Dealing with conflicts of interest


Professor James Best

1 May 2009

A pharmaceutical company offers to fund your biomedical research project, but may have a vested interest in your findings. What should you do? Refuse the offer on principle? Take the money? But then, how do you manage your situation?

At NHMRC’s recent Transparency and Conflict of Interest Workshop in Canberra, experts from all sides of the debate expressed their views. One of those present was Professor James Best, Head of School of Medicine at the University of Melbourne and Chair of NHMRC’s previous Research Committee. Prof Best has been involved with conflict-of-interest debates for more than 30 years.

Speaking with Marilyn Chalkley during the workshop, Professor Best says honesty, openness and peer review is the best policy. He also discusses whether NHMRC should establish more formalised guidelines.

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Transcript of podcast

Voice-over: Welcome to this National Health and Medical Research Council podcast. Our podcasts aim to keep you in touch with major health and medical research issues and the people who shape them.

Introduction: Hello, I’m Carolyn Norrie. Conflicts of interest between medical researchers and pharmaceutical companies have long generated attention not just in Australia but all over the world. Recent events prompted NHMRC to hold a workshop on transparency and conflict of interest. People from all sides of the debate were invited to participate. One of them was Professor James Best who has had more than 30 years experience in biomedical research. Marilyn Chalkley spoke to him at the workshop.

Interviewer: Jim you’re Chair of the NHMRC Research Committee and Head of the School of Medicine at the University of Melbourne, you must see the issue of conflict of interest frequently. What are some of the issues and how do we deal with them?

Prof. Best: Well there are a number of ways that conflict of interest can arise for researchers, particularly clinician researchers. One way is through pharmaceutical company sponsorship of travel to scientific meetings, of provision of grants in aid for example to researchers and of researchers participating in clinical trials that are run by pharmaceutical companies. In addition, some researchers work with pharmaceutical companies through positions on advisory boards and also speak at meetings that are sponsored by pharmaceutical companies. So there are multiple ways in which conflicts of interest can arise.

Interviewer: And how do you manage that, I mean that’s very much part of many researchers lives isn’t it all those sorts of things, going to meetings, going to conferences, being sponsored in some way. How on earth to you deal with those issues?

Prof. Best: Well I think that recognizing the conflict of interest is the starting point. It’s being able to acknowledge firstly to yourself that this level of engagement with pharmaceutical industry may lead to conflict of interests, so it’s a self examination firstly. The second important step is addressing the perception of conflict of interest and being able to justify to colleagues, friends or family the nature of the relationship and if you can feel that you can do that adequately then you are probably traveling the right path.

Interviewer: There was some discussion at the workshop we’ve just been to which has been an NHMRC workshop on transparency in conflict of interest, there’s been discussion about how people tend to just declare their conflict of interest and then that’s it, and that isn’t enough, so what can you do that is more than that in a sense?

Prof. Best: Well our discussion today came up with a number of suggestions. One was that it may be useful to consult with a colleague. It may be useful for someone else to make that judgment call about whether you’re managing the conflict of interest appropriately. Certainly what came up a number of occasions is that conflict of interest is inevitable, so number one recognizing it yourself and number two either consulting with a colleague or subjecting yourself to peer review or review by someone who’s independent, as to whether you’re managing that conflict appropriately. I think they were some of the suggestions that came up today.

Interviewer: In as sense Australia’s almost too small a country to absent yourself from research projects or for the development of clinical guidelines isn’t it?

Prof. Best: It is and it’s the same issue that comes up Marilyn with peer review. Because it’s a small country it’s inevitable that there are going to be conflicts, so transparency in terms of declaring them and then allowing someone else to be involved in advising you or judging how that conflict should be managed I think is the solution.

Interviewer: We already have guidelines on conflict of interest or ways of looking at it, but in fact is that enough, do we need to do more? Does the NHMRC need to do more do you think?

Prof. Best: We do quite well with managing the peer review conflicts. I think there is a good process both in terms of declaring an interest and also in someone independent – that’s usually NHMRC management or NHMRC staff – making the decision, so it’s at arm’s length from the person declaring the interest. In terms of interactions between researchers and the pharmaceutical company there are some implicit guidelines in the ethical guidelines for conduct of research, but I think it would be useful for NHMRC to develop some more explicit guidelines for guiding behavior in this or setting the standards for behavior in this area.

Interviewer: So increasing transparency do you think?

Prof. Best: Around transparency, ah but then the next step that you’ve mentioned and that is how do you manage it, having declared it how do you manage the interest or conflict of interest?

Interviewer: So it seems like, well we’ve got to a certain point but actually we really need to do more and there was agreement I think at the workshop that that was the case do you think?

Prof Best: I think there was agreement that it’s a difficult area. Words like minefield were used fairly frequently, a highly complex area, but there was also a suggestion that NHMRC could provide guidance or set some standards. But NHMRC would have to be careful not to write a phone book on the topic and have to be fairly readily interpreted standards that people could use that were user friendly.

Interviewer: Professor Jim Best thank you very much indeed for your time today.

Prof. Best: Thanks Marilyn.

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