Continuing Medical Education

Identification & Resolution of
Conflict of Interests

Identification and Resolution of Conflicts of Interest (COI) and Transparency to Learners:

Collection of COI Information.
Stanford requires that everyone who is in a position to control the content of a Stanford CME activity (including faculty, planners, reviewers, speakers, moderators, and staff), disclose all relevant financial relationships with any commercial interest. The Accreditation Council for Continuing Medical Education (ACCME) defines “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. ACCME considers relationships of the person involved in the CME activity to include financial relationships of a spouse or partner.

COI information is obtained through a standard COI form and is disclosed to learners prior to an educational activity. COI disclosure forms are analyzed by the Stanford Center for CME and a mechanism to resolve reported conflicts is implemented.

Resolution of Reported COI.
When COI is present, course materials including slides and syllabi are reviewed by the course director and/or one or more the following: the Associate Dean for Postgraduate Medical Education, a member of the CME Faculty Advisory Council or a non-conflicted peer reviewer. Should resolution not be possible through content review, speakers may be asked to limit their talk to the presentation of scientific information only, or in some cases the presenter may be replaced by another expert.   Documentation of the resolution of COI is maintained in the activity file.

Transparency to Learners.
COI disclosure information is published in course syllabi, handouts, presentation slides and/or is posted with sign-in sheets so that it may be viewed by learners prior to the start of the activity. Evaluation data regarding the learners’ perception of bias is gathered as part of the resolution of COI process.

Definitions:

Commercial Interest.
The ACCME defines a “commercial interest” as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. 
The ACCME does not consider providers of clinical service directly to patients to be commercial interests.

Financial Relationships.
Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit.  Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities from which remuneration is received, or expected.  ACCME considers relationships of the person involved in the CME activity to include financial relationships of a spouse or partner.

Relevant Financial Relationships. 
ACCME focuses on financial relationships with commercial interests in the 12-month period preceding the time that the individual is being asked to assume a role controlling content of the CME activity. ACCME has not set a minimal dollar amount for relationships to be significant.  Inherent in any amount is the incentive to maintain or increase the value of the relationship. The ACCME defines “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest.

Conflict of Interest.
Circumstances create a conflict of interest when an individual has an opportunity to affect CME content about products or services of a commercial interest with which he/she has a financial relationship.

 

Stanford Center for CME 6/19/10

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