The American Medical Association's Council on Ethical and Judicial Affairs issued the fourth version of its Report on Financial Relationships with Industry in Continuing Medical Education in May. The AMA's House of Delegates sent the first three attempts to change the AMA's policies on commercial support — the most recent of which was rejected just last fall — back to the committee for revision. The House of Delegates was slated to discuss the fate of the most recent revision at its June meeting in Chicago.
The majority of the latest edition contains the following revisions:
Under the section that addresses ensuring the independence, objectivity, and integrity of CME, the committee expanded upon language around the appearance of conflicts of interest resulting from financial relationships. The previous version said that the appearance of these relationships undermining the independence and objectivity of CME could be just as important as actual COI. The 2010 version acknowledges that not all COI are equally problematic ethically, but also stresses that the appearance of COI could be just as “damaging” as actual conflicts. The three solutions it proposes — eliminate the conditions that give rise to potential bias, put mitigation strategies in place, or both — are unchanged from the fall 2009 version.
In the section that addresses ways to avoid compromising conditions,added avoiding “the chance that confidence in the integrity and independence of professional education could be diminished” to the ethical aspirations the enterprise should strive for, along with avoiding actual potential for bias.
While the language that initially describes activities that wouldn't be feasible without commercial support has been stripped of examples and trimmed down in the section on mitigating strategies, the meaning remains essentially the same, and the examples are added further on in the “exceptional cases” section. An addition to that section is that “comparable criteria might apply when an educational activity cannot be reasonably carried out without financial or in-kind support from sources that have a direct financial interest in physicians' clinical recommendations.”
The recommendations were amended to note that financial and/or in-kind support of CME from sources that have a direct financial interest in physicians “creates conditions in which financial interests could influence the availability and/or content of education.” They also spell out thatand other content developers who have recent (within 12 months) or current financial ties with commercial interests could also “create conditions in which CME content may be influenced inappropriately.”
Also included in the latest revision is a recommendation that CME providers and content creators avoid funding and in-kind support for activities in which they might have current, recent, or anticipated financial interest. When industry support can't be avoided, all involved should abide by the mitigating strategies it outlines, which are mainly unchanged from the November 2009 report, except for a reshuffle in the order in which they appear.
The references upon which the report is based, and the order in which they appear, are unchanged from the November 2009 version.
Meet a Rising Star
Karen Thomas, BSBA, CCMEP, associate director, compliance and accreditation at the Institute for Continuing Healthcare Education, was named as one of The Healthcare Businesswomen's Association's Rising Stars, an annual list of up-and-coming professionals in various sectors of the healthcare industry. She was nominated because of her expertise in the compliance arena and significant contributions to the Institute's success. She has presented at the annual meetings of the Alliance for Continuing Medical Education and participated in a panel discussion at the 6th Annual Pharmaceutical Meeting Management Forum, sponsored by the Center for Business Intelligence andmagazine.