Nonfinancial conflict of interests: the current situation_Chinese Journal of Evidence-Based Medicine

Authors：

SONG Xiaoyang ^1# , GAO Yuting ^1# , WANG Xiaoqin ^2,3,4 , WANG Qi ^2,3,4 ,  CHEN Yaolong ⁵ , ZHOU Qi ¹ ,  SHANG Hongcai ⁵

1. First Clinical Medical College, Lanzhou University, Lanzhou, 730000, P.R.China;
2. Evidence-based Medicine Center, School of Basic Medical Science, Lanzhou University, Lanzhou, 730000, P.R.China;
3. Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, P.R.China;
4. Chinese GRADE Center, Lanzhou, 730000, P.R.China;
5. Key Laboratory of Chinese Internal Medicine, Ministry of Education, Beijing University of Chinese Medicine, Beijing, 100700, P.R.China;

Corresponding author：

CHEN Yaolong, Email: chenyaolong21@163.com; SHANG Hongcai, Email: shanghongcai@126.com

Keywords：

Conflict of interests; Clinical practice guideline; Evidence-based medicine

DOI：

10.7507/1672-2531.201612027

Video：

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The financial conflict of interests is drawing a wide attention, while several problems such as the unclarity of definition and blurred boundary of classification exist when it comes to the nonfinancial conflict of interests. Taking clinical practice guidelines as the example, this study introduce how nonfinancial conflict of interests happen, their classifications and impact based on present situation of relevant studies.

Citation： SONG Xiaoyang, GAO Yuting, WANG Xiaoqin, WANG Qi, CHEN Yaolong, ZHOU Qi, SHANG Hongcai. Nonfinancial conflict of interests: the current situation. Chinese Journal of Evidence-Based Medicine, 2017, 17(5): 607-611. doi: 10.7507/1672-2531.201612027 Copy

