stronger evidence base for improving conflict of interest policies and their application.

Society has traditionally granted the medical profession considerable autonomy to regulate itself. Society may be willing to continue do so in the case of conflicts of interest; but concern is growing in the U.S. Congress, state legislatures, federal agencies, and elsewhere that stronger measures are needed. Physicians and researchers can play a vital role in designing responsible and reasonable conflict of interest policies and procedures that reduce the risks of bias and the loss of trust while avoiding undue burdens or even harms. They and the institutions that carry out medical research, education, clinical care, and practice guideline development must recognize public concerns about conflicts of interest and take effective measures soon to maintain public trust.

OVERVIEW AND LIST OF RECOMMENDATIONS

TABLE S-1 Report Recommendations in Overview

Recommendation Number and Topic

Primary Actors

General policy

3.1

Adopt and implement conflict of interest policies

Institutions that carry out medical research and education, clinical care, and clinical practice guideline development

3.2

Strengthen disclosure policies

Institutions that carry out medical research and education, clinical care, and clinical practice guideline development

3.3

Standardize disclosure content and formats

Institutions that carry out medical research and education, clinical care, and clinical practice guideline development and other interested organizations (e.g., accrediting bodies, health insurers, consumer groups, and government agencies)

3.4

Create a national program for the reporting of company payments

U.S. Congress; pharmaceutical, medical device, and biotechnology companies

Medical research

4.1

Restrict participation of researchers with conflicts of interest in research with human participants

Academic medical centers and other research institutions; medical researchers



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