conflict of interest

利益冲突
  • 文章类型: Journal Article
    作为平价医疗法案的一部分于2010年颁布,《医生支付阳光法案》(PPSA)要求制药公司和医疗保健提供者之间财务互动的透明度。这项研究调查了PPSA的有效性及其对行业支付给医生的影响。利用ProPublica和OpenPayments数据库,在10个州进行了差异分析.结果显示,制药公司在PPSA后与膳食相关的支付大幅减少,影响总支付金额和达到的独特医生数量。相反,在主要分析中,差旅费没有显著影响。然而,随后的分析显示,所达到的独特医生数量有细微的减少,强调一种更复杂的关系,其中制药公司可能会在各州不同地调整与医生的财务互动策略。膳食的州层面差异进一步强调了PPSA影响的复杂性。这项开创性的研究贡献了宝贵的经验证据,解决先前研究中的差距,并强调持续需要进行政策评估以指导行业与医生的关系。
    Enacted in 2010 as part of the Affordable Care Act, the Physician Payments Sunshine Act (PPSA) mandates transparency in financial interactions between pharmaceutical companies and healthcare providers. This study investigates the PPSA\'s effectiveness and its impact on industry payments to physicians. Utilizing ProPublica and Open Payments databases, a difference-in-difference analysis was conducted across ten states. Results reveal a significant reduction in pharmaceutical companies\' meal-related payments post-PPSA, impacting both the total payment amount and the number of unique physicians reached. Conversely, travel payments showed no significant impact in the primary analysis. However, subsequent analyses revealed nuanced reductions in the number of unique physicians reached, highlighting a more intricate relationship wherein pharmaceutical companies likely adjusted their financial interaction strategies with physicians differently across states. State-level variations in meals further underscore the complexity of PPSA\'s influence. This pioneering research contributes valuable empirical evidence, addressing gaps in prior studies and emphasizing the ongoing need for policy assessment to guide industry-physician relationships.
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  • 文章类型: Journal Article
    一再呼吁学术机构制定政策和程序,以管理技术转让活动引起的机构利益冲突(ICOI)。虽然先前的研究已经检查了医学院和大学对ICOI政策的采用,对这些机构在实践中如何处理ICOI知之甚少,阻碍了以证据为基础的建议的发展,以改善ICOI管理。为了解决这个差距,我们对25名负责学术机构研究诚信和利益冲突问题的高级管理人员进行了半结构化采访。使用描述性定性内容分析方法对数据进行分析,结合灵活的编码对面试数据进行索引和密切检查,解释,和编码内容的合成。与会者认为,利益冲突(COI)和技术转让(TT)办公室之间的交流和信息共享是有效管理ICOI的关键因素,并提出了加强这些办公室之间协调的若干战略。这些发现表明,学术研究机构可以通过采取措施改善COI和TT办公室之间的沟通和信息共享来加强COI计划。
    There have been repeated calls for academic institutions to develop policies and procedures to manage institutional conflicts of interest (ICOI) arising from technology transfer activities. While prior research has examined adoption of ICOI policies by medical schools and universities, little is known about how these institutions handle ICOI in practice, hindering the development of evidence-based recommendations to improve ICOI management. To address this gap, we conducted semi-structured interviews with 25 senior administrators responsible for research integrity and conflict of interest issues at academic institutions. Data were analyzed using a descriptive qualitative content analysis approach, combining flexible coding to index the interview data with close examination, interpretation, and synthesis of coded content. Participants identified communication and information sharing between conflict of interest (COI) and technology transfer (TT) offices as a critical factor in the effective management of ICOI and suggested several strategies to strengthen coordination between these offices. These findings suggest that academic research institutions could strengthen COI programs by taking measures to improve communication and information sharing between COI and TT offices.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    目的:评估制药公司向日本循环学会认证的心脏病专家委员会支付个人费用的程度和趋势。
    方法:使用公开数据库数据的回顾性分析研究。
    方法:该研究的重点是向日本的心脏病专家支付费用。
    方法:截至2021年,所有15048名心脏病专家均获得了日本循环学会的董事会认证。
    方法:主要结果是2016-19年度心脏病专家的个人支付程度。次要结果包括对同期这些付款趋势的分析。
    结果:在所有15048名获得董事会认证的心脏病专家中,9858(65.5%)在2016-19年度收到的个人付款总额为112934503美元,涉及165013笔交易。每位心脏病专家的薪酬中位数为2947美元(IQR,$1012-$8787),平均值为11456美元(SD,$35876)。基尼系数为0.840,表明支付给少数心脏病专家的费用高度集中。前1%,5%和10%的心脏病专家接受了31.6%,所有付款的59.4%和73.5%,分别。在研究期间,接受付款的心脏病专家数量或每位心脏病专家的付款数量没有显着趋势。
    结论:在4年的研究期间,超过65%的日本心脏病专家从制药公司获得了个人报酬。尽管大多数心脏病专家的付款金额相对较小,少数心脏病专家收到了绝大多数的付款。
    OBJECTIVE: To evaluate the extent and trends of personal payments from pharmaceutical companies to cardiologists board-certified by the Japanese Circulation Society.
    METHODS: A retrospective analysis study using data from a publicly available database.
    METHODS: The study focused on payments to cardiologists in Japan.
    METHODS: All 15 048 cardiologists who were board-certified by the Japanese Circulation Society as of 2021.
    METHODS: The primary outcome was the extent of personal payments to cardiologists in 2016-19. Secondary outcomes included the analysis of trends in these payments over the same period.
    RESULTS: Of all 15 048 board-certified cardiologists, 9858 (65.5%) received personal payments totaling $112 934 503 entailing 165 013 transactions in 2016-19. The median payment per cardiologist was $2947 (IQR, $1022-$8787), with a mean of $11 456 (SD, $35 876). The Gini Index was 0.840, indicating a high concentration of payments to a small number of cardiologists. The top 1%, 5% and 10% of cardiologists received 31.6%, 59.4% and 73.5% of all payments, respectively. There were no significant trends in the number of cardiologists receiving payments or number of payments per cardiologist during the study period.
    CONCLUSIONS: More than 65% of Japanese cardiologists received personal payments from pharmaceutical companies over the 4-year study period. Although the payment amount was relatively small for the majority of cardiologists, a small number of cardiologists received the vast majority of the payments.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    背景:人们对权力的关注与日俱增,影响力,以及大型全球咨询公司的运营对健康和公平的威胁。总的来说,这些公司支持新自由主义的政策环境,在公共卫生之前促进商业利益。全球咨询公司是健康的商业决定因素,近年来不断发展的研究领域。然而,这项研究主要集中在特定的公司或行业部门,尤其是那些生产有害产品的产品,包括超加工食品,酒精,和化石燃料。因此,重要的是将重点扩大到包括大型全球咨询公司,并将公共卫生和公平视角置于其运营之上。
    方法:全球咨询公司存在广泛的利益冲突。这些源于他们自己的员工与政府和监管机构之间的“旋转门”就业策略。这些公司还就税收和其他事项向政府提供建议,同时向企业客户提供减少税收的方法。他们为化石燃料公司提供建议,同时也为政府提供气候和健康政策方面的建议。这些公司通过将传统的公共部门角色外包给这些私人利益来破坏公共部门的能力。咨询公司通过与高等教育部门的接触来促进私人利益,从而削弱了负责任的大学理事会对大学事务进行透明管理的传统。虽然不能将全球化和先进资本主义相关问题对健康和公平造成的所有负面影响归咎于私人咨询公司,它们在放大它们方面发挥了作用。
    结论:解决全球咨询公司的负面影响将需要加强公共部门,加强透明度,问责制,尽量减少利益冲突。它还需要批判性思维,反话语,和行动主义重新构建支持新自由主义治理思想的叙述,这些思想在政府和商业领域都得到了推广。
    BACKGROUND: Concern is growing over the power, influence, and threats to health and equity from the operations of large global consultancy firms. Collectively, these firms support a neoliberal policy environment promoting business interests ahead of public health. Global consultancy firms act as commercial determinants of health, an evolving area of research over recent years. However, this research mainly focuses on specific corporations or industry sectors, especially those which produce harmful products, including ultra-processed food, alcohol, and fossil fuels. It is therefore important to expand the focus to include large global consultancy firms and place a public health and equity lens over their operations.
    METHODS: Global consultancy firms have wide-ranging conflicts of interest. These arise from the \'revolving door\' employment strategies between their own staff and those from government and regulatory bodies. These firms also advise governments on taxation and other matters while concurrently advising corporate clients on ways to minimise taxation. They advise fossil fuel corporations while also advising governments on climate and health policies. These firms undermine the capabilities of the public sector through the outsourcing of traditional public sector roles to these private interests. Consultancy firms foster private interests through their engagement with the higher education sector, and thereby weaken the tradition of transparent management of university affairs by accountable university councils. While private consultancies cannot be blamed for all the negative consequences for health and equity caused by the problems associated with globalisation and advanced capitalism, they have played a role in amplifying them.
    CONCLUSIONS: Addressing the negative impacts of global consultancy firms will require strengthening the public sector, enforcing greater transparency, accountability, and minimising conflicts of interest. It will also demand critical thought, counter discourses, and activism to reframe the narratives supporting neo-liberal ideas of governance that are promoted in both government and business arenas.
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  • 文章类型: News
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  • 文章类型: Journal Article
    背景:国际医学杂志编辑委员会(ICMJE)发表了《行为建议》,报告,编辑,医学期刊学术工作的出版。这些为撰写和编辑医学文章提供了全球标准,包括研究完整性。然而,没有一项研究检查了日本医学期刊“作者指南”的研究完整性相关内容。因此,我们将ICMJE会员期刊中的研究完整性内容与日本医学科学协会(JAMS)的英语和日语期刊中的研究完整性内容进行了比较。
    方法:这是一项描述性文献研究。截至2021年9月1日,我们从JAMS网站上列出的英语和日语期刊以及ICMJE网站上列出的ICMJE成员期刊获得了作者说明。我们比较了作者说明中20个主题(ICMJE建议中的19个主题加上ICMJE的合规性)的存在,并分析了利益冲突披露的内容。
    结果:我们评估了12种ICMJE会员期刊,以及82种英语和99种日语小组委员会期刊。ICMJE成员期刊涵盖的主题中位数为10.5,英语期刊为10,三个是日语期刊。10家(83%)ICMJE成员期刊提到了ICMJE的合规性,75(91%)英语期刊,和29种(29%)日语期刊。七份(64%)ICMJE成员期刊要求使用ICMJE利益冲突披露表格,15种(18%)英语期刊,和一本(1%)日语杂志。
    结论:尽管JAMS英语期刊中的主题与ICMJE成员期刊中的主题相似,在JAMS日语期刊中,ICMJE相关主题纳入的中位数比ICMJE会员期刊低约1/3.希望利益冲突披露政策与ICMJE标准不同的日语期刊采用国际标准,以遏制不当行为并确保出版物质量。
    BACKGROUND: The International Committee of Medical Journal Editors (ICMJE) has published Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals. These provide a global standard for writing and editing medical articles, including research integrity. However, no study has examined the research integrity-related content of Japanese medical journals\' Instructions for Authors. We therefore compared research integrity content in ICMJE member journals with those in the English- and Japanese-language journals of the Japanese Association of Medical Sciences (JAMS).
    METHODS: This was a descriptive literature study. We obtained Instructions for Authors from English- and Japanese-language journals listed on the JAMS website and the ICMJE member journals listed on the ICMJE website as of September 1, 2021. We compared the presence of 20 topics (19 in the ICMJE Recommendations plus compliance with ICMJE) in the Instructions for Authors, and analyzed the content of the conflict of interest disclosure.
    RESULTS: We evaluated 12 ICMJE member journals, and 82 English-language and 99 Japanese-language subcommittee journals. The median number of topics covered was 10.5 for ICMJE member journals, 10 for English-language journals, and three for Japanese-language journals. Compliance with ICMJE was mentioned by 10 (83%) ICMJE member journals, 75 (91%) English-language journals, and 29 (29%) Japanese-language journals. The ICMJE Conflicts of Interest Disclosure Form was requested by seven (64%) ICMJE member journals, 15 (18%) English-language journals, and one (1%) Japanese-language journal.
    CONCLUSIONS: Although the topics in the JAMS English-language journals resembled those in the ICMJE member journals, the median value of ICMJE-related topic inclusion was approximately one-third lower in JAMS Japanese-language journals than in ICMJE member journals. It is hoped that Japanese-language journals whose conflict of interest disclosure policies differ from ICMJE standards will adopt international standards to deter misconduct and ensure publication quality.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
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