critically the evidence presented in (or absent from) journal articles, practice guidelines, and other sources of clinical information and advice (see, e.g., Bennett et al. [1987] and EBM Working Group [1992]). Others have worked to shift methods for the development of clinical practice guidelines away from unsystematic expert opinion and consensus processes toward formal, objective procedures for identifying and reviewing the relevant evidence and linking the strength and quality of the evidence to recommendations (see Chapter 7). These techniques and strategies work together with conflict of interest policies to reduce the risk of bias and maintain public trust in medical research, education, and practice.


Chapter 2 sets forth a normative and conceptual framework for the report, including definitions and the criteria used to assess the potential benefits and harms created by financial relationships. Chapter 3 presents an overview of conflict of interest policies and what is known about their impact.

Chapters 4 through 7 are devoted to examinations of industry relationships and conflicts of interest in the domains of medical research, medical education, clinical practice, and practice guideline development, respectively. Chapter 8 discusses the importance of policies on conflicts that arise at the level of the institution. Finally, Chapter 9 discusses the role that accrediting and other supporting organizations can play in promoting the adoption and implementation of conflict of interest policies by the institutions that are on the front lines of medical education, research, and practice. Several appendixes provide additional background about the report or topics mentioned in the report.

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