1.	GPAC. GPAC handbook-clinical practice guidelines and protocols by the guidelines and protocols advisory committee. Vancouver: British Columbia. 2012, 20-22.
2.	World Health Organization. WHO handbook for guideline development. World Health Organization, 2014.
3.	Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions, Version 5. 1. 0. The Cochrane Collaboration, 2011. Available at: .
4.	Institute of Medicine (US) Committee on Standards for Developing Trustworthy Clinical Practice Guidelines. Clinical Practice Guidelines We Can Trust. Washington (DC): National Academies Press (US), 2011.
5.	Schünemann HJ, Osborne M, Moss J, et al. An official American Thoracic Society Policy statement: managing conflict of interest in professional societies. Am J Respir Crit Care Med, 2009, 180(6): 564-580.
6.	Hakoum MB, Anouti S, Al-Gibbawi M, et al. Reporting of financial and non-financial conflicts of interest by authors of systematic reviews: a methodological survey. BMJ open, 2016, 6(8): e011997.
7.	Rochon PA, Hoey J, Chan AW, et al. Financial Conflicts of Interest Checklist 2010 for clinical research studies. Open Med, 2010, 4(1): e69-e91.
8.	Viswanathan M, Carey TS, Belinson SE, et al. A proposed approach May help systematic reviews retain needed expertise while minimizing bias from nonfinancial conflicts of interest. J Clin Epidemiol, 2014, 67(11): 1229-1238.
9.	Poole D. When does a point of view become an intellectual conflict of interest? Crit Care Med, 2008, 36(5): 1688-1689.
10.	Bero L. What is in a Name? Nonfinancial influences on the outcomes of systematic reviews and guidelines. J Clin Epidemiol, 2014, 67(11): 1239-1241.
11.	Bion J. Financial and intellectual conflicts of interest: confusion and clarity. Curr Opin Crit Care, 2009, 15(6): 583-590.
12.	Guyatt G, Akl EA, Hirsh J, et al. The vexing problem of guidelines and conflict of interest: a potential solution. Ann Intern Med, 2010, 152(11): 738-741.
13.	Akl EA, El-Hachem P, Abou-Haidar H, et al. Considering intellectual, in addition to financial, conflicts of interest proved important in a clinical practice guideline: a descriptive study. J Clin Epidemiol, 2014, 67(11): 1222-1228.
14.	Farmer BM, Nelson LS. Conflicts of interest on pharmacy and therapeutics committees at academic medical centers. J Med Toxicol, 2011, 7(2): 175-176.
15.	Lipton S, Boyd EA, Bero LA. Conflicts of interest in academic research: policies, processes, and attitudes. Account Res, 2005, 11(2): 83-102.
16.	Sollitto S. Nonfinancial conflicts of interest in research. N Engl J Med, 2002, 347(26): 2173.
17.	Abdoul H, Perrey C, Tubach F, et al. Non-financial conflicts of interest in academic grant evaluation: a qualitative study of multiple stakeholders in France. Plos One, 2012, 7(4): e35247.
18.	Marshall E. When does intellectual Passion become conflict of interest? Science, 1992, 257(570): 620-623.
19.	Greenberg RD. Conflicts of Interest: can a physician serve two masters? Clinics in Dermatology, 2012, 30(2): 160-173.
20.	Viswanathan M, Carey TS, Belinson SE, et al. Identifying and Managing Nonfinancial Conflicts of Interest for Systematic Reviews. 2013. Available at: .
21.	Rowan-Legg A, Weijer C, Gao J, et al. A comparison of journal instructions regarding institutional review board approval and conflict-of-interest disclosure between 1995 and 2005. J Med Ethics, 2009, 35(1): 74-78.
22.	Gray SW, Hlubocky FJ, Ratain MJ, et al. Attitudes toward research participation and investigator conflicts of interest among advanced cancer patients participating in early phase clinical trials. J Clin Oncol, 2007, 25(23): 3488-3494.
23.	Norris SL, Holmer HK, Ogden LA, et al. Conflict of interest in clinical practice guideline development: a systematic review. Plos One, 2011, 6(10): e25153.
24.	Peh WC, Ng KH. Conflict-of-interest, copyright and other declarations. Singapore Med J, 2010, 51(11): 844-846; quiz 847.
25.	Gasparyan AY, Ayvazyan L, Akazhanov NA, et al. Conflicts of interest in biomedical publications: considerations for authors, peer reviewers, and editors. Croat Med J, 2013, 54(6): 600-608.
26.	Gallo SA, Lemaster M, Glisson SR. Frequency and type of conflicts of interest in the peer review of basic biomedical research funding applications: Self-Reporting versus manual detection. Sci Eng Ethics, 2016, 22(1): 189-197.
27.	Kesselheim AS, Maisel WH. Managing financial and nonfinancial conflicts of interest in healthcare delivery. Am J Ther, 2010, 17(4): 440-443.
28.	Deangelis C. Facts and frictions: conflicts of interest in medical research. Methodist Debakey Cardiovasc J, 2011, 7(4): 24-27.
29.	Alpert JS, Shine KI, Adams RJ, et al. Task force 1: The ACCF and AHA codes of conduct in human subjects research. J Am Coll Cardiol, 2004, 44(8): 1724-1728.
30.	Schünemann HJ, Al-Ansary LA, Forland F, et al. Guidelines international network: principles for disclosure of interests and management of conflicts in guidelines. Ann Intern Med, 2015, 163(7): 548-553.
31.	Panagiotou OA, Ioannidis JP. Primary study authors of significant studies are more likely to believe that a strong association exists in a heterogeneous meta-analysis compared with methodologists. J Clin Epidemiol, 2012, 65(7): 740-747.
32.	Cosgrove L, Bursztajn HJ, Erlich DR, et al. Conflicts of interest and the quality of recommendations in clinical guidelines. J Eval Clin Pract, 2013, 19(4): 674-681.
33.	Norris SL, Burda BU, Holmer HK, et al. Author’s specialty and conflicts of interest contribute to conflicting guidelines for screening mammography. J Clin Epidemiol, 2012, 65(7): 725-733.
34.	Lo B. Commentary: conflict of interest policies: an opportunity for the medical profession to take the Lead. Acad Med, 2010, 85(1): 9-11.

