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Addressing Conflicts of Interest in Health and Medicine: Current Evidence and Implications for Patient Decision Aid Development

Author

Listed:
  • Rachel Thompson

    (School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia)

  • Zoe Paskins

    (School of Medicine, Keele University, Keele, Staffordshire, UK
    Haywood Academic Rheumatology Centre, Haywood Hospital, UK)

  • Barry G. Main

    (Centre for Surgical Research and National Institute for Health Research Bristol Biomedical Research Centre, School of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK)

  • Thaddeus Mason Pope

    (Health Law Institute, Mitchell Hamline School of Law, Saint Paul, MN, USA)

  • Evelyn C. Y. Chan

    (Medical College of Wisconsin, Milwaukee, WI, USA)

  • Ben W. Moulton

    (Informed Consulting, LLC, Boston, MA, USA)

  • Michael J. Barry

    (Massachusetts General Hospital, Boston, MA, USA)

  • Clarence H. Braddock III

    (Deans Office, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, USA)

Abstract

Background More stringent policies for addressing conflicts of interest have been implemented around the world in recent years. Considering the value of revisiting conflict of interest quality standards set by the International Patient Decision Aid Standards (IPDAS) Collaboration, we sought to review evidence relevant to 2 questions: 1) What are the effects of different strategies for managing conflicts of interest? and 2) What are patients’ perspectives on conflicts of interest? Methods We conducted a narrative review of English-language articles and abstracts from 2010 to 2019 that reported relevant quantitative or qualitative research. Results Of 1743 articles and 118 abstracts identified, 41 articles and 2 abstracts were included. Most evidence on the effects of conflict of interest management strategies pertained only to subsequent compliance with the management strategy. This evidence highlighted substantial noncompliance with prevailing requirements. Evidence on patient perspectives on conflicts of interest offered several insights, including the existence of diverse views on the acceptability of conflicts of interest, the salience of conflict of interest type and monetary value to patients, and the possibility that conflict of interest disclosure could have unintended effects. We identified no published research on the effects of IPDAS Collaboration conflict of interest quality standards on patient decision making or outcomes. Limitations Because we did not conduct a systematic review, we may have missed some evidence relevant to our review questions. In addition, our team did not include patient partners. Conclusions The findings of this review have implications for the management of conflicts of interest not only in patient decision aid development but also in clinical practice guideline development, health and medical research reporting, and health care delivery.

Suggested Citation

  • Rachel Thompson & Zoe Paskins & Barry G. Main & Thaddeus Mason Pope & Evelyn C. Y. Chan & Ben W. Moulton & Michael J. Barry & Clarence H. Braddock III, 2021. "Addressing Conflicts of Interest in Health and Medicine: Current Evidence and Implications for Patient Decision Aid Development," Medical Decision Making, , vol. 41(7), pages 768-779, October.
    • Handle: RePEc:sae:medema:v:41:y:2021:i:7:p:768-779
    DOI: 10.1177/0272989X211008881
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    References listed on IDEAS

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    1. Street, Jackie & Duszynski, Katherine & Krawczyk, Stephanie & Braunack-Mayer, Annette, 2014. "The use of citizens' juries in health policy decision-making: A systematic review," Social Science & Medicine, Elsevier, vol. 109(C), pages 1-9.
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    3. Susan L Norris & Haley K Holmer & Brittany U Burda & Lauren A Ogden & Rongwei Fu, 2012. "Conflict of Interest Policies for Organizations Producing a Large Number of Clinical Practice Guidelines," PLOS ONE, Public Library of Science, vol. 7(5), pages 1-12, May.
    4. Grundy, Quinn & Habibi, Roojin & Shnier, Adrienne & Mayes, Christopher & Lipworth, Wendy, 2018. "Decoding disclosure: Comparing conflict of interest policy among the United States, France, and Australia," Health Policy, Elsevier, vol. 122(5), pages 509-518.
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    Cited by:

    1. Holly O. Witteman & Ruth Ndjaboue & Gratianne Vaisson & Selma Chipenda Dansokho & Bob Arnold & John F. P. Bridges & Sandrine Comeau & Angela Fagerlin & Teresa Gavaruzzi & Melina Marcoux & Arwen Pieter, 2021. "Clarifying Values: An Updated and Expanded Systematic Review and Meta-Analysis," Medical Decision Making, , vol. 41(7), pages 801-820, October.
    2. Dawn Stacey & Robert J. Volk, 2021. "The International Patient Decision Aid Standards (IPDAS) Collaboration: Evidence Update 2.0," Medical Decision Making, , vol. 41(7), pages 729-733, October.

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