Proposal for a graded approach to disclosure of interests in accredited CME/CPD

Abstract

Disclosing conflicts of interest (COIs) is an important step in the management of COIs and is considered to be crucial to the trustworthiness of presenters. There are significant variations in disclosure procedures regarding the following: a. How COI is assessed in declaration forms (e.g. type of question, respondent awareness) b. Type of relationships c. Detailing of information to program committee members These variations in procedures have in effect led to a. Underreporting of COI b. Reducing the informational value of declared COI to participants Thus, it has been the aim of the authors to propose a basic formula for a minimum standard declaration of financial COI, with the potential to be applicable to all types of accredited continuing medical education (CME) as well as to all individuals (e.g. speakers, authors) involved in planning and conduct of CME activities. This approach should also serve as basis for more elaborate disclosures as well as strategies for management of conflict of interests adapted to the risk of bias. Furthermore, we also propose a basic set of items to be declared as nonfinancial interests.

Position paper on current aspects of sponsoring in accredited CME

“…Major accreditors all require that interests of members of this group should be comprehensively declared and, in addition, offer forms to be used for declaration [1]. Furthermore, providing no declaration at all is one of the few reasons for exclusion from a faculty or other position involved in the planning and/or delivery of CME/CPD (besides being an employee of a commercial interest, including PCOs).…”

Competing interests in continuing medical education – what should accreditors do?

“…This terminology has caused some confusion, since many physicians believe that only in case of a real conflict an interest needs to be declared, and has lead to underreporting of interests. The mere quantity of interests, as pursued by members of the medical profession, often poses a challenge regarding the choice of the best method of declaration, in order to provide timely and meaningful information to participants in CME. This has lead to huge discrepancies regarding the availability of relevant data in disclosure forms: when digital media are involved (e.g., in CME in print media) elaborate and detailed declarations are often provided, while the most challenging and yet unresolved scenario is represented by congresses with high numbers of speakers and short presentation times, respectively, where often poorly defined declarations are demonstrated in a manner which does not represent meaningful information of the audience. And since most accredited CME activities still are live events , this situation has the potential to harm the reputation of accreditation by trivializing this important part of all accredited CME activities.…”

“…Given this background, a group of authors, who have all been part of the faculty of the Cologne Consensus Conference (CCC) 2014, which has dealt with management of conflict of interests, has just recently published a proposal for a graded approach to disclosure of interests in accredited CME .…”

“…This may not only include more detailed disclosures, but also additional procedures to identify the risk and prevent the occurrence of bias. Recommendations for how to design such a strategy, have been published by accreditors, and the new proposal also offers recommendations for how to further augment disclosure and introduce additional procedures, based on the perceived risk of bias . Up to now, these recommendations have been implemented as standard operating procedures mainly on the institutional level (licensing authorities, guideline writing committees, national medical associations).…”

“…The new proposal for declaration of interests now needs not only to be implemented but also evaluated by scientifically accepted methods.…”