Hyperscrutiny of Academic-Industrial Relationships: Potential for Unintended Consequences

 

A paper in the Journal of the American College of Radiology titled “Hyperscrutiny of Academic-Industrial Relationships: Potential for Unintended Consequences—A Response,” examines the current environment of academic-industrial relationships.

Although the authors note that such relationships “are coming under intense scrutiny from government and other regulatory bodies … academic-industrial collaboration is an engine that drives innovation in the biomedical sciences in this country.” As a result, the article calls on members of the academic radiology community to ensure that the societal benefits of these relationships are not sacrificed via “overregulation.”

 

The reason industry support is needed for academic radiology is to ensure that society can educate the next generation of radiologists, and help clinicians maintain and enhance their expertise as science and the practice of medicine continuously advance, and being. Another reason why industry support of radiology is important is because it allows radiologists “to do the seminal research projects that drive innovation and improve human health through superior diagnostic and therapeutic technologies and techniques.” The private industry funding of such techniques and technologies are extremely important because “government priorities and budget shortfalls threaten sources of research funding for radiologists.”

 

To address the need for more radiologists in academia, “leading academic radiologists created the Association of University Radiologists (AUR), to “stimulate interest in academic radiology as a medical career; advancing radiology as a medical science; and representing academic radiology at a national level.” In collaboration with the AUR, the authors acknowledged “one very successful program that was created through an alliance with a major industrial partner that has a strong business interest in the continued vitality of academic radiology: GE Healthcare.”

 

Although the authors exaggerate some of the recent conflicts associated with academia and industry, their analysis of AUR’s GE-AUR Radiology Research Academic Fellowship (GERRAF) program, reveals just how crucial these relationships can be. Additionally, while it is important that industry and academia learn from the very few mistakes in the past by driving for greater transparency, this does not mean the overregulation of collaboration between academia and industry.

 

Rothman Recommendations

 

In analyzing the GERRAF program, the authors dispute three recommendations from the April 1, 2009, JAMA article by David J.Rothman, et al. Specifically, they assert that adopting such recommendations would be unnecessary, burdensome, and would eliminate many professional medical associations (PMAs).

 

In the case of the GERRAF program, fellows receive annual stipends of $70,000 per fellow, travel support for fellows and mentors, and honoraria for non-radiology board members from GE. If the program was to follow Rothmans first recommendation—completely banning pharmaceutical and medical device industry funding except for income from journal advertising and exhibit hall fees—GERRAF would see its 17 years of success meet a quick end.

 

Instead, the authors assert that transparency is a “far better” option than prohibition because like many fellowships, resources are limited and shrinking.

The authors also believe that implementing Rothman’s fourth recommendation– preventing appointees from knowing which company’s funds underwrote their fellowship or travel—is “impractical and inappropriate.” In fact, they acknowledge that “the policies and procedures needed to protect this secret would contradict the drive for transparency and full disclosure.” Another undesirable result from this recommendation would be that “small societies with limited financial resources would not be able to fund fellowships and training programs.”

 

The article asserts that banning research “support for the current and future officers and board members of an organization such as the AUR would be unnecessary, counterproductive, and catastrophic to the future of the organization.”

 

Conclusion

 

The authors concluded that the GERRAF program “has generated impressive results and provides an informative example of a healthy industrial-academic partnership” because it fostered “a reciprocal relationship that benefits the radiology profession, the industry, and GE.”  The article found that “the training provided via the GERRAF program develops highly skilled health outcome researchers necessary to conduct the studies that demonstrate improved quality or health outcomes, reduced costs, and assessed treatment options using medical imaging.”

 

Considering the relatively “modest level of industry funding required to operate, the GERRAF program is an example of industry support for a specific PMA program that is core to the PMA’s mission.” As a result, the authors felt that “academic-industrial partnerships in research and education have provided the impetus for tremendous advances in medicine and have helped train generations of practitioners.”

 

Since these partnerships are “good public policy and should be preserved,” the authors recommended that the recent “hyperscrutiny” that attacks the physician-industry relationships should be abandoned. In fact, the article noted that “such a paradigm shift would end decades of productive partnership.”

 

These programs are important because participants are “influenced far more by their real-life experiences both before and after their involvement than by the knowledge that a particular company funded their program.” Academic-industry relationships “benefit academic radiology and other practice areas and are “rationally” regulated to avoid inappropriate industry involvement.” These partnerships “should be celebrated, and encouragement for the development of similar programs should be freely given.”