Comparison of conflict of interest policies and reported practices in academic medical centers in the United States

The authors reviewed the conflict of interest policies of 9 academic medical centers in the United States and interviewed members of the Institutional Review Boards (IRBs) and Conflict of Interest Committees (COICs) at those institutions. They found that many institutions used processes for reporting and managing conflicts of interest that were more decentralized than the processes described in their policies. Also, most institutions had no clear and comprehensive policy to guide investigators regarding disclosure of conflicts of interest to potential research participants. Considerable differences in understanding of conflict of interest policies were observed between IRB and COIC officials.     

Conflict of Interest Policies and Industry Relationships of Guideline Development Group Members: A Cross-Sectional Study of Clinical Practice Guidelines for Depression

Because of increased attention to the issue of trustworthiness of clinical practice guidelines, it may be that both transparency and management of industry associations of guideline development groups (GDGs) have improved. The purpose of the present study was to assess a) the disclosure requirements of GDGs in a cross-section of guidelines for major depression; and, b) the extent and type of conflicts of panel members. Treatment guidelines for major depression were identified and searched for conflict of interest policies and disclosure statements. Multi-modal screens for undeclared conflicts were also conducted. Fourteen guidelines with a total of 172 panel members were included in the analysis. Eleven of the 14 guidelines (78%) had a stated conflict of interest policy or disclosure statement, although the policies varied widely. Most (57%) of the guidelines were developed by panels that had members with industry financial ties to drug companies that manufacture antidepressant medication. However, only a minority of total panel members (18%) had such conflicts of interest. Drug company speakers bureau participation was the most common type of conflict. Although some progress has been made, organizations that develop guidelines should continue to work toward greater transparency and minimization of financial conflicts of interest.     

COI Policies: Tax Dollars Should Not Be Used to Fund U.S. Institutions Not Making the Grade

Over two billion dollars was awarded by the U.S. Department of Health and Human Services (HHS) in research funding from 2010 to March 2012 to institutions receiving a grade of “C,” “D,” or “F” on their conflict of interest policies, as determined by the American Medical Student Association's scorecard on conflict of interest policies. More institutional oