Healthcare research vulnerable to conflicts of interest

Canadians may be in the dark about conflicts of interest affecting research into new drugs and devices because the standards set by some health science centres aren’t rigorous enough, says a York University professor.

Joel Lexchin (right), professor of Health Policy & Management in York’s Faculty of Health, is the lead author of a new study that reviews policies toward human participant research at Canadian academic health centres, including medical schools, faculties of medicine and teaching hospitals.

The goal of the study, published online this month in the Journal of General Internal Medicine, is to determine if there are proper guidelines in place to prevent financial conflicts of interest from compromising individual researchers’ work.

"These conflicts can unconsciously lead to biases in the way that research is reported," Lexchin says. "If policies around conflicts of interest were more comprehensive and easier to access, then researchers may be able to avoid putting themselves into situations where their research could be compromised because of conflicts."

Lexchin explains that potential financial conflicts of interest range from those that can be measured in dollars and cents – owning stock in a company that has retained you to do research or holding patents in the products you are investigating – to concerns about academic freedom, such as retaining the right to publish study results.

By comparing policies of 74 health centres to a list of 61 items that detailed the various types of conflicts – the process through which researchers disclose conflicts and how to manage conflicts of interest, for example – the authors determined if institutions had adequately addressed the issue of financial conflict of interest.

The authors found that no single policy in any Canadian health research centre currently informs individual researchers about the broad range of financial conflicts of interest that could compromise their work.

On the contrary, Canadian centres within the same level, be it teaching hospitals, medical schools or faculties of medicine, differ significantly in the areas that their policies cover.

Canadians need to be made aware that more comprehensive standards around conflict of interest should be developed so that the integrity of research into the latest drugs and devices is not compromised, says Lexchin. A study has shown, for example, that almost 40 per cent of drug investigation studies published in The Journal of the American Medical Association and The New England Journal of Medicine had authors with reported conflicts of interest.

"A lot of the time, when reporters are writing about research in newspaper articles, they don’t bring up the fact that the research that’s being presented may have been paid for by a commercial entity," says Lexchin. "They don’t report about the possible conflict the researchers themselves may have."

The development of better polices to govern financial conflicts of interest needs to be a bigger priority in both health centres and the minds of the public, says Lexchin. The study recommends that health centres post comprehensive, standard, up-to-date policies in places that are easily accessible to researchers.

An additional concern raised in the paper is whether industry sponsors of research are shopping around for hospitals with relatively lenient conflict of interest policies. This question should be addressed in future studies, explains Lexchin.

The article, "National Evaluation of Policies on Individual Conflicts of Interest in Canadian Academic Health Science Centres", is part of a larger project – the Evaluation of the Integrity of Clinical Research in Canada – funded by the Canadian Institutes of Health Research and led by Dr. Paula Rochon at Baycrest Centre.