/technology based therapy has a major clinical role. The authors supervise industry sponsored clinical teaching at a purpose built independent teaching facility, and have developed the concept of educational governance to regulate their relationship with their industry sponsor and that concept is presented.