1. GPAC. GPAC handbook-clinical practice guidelines and protocols by the guidelines and protocols advisory committee. Vancouver: British Columbia. 2012, 20-22.
2. World Health Organization. WHO handbook for guideline development. World Health Organization, 2014.
3. Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions, Version 5. 1. 0. The Cochrane Collaboration, 2011. Available at: .
4. Institute of Medicine (US) Committee on Standards for Developing Trustworthy Clinical Practice Guidelines. Clinical Practice Guidelines We Can Trust. Washington (DC): National Academies Press (US), 2011.
5. Schünemann HJ, Osborne M, Moss J, et al. An official American Thoracic Society Policy statement: managing conflict of interest in professional societies. Am J Respir Crit Care Med, 2009, 180(6): 564-580.
6. Hakoum MB, Anouti S, Al-Gibbawi M, et al. Reporting of financial and non-financial conflicts of interest by authors of systematic reviews: a methodological survey. BMJ open, 2016, 6(8): e011997.
7. Rochon PA, Hoey J, Chan AW, et al. Financial Conflicts of Interest Checklist 2010 for clinical research studies. Open Med, 2010, 4(1): e69-e91.
8. Viswanathan M, Carey TS, Belinson SE, et al. A proposed approach May help systematic reviews retain needed expertise while minimizing bias from nonfinancial conflicts of interest. J Clin Epidemiol, 2014, 67(11): 1229-1238.
9. Poole D. When does a point of view become an intellectual conflict of interest? Crit Care Med, 2008, 36(5): 1688-1689.
10. Bero L. What is in a Name? Nonfinancial influences on the outcomes of systematic reviews and guidelines. J Clin Epidemiol, 2014, 67(11): 1239-1241.
11. Bion J. Financial and intellectual conflicts of interest: confusion and clarity. Curr Opin Crit Care, 2009, 15(6): 583-590.
12. Guyatt G, Akl EA, Hirsh J, et al. The vexing problem of guidelines and conflict of interest: a potential solution. Ann Intern Med, 2010, 152(11): 738-741.
13. Akl EA, El-Hachem P, Abou-Haidar H, et al. Considering intellectual, in addition to financial, conflicts of interest proved important in a clinical practice guideline: a descriptive study. J Clin Epidemiol, 2014, 67(11): 1222-1228.
14. Farmer BM, Nelson LS. Conflicts of interest on pharmacy and therapeutics committees at academic medical centers. J Med Toxicol, 2011, 7(2): 175-176.
15. Lipton S, Boyd EA, Bero LA. Conflicts of interest in academic research: policies, processes, and attitudes. Account Res, 2005, 11(2): 83-102.
16. Sollitto S. Nonfinancial conflicts of interest in research. N Engl J Med, 2002, 347(26): 2173.
17. Abdoul H, Perrey C, Tubach F, et al. Non-financial conflicts of interest in academic grant evaluation: a qualitative study of multiple stakeholders in France. Plos One, 2012, 7(4): e35247.
18. Marshall E. When does intellectual Passion become conflict of interest? Science, 1992, 257(570): 620-623.
19. Greenberg RD. Conflicts of Interest: can a physician serve two masters? Clinics in Dermatology, 2012, 30(2): 160-173.
20. Viswanathan M, Carey TS, Belinson SE, et al. Identifying and Managing Nonfinancial Conflicts of Interest for Systematic Reviews. 2013. Available at: .
21. Rowan-Legg A, Weijer C, Gao J, et al. A comparison of journal instructions regarding institutional review board approval and conflict-of-interest disclosure between 1995 and 2005. J Med Ethics, 2009, 35(1): 74-78.
22. Gray SW, Hlubocky FJ, Ratain MJ, et al. Attitudes toward research participation and investigator conflicts of interest among advanced cancer patients participating in early phase clinical trials. J Clin Oncol, 2007, 25(23): 3488-3494.
23. Norris SL, Holmer HK, Ogden LA, et al. Conflict of interest in clinical practice guideline development: a systematic review. Plos One, 2011, 6(10): e25153.
24. Peh WC, Ng KH. Conflict-of-interest, copyright and other declarations. Singapore Med J, 2010, 51(11): 844-846; quiz 847.
25. Gasparyan AY, Ayvazyan L, Akazhanov NA, et al. Conflicts of interest in biomedical publications: considerations for authors, peer reviewers, and editors. Croat Med J, 2013, 54(6): 600-608.
26. Gallo SA, Lemaster M, Glisson SR. Frequency and type of conflicts of interest in the peer review of basic biomedical research funding applications: Self-Reporting versus manual detection. Sci Eng Ethics, 2016, 22(1): 189-197.
27. Kesselheim AS, Maisel WH. Managing financial and nonfinancial conflicts of interest in healthcare delivery. Am J Ther, 2010, 17(4): 440-443.
28. Deangelis C. Facts and frictions: conflicts of interest in medical research. Methodist Debakey Cardiovasc J, 2011, 7(4): 24-27.
29. Alpert JS, Shine KI, Adams RJ, et al. Task force 1: The ACCF and AHA codes of conduct in human subjects research. J Am Coll Cardiol, 2004, 44(8): 1724-1728.
30. Schünemann HJ, Al-Ansary LA, Forland F, et al. Guidelines international network: principles for disclosure of interests and management of conflicts in guidelines. Ann Intern Med, 2015, 163(7): 548-553.
31. Panagiotou OA, Ioannidis JP. Primary study authors of significant studies are more likely to believe that a strong association exists in a heterogeneous meta-analysis compared with methodologists. J Clin Epidemiol, 2012, 65(7): 740-747.
32. Cosgrove L, Bursztajn HJ, Erlich DR, et al. Conflicts of interest and the quality of recommendations in clinical guidelines. J Eval Clin Pract, 2013, 19(4): 674-681.
33. Norris SL, Burda BU, Holmer HK, et al. Author’s specialty and conflicts of interest contribute to conflicting guidelines for screening mammography. J Clin Epidemiol, 2012, 65(7): 725-733.
34. Lo B. Commentary: conflict of interest policies: an opportunity for the medical profession to take the Lead. Acad Med, 2010, 85(1): 9-11.

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