{"id":11651,"date":"2009-03-31T09:01:43","date_gmt":"2009-03-31T13:01:43","guid":{"rendered":"https:\/\/www.policymed.com\/2009\/03\/jama-calls-for-ban-on-industry-contributions-to-medical-societies.html"},"modified":"2009-03-31T09:01:43","modified_gmt":"2009-03-31T13:01:43","slug":"jama-calls-for-ban-on-industry-contributions-to-medical-societies","status":"publish","type":"post","link":"https:\/\/www.policymed.com\/2009\/03\/jama-calls-for-ban-on-industry-contributions-to-medical-societies.html","title":{"rendered":"JAMA: Calls for Ban on Industry Contributions to Medical Societies"},"content":{"rendered":"<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 10pt\"><font face=\"Arial\" size=\"3\"><img loading=\"lazy\" decoding=\"async\" height=\"189\" src=\"http:\/\/purgatorio1.com\/wp-content\/pics\/burningbook.jpg\" style=\"WIDTH: 218px; HEIGHT: 144px\" width=\"252\" \/><\/font><\/p>\n<p><font face=\"Arial\" size=\"3\"><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\">\u201cProfessional Medical Associations (PMAs) should work toward a complete ban on pharmaceutical and medical device industry funding ($0), except for income from journal advertising and exhibit hall fees.\u201d<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\">This is the bottom line of <em style=\"mso-bidi-font-style: normal\">The Journal of the American Medical Association\u2019s<\/em> (<em style=\"mso-bidi-font-style: normal\">JAMA)<\/em> Special Communication entitled: <strong style=\"mso-bidi-font-weight: normal\"><a href=\"http:\/\/jama.ama-assn.org\/cgi\/content\/abstract\/301\/13\/1367\"><font color=\"#800080\">Professional Medical Associations and Their Relationships with Industry a Proposal for Controlling Conflicts of Interest<span style=\"FONT-WEIGHT: normal\">.<\/span><\/font><\/a><\/strong><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\">The Special Communication is authored by ardent anti-industry critics, David Rothman, Ph.D., the Director of the Institute of Medicine as a Profession (IMAP) at Columbia, Katherine DeAngelis, M.D., Editor of JAMA, one current and several former medical society officers including Steve Nissen, M.D., former President of the American College of Cardiology, and James Scully Jr., M.D., CEO of the American Psychiatric Association.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\">The \u201cSpecial Communication\u201d covers several major operations that they believe the medical societies should discontinue seeking funding for including: general budget support, national conferences, regional meetings, research, fellowship and training programs, practice guideline distribution, outcome measures, certain publications, and product endorsements.<span style=\"mso-spacerun: yes\">  <\/span>In addition, they call for the elimination of all ties to industry, including funded research by presidents and officers of medical societies. <\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\">The paper funded by the Pew Charitable Trust but not disclosed through the Prescription Project to IMAP, follows the pattern of a similar paper entitled <a href=\"http:\/\/jama.ama-assn.org\/cgi\/content\/short\/295\/4\/429\"><font color=\"#800080\">Health Industry Practices that Create a Conflict of Interest: a Policy Proposal for Academic Medical Centers<\/font><\/a> that was orchestrated by the same groups (but not disclosed) and published in JAMA in 2006 that has lead to the Association of American Medical Colleges and major universities to revise their conflicts of interest guidelines.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\">The goal of this paper is stated plainly in the conclusion: <\/p>\n<p class=\"MsoListParagraphCxSpFirst\" style=\"MARGIN: 0in 0in 12pt 0.5in; TEXT-INDENT: -0.25in; mso-list: l0 level1 lfo1; mso-add-space: auto\"><span style=\"FONT-FAMILY: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol\"><span style=\"mso-list: Ignore\">\u00b7<span style=\"FONT: 7pt 'Times New Roman'\">         <\/span><\/span><\/span>PMAs should work toward a goal of $0 contributions from industry;<\/p>\n<p class=\"MsoListParagraphCxSpMiddle\" style=\"MARGIN: 0in 0in 12pt 0.5in; TEXT-INDENT: -0.25in; mso-list: l0 level1 lfo1; mso-add-space: auto\"><span style=\"FONT-FAMILY: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol\"><span style=\"mso-list: Ignore\">\u00b7<span style=\"FONT: 7pt 'Times New Roman'\">         <\/span><\/span><\/span>PMAs leaders and executive staff should be free of conflict of interest; and<\/p>\n<p class=\"MsoListParagraphCxSpLast\" style=\"MARGIN: 0in 0in 12pt 0.5in; TEXT-INDENT: -0.25in; mso-list: l0 level1 lfo1; mso-add-space: auto\"><span style=\"FONT-FAMILY: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol\"><span style=\"mso-list: Ignore\">\u00b7<span style=\"FONT: 7pt 'Times New Roman'\">         <\/span><\/span><\/span>In time, the entirety of the board and members of the practice guidelines committees should be free from conflict ($0 dollars).<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\"><strong style=\"mso-bidi-font-weight: normal\">Conferences<o:p><\/o:p><\/strong><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\"><strong style=\"mso-bidi-font-weight: normal\">Industry Sponsorship of Conference Programs<o:p><\/o:p><\/strong><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 1in\">Establish Continuing Medical Education (CME) Committees that are free of conflicts of interest who could freely distribute the (I thought they wanted this banned) unrestricted educational grants from industry.<span style=\"mso-spacerun: yes\">  <\/span>And, PMAs should seek funding from foundations and\/or the National Institutes of Health (NIH) for specific courses or endowed chairs.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 1in\">Funding, if sought, should go through a PMAs central repository or committee.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\"><strong style=\"mso-bidi-font-weight: normal\">Conflicts of Interest Standards for Program Committee Members<o:p><\/o:p><\/strong><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 1in\">At a minimum, members of the program committee should disclose any financial ties with industry to the committee chairman and legal counsel.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\"><strong style=\"mso-bidi-font-weight: normal\">Gifting of Promotional Items<o:p><\/o:p><\/strong><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\"><span style=\"mso-tab-count: 1\">            <\/span>A ban on all gifts and food.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\"><strong style=\"mso-bidi-font-weight: normal\">Satellite Symposium<o:p><\/o:p><\/strong><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 1in\">PMAs should not endorse, facilitate, or accept funding for satellite symposia. <\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\"><strong style=\"mso-bidi-font-weight: normal\">Research by PMAs and \u201cMembers\u201d<o:p><\/o:p><\/strong><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\">Industry should not be allowed to provide a grant for a project of its choosing or be associated with a specific project.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\">The research awards should be peer reviewed without any involvement from industry.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt; TEXT-INDENT: 0.5in\">Funds should go to a central repository or committee.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\"><strong style=\"mso-bidi-font-weight: normal\">Fellowships and Training Programs<o:p><\/o:p><\/strong><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\">Fellowships should not be named after the pharmaceutical company or device manufacturer.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\">Fellows should not know which company funds underwrote their fellowships.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\">Small societies should consider avoiding all such support.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\"><strong style=\"mso-bidi-font-weight: normal\">Committees that Formulate Practice Guidelines and Outcome Measures<o:p><\/o:p><\/strong><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\">The establishment of guidelines and registries must be independent of all industry influence, actual or perceived.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\">Disclosure of industry relationships by committee members is not sufficient protection.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\">PMAs must excluded from guidelines committee persons with any conflicts of interest ($0 threshold) involving research support or additional income from a company whose products could be effected by the guidelines.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\"><strong style=\"mso-bidi-font-weight: normal\">Publications (Journals)<o:p><\/o:p><\/strong><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\">Creation and distribution of guidelines and other advisory materials should be independent of industry funding.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\">Should not accept industry funding of journal supplements.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\">Companies are free to purchase the materials (journal articles), and distribute and refer to them in their promotional materials but without a logo or branding.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\">Advertising can be acceptable when it is clearly identified as such.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\">Companies should be permitted to purchase reprints of articles published in journals.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\"><strong style=\"mso-bidi-font-weight: normal\">Product Endorsements<o:p><\/o:p><\/strong><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\">Never solicit or accept any offer that would attach its name or logo to a commercial product, service, or activity.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\"><strong style=\"mso-bidi-font-weight: normal\">Affiliated Foundations<o:p><\/o:p><\/strong><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\">Affiliated foundations must be held to the same standards on conflicts of interest as the parent PMA. <strong style=\"mso-bidi-font-weight: normal\"><o:p><\/o:p><\/strong><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\"><strong style=\"mso-bidi-font-weight: normal\">Presidents, Officers, and Board Members<o:p><\/o:p><\/strong><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\">At a minimum the president, president-elect, immediate past president, vice president, secretary, and treasurer of a PMA should be conflict free ($0 threshold) during their tenure.<span style=\"mso-spacerun: yes\">  <\/span>This includes no personal income, and no research support should be derived from industry.<span style=\"mso-spacerun: yes\">  <\/span><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\"><strong style=\"mso-bidi-font-weight: normal\">Guidance for PMA Members<o:p><\/o:p><\/strong><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\">As PMAs strengthen their conflicts of interest policies, they should use the policies to influence and lead their members to adopt similar standards.<span style=\"mso-spacerun: yes\">  <\/span>The PMA should make it explicit that the principles underlying the organization\u2019s behavior apply to the physician behavior.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt 0.5in\">Physicians should avoid marketing industry products.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\"><strong style=\"mso-bidi-font-weight: normal\">Summary<o:p><\/o:p><\/strong><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\">They present no evidence of a problem, and they offer no viable solutions to solve the problem for which they show no evidence.<span style=\"mso-spacerun: yes\">  <\/span><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\">The papers views only represent a very small but vocal minority of medical society members.<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\">This is an opt-ed editorial with no balance or opposite opinion disguised as a \u201cspecial communication.\u201d<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\">In reading the \u201cSpecial Communication,\u201d there is no mention of peer review.<span style=\"mso-spacerun: yes\">  <\/span>Also, Katherine DeAngelis states she has no influence in its publication, sure\u2026<\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\">This is the typical rhetoric of anti-industry purists who seek to scare the public into believing that all medical professionals who collaborate with industry are somehow tainted and that there is no good reason to collaborate with industry even in research.<span style=\"mso-spacerun: yes\">  <\/span><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\"><span style=\"COLOR: black\">Nowhere does it focus on the best interest of patients.<span style=\"mso-spacerun: yes\">  <\/span>It just assumes that conflicts of interest are bad, but does not speak to the value of collaboration.<span style=\"mso-spacerun: yes\">  <\/span>While the United States government is developing a system to solve the nation's financial crisis through government\/industry collaborations, this group seeks to end pharma and device industry collaboration with medical researchers and clinicians.<span style=\"mso-spacerun: yes\">  <\/span>How can that be good for patients, and increasing access to medical care?<o:p><\/o:p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\"><span style=\"COLOR: black\">Certainly, it is a good idea for any organization or group of organizations to engage in self-reflection and self-regulation.<span style=\"mso-spacerun: yes\">  <\/span>Indeed, the pharma and device industries have self-regulatory codes, and almost all associations have internal and external guidelines for dealing with conflicts of interest.<span style=\"mso-spacerun: yes\">  <\/span>Most have revised their conflicts of interest policies in the last four years, and this \u201cSpecial Communication\u201d gives no credit to the changes.<o:p><\/o:p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\"><span style=\"COLOR: black\">Though the paper praises disclosure regimes, it says they do not go far enough.<span style=\"mso-spacerun: yes\">  <\/span>What is their basis for that?<span style=\"mso-spacerun: yes\">  <\/span>I believe we praise openness, transparency, disclosure efforts, and support programs that expand their reach and effectiveness.<o:p><\/o:p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\"><span style=\"COLOR: black\">The exclusion of journal advertising and supplements is self-serving to say the least, if this group is serious about a complete separation, they may want to start at home (Journals), as opposed to inflicting their self-righteous moral stance on everyone else. <o:p><\/o:p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\"><span style=\"COLOR: black\">This also explains the stance that the American Psychiatric Association took last week on sponsored food and education for their meeting, they were fully aware of this week\u2019s publication.<o:p><\/o:p><\/span><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\"><span style=\"COLOR: black\">They go out of their way to relate PMAs to university medical centers and push for even further restrictions (<em style=\"mso-bidi-font-style: normal\">i.<\/em>e., ban on industry funded research).<span style=\"mso-spacerun: yes\">  <\/span>The major difference is that PMAs are not universities and the barrier to create a new medical association is quite small (this is America), and disgruntled members can easily form a less intrusive organization.<span style=\"mso-spacerun: yes\">     <\/span>Um\u2026 The American Society of Clinical Psychiatrists\u2026.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\"><span style=\"COLOR: black\">One note sent to me by Bruce Ballande former Executive Director of the Alliance for Continuing Medical Education made a good point that the special communication recommends that \u201cThe American Association of Medical Colleges have recently adopted conflict of interest policies for faculty that can serve as useful models\u201d.  <\/span><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 10pt\">This is an interesting suggestion which contradicts the recommendations of the AAMC paper.   <\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 10pt\">Essentially the AAMC strongly recommends that faculty, students, residents and fellows participate in and attend only ACCME Certified education and not promotional education.  <\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 10pt\">Moreover the AAMC strongly endorses the continuation of commercial support for education and research unlike the recommendations of the article. <\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 12pt\"><o:p><\/o:p><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 10pt\">\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 10pt\">\n<p><\/font><\/p>\n<p class=\"MsoNormal\" style=\"MARGIN: 0in 0in 10pt\">\n<\/p>\n<\/p>\n<\/p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u201cProfessional Medical Associations (PMAs) should work toward a complete ban on pharmaceutical and medical device industry funding ($0), except for income from journal advertising and exhibit hall fees.\u201d This is the bottom line of The Journal of the American Medical Association\u2019s (JAMA) Special Communication entitled: Professional Medical Associations and Their Relationships with Industry a Proposal […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[67],"tags":[1101],"class_list":["post-11651","post","type-post","status-publish","format-standard","hentry","category-medical-journals","tag-new"],"_links":{"self":[{"href":"https:\/\/www.policymed.com\/wp-json\/wp\/v2\/posts\/11651","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.policymed.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.policymed.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.policymed.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.policymed.com\/wp-json\/wp\/v2\/comments?post=11651"}],"version-history":[{"count":0,"href":"https:\/\/www.policymed.com\/wp-json\/wp\/v2\/posts\/11651\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.policymed.com\/wp-json\/wp\/v2\/media?parent=11651"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.policymed.com\/wp-json\/wp\/v2\/categories?post=11651"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.policymed.com\/wp-json\/wp\/v2\/tags?post=11651"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}