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JAMA | Conflict of Interest: Why Does It Matter?

While endeavoring to protect the interests and well-being of their patients and maintain professional competence, physicians may develop secondary interests such as the competition for patients and trainees, extramural research funding, and high-profile publications. Financial and other rewards of medical practice can create conflicts of interest.
This issue of JAMA features 23 Viewpoint articles on conflict of interest for physicians in settings such as academic medicine, biomedical research, medical education, guideline development, health care management, and medical publishing.
Two Editorials discuss the pervasive opportunities for conflict of interest in health care and medical journalism.

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In This Issue of JAMA

Highlights

Abstract Full Text
free access has audio
JAMA. 2017;317(17):1707-1709. doi:10.1001/jama.2016.13108

Conflict of InterestWhy Does It Matter?

Abstract Full Text
JAMA. 2017;317(17):1717-1718. doi:10.1001/jama.2017.1869

In this Viewpoint, the former president of the Institute of Medicine discusses the importance of conflicts of interest to the integrity of the medical profession, and the importance of policies to manage conflicts of interest that are specific, clear, public, comprehensible, and fair.

Payments to PhysiciansDoes the Amount of Money Make a Difference?

Abstract Full Text
JAMA. 2017;317(17):1719-1720. doi:10.1001/jama.2017.1872

This Viewpoint considers if conflict of interest (COI) is proportional to the size of financial payment or reward and how size and type of payment should be accounted for in attempts to manage COIs.

Why There Are No “Potential” Conflicts of Interest

Abstract Full Text
JAMA. 2017;317(17):1721-1722. doi:10.1001/jama.2017.2308

This Viewpoint argues that “potential” conflicts of interest (COIs) are actual COIs that are effectively managed, and calls for clear terminology to describe the severity of COIs and how they are identified and managed.

Addressing Bias and Conflict of Interest Among Biomedical Researchers

Abstract Full Text
JAMA. 2017;317(17):1723-1724. doi:10.1001/jama.2017.3854

This Viewpoint explores the differences between financial and nonfinancial conflicts of interest, the effects of both on research bias, and the importance of managing each in ways that reduce bias.

Conflict of Interest and the Integrity of the Medical Profession

Abstract Full Text
JAMA. 2017;317(17):1725-1726. doi:10.1001/jama.2017.3191

This Viewpoint discusses the complexities of meaningful conflicts of interest, how they affect the integrity of the medical profession, and progress the profession has made in developing organizational responses to conflicts of interest.

Strategies for Addressing a Broader Definition of Conflicts of Interest

Abstract Full Text
JAMA. 2017;317(17):1727-1728. doi:10.1001/jama.2017.3857

This Viewpoint argues that a successful approach to managing financial conflicts of interest would involve strategies to identify and manage bias more generally.

Role of Leaders in Fostering Meaningful Collaborations Between Academic Medical Centers and Industry While Also Managing Individual and Institutional Conflicts of Interest

Abstract Full Text
JAMA. 2017;317(17):1729-1730. doi:10.1001/jama.2017.2573

This Viewpoint discusses the important role that leaders of academic medical centers (AMCs) play in fostering collaborations with industry while managing individual and institutional conflicts of interest (COI).

Conflict of Interest Among Medical School FacultyAchieving a Coherent and Objective Approach

Abstract Full Text
JAMA. 2017;317(17):1731-1732. doi:10.1001/jama.2017.1751

In this Viewpoint the dean of Harvard Medical School surveys the multifaceted aspects of conflict of interest among medical school faculty and urges a conflict-of-intererst research program to ensure objective and effective management of inevitable conflicts

Teaching Medical Students About Conflicts of Interest

Abstract Full Text
JAMA. 2017;317(17):1733-1734. doi:10.1001/jama.2017.2079

This Viewpoint argues for the importance of medical school curricula and policies that educate students about conflicts of interest, their consequences, and how to manage them.

Funding, Institutional Conflicts of Interest, and Schools of Public HealthRealities and Solutions

Abstract Full Text
JAMA. 2017;317(17):1735-1736. doi:10.1001/jama.2017.1659

This Viewpoint considers when extramural funding might represent a conflict of interest for schools of public health and suggests approaches for managing institutional conflicts of interest.

Conflicts of Interest and Professional Medical AssociationsProgress and Remaining Challenges

Abstract Full Text
JAMA. 2017;317(17):1737-1738. doi:10.1001/jama.2017.2516

This Viewpoint reviews relationships that professional medical associations (PMAs) can develop with commercial entities, the effects of conflicts of interest on PMA activities, including development of practice guidelines, and ways PMAs can prevent and manage adverse influences of those conflicts.

Conflict of Interest in Practice Guidelines Panels

Abstract Full Text
JAMA. 2017;317(17):1739-1740. doi:10.1001/jama.2017.2701

This Viewpoint proposes policies for managing conflicts of interest related to practice guideline development, including conflicts among guideline committee panelists and those that derive from guideline sponsors.

Financial Conflicts of Interest in Continuing Medical EducationImplications and Accountability

Abstract Full Text
JAMA. 2017;317(17):1741-1742. doi:10.1001/jama.2017.2981

This Viewpoint discusses conflicts of interest associated with continuing medical education and proposes strategies to address their influence on continuing medical education activities.

Challenges and Opportunities in Disclosing Financial Interests to Patients

Abstract Full Text
JAMA. 2017;317(17):1743-1744. doi:10.1001/jama.2017.2656

This Viewpoint discusses the need for physicians and hospitals to disclose relevant financial interests to patients and challenges to effective disclosure of those interests, and suggests principles that might guide effective policies for approaches to disclosure.

Business Model–Related Conflict of Interests in MedicineProblems and Potential Solutions

Abstract Full Text
JAMA. 2017;317(17):1745-1746. doi:10.1001/jama.2017.2275

This Viewpoint considers how payment models for clinical services create conflicts of interest in medical practice and how a salary model of payment might diminish the conflict and have other benefits.

What Do Patients Think About Physicians’ Conflicts of Interest?Watching Transparency Evolve

Abstract Full Text
JAMA. 2017;317(17):1747-1748. doi:10.1001/jama.2017.2995

This Viewpoint discusses the challenges to fully informing patients about physician conflicts of interest (COIs) and questions if attempts to improve COI transparency will make a difference to and for patients.

Public Disclosure of Payments to Physicians From Industry

Abstract Full Text
JAMA. 2017;317(17):1749-1750. doi:10.1001/jama.2017.2613

This Viewpoint describes the US government’s Open Payments program and initiatives by ProPublica, a nonprofit investigative news program, all of which make information about physicians’ financial relationships with drug companies and associated prescribing habits free and accessible to the public.

Managing Conflicts of Interest in Industry-Sponsored Clinical ResearchMore Physician Engagement Is Required

Abstract Full Text
JAMA. 2017;317(17):1751-1752. doi:10.1001/jama.2017.4160

This Viewpoint discusses the conflicts of interest that arise from industry’s dual obligations to patients and shareholders and outlines progress academic medical centers and others have made managing conflicts of interest in industry-sponsored clinical research.

Physicians, Industry Payments for Food and Beverages, and Drug Prescribing

Abstract Full Text
JAMA. 2017;317(17):1753-1754. doi:10.1001/jama.2017.2477

This Viewpoint discusses whether payments to physicians for food and beverages from the pharmaceutical industry and other health care companies influence physicians’ drug prescribing behaviors.

Conflict of Interest and the Role of the Food Industry in Nutrition Research

Abstract Full Text
JAMA. 2017;317(17):1755-1756. doi:10.1001/jama.2017.3456

This Viewpoint discusses the role of the food industry in funding nutrition research, the risk of bias in nutritional evidence arising from funders’ conflicts of interest (COIs), and actions recommended by the CDC to manage those COIs.

How Should Journals Handle the Conflict of Interest of Their Editors?Who Watches the “Watchers”?

Abstract Full Text
JAMA. 2017;317(17):1757-1758. doi:10.1001/jama.2017.2207

This Viewpoint discusses the importance of high standards for editorial conflict of interest and suggests recusal procedures for editors that can help maintain the trust of readers.

Medical Journals, Publishers, and Conflict of Interest

Abstract Full Text
JAMA. 2017;317(17):1759-1760. doi:10.1001/jama.2017.3421

This Viewpoint discusses the role of publishers and editors in managing conflict of interest policies and practices for medical journals.

Conflict of Interest and Legal Issues for Investigators and Authors

Abstract Full Text
JAMA. 2017;317(17):1761-1762. doi:10.1001/jama.2017.4235

This Viewpoint discusses the duty of authors to report potential conflicts of interest, the legal and professional consequences of omissions, and processes for investigating allegations of failure to disclose conflicts of interest.

A Piece of My Mind

After the Medical Error

Abstract Full Text
JAMA. 2017;317(17):1763-1764. doi:10.1001/jama.2017.0004
Editorial

The Complex and Multifaceted Aspects of Conflicts of Interest

Abstract Full Text
JAMA. 2017;317(17):1765-1767. doi:10.1001/jama.2017.3435

Conflict of Interest and Medical Journals

Abstract Full Text
JAMA. 2017;317(17):1768-1771. doi:10.1001/jama.2017.4563

Reconsidering Physician–Pharmaceutical Industry Relationships

Abstract Full Text
JAMA. 2017;317(17):1772-1773. doi:10.1001/jama.2017.4455
Original Investigation

Types and Distribution of Payments From Industry to Physicians in 2015

Abstract Full Text
has active quiz
JAMA. 2017;317(17):1774-1784. doi:10.1001/jama.2017.3091

This study uses Open Payments reporting data to describe industry payments to physicians in 2015 and to compare payments by physician specialty and sex.

Association Between Academic Medical Center Pharmaceutical Detailing Policies and Physician Prescribing

Abstract Full Text
has active quiz
JAMA. 2017;317(17):1785-1795. doi:10.1001/jama.2017.4039

This study compares changes in physician prescribing patterns before and after implementation of policies at academic medical centers restricting on-site activities of pharmaceutical salespeople.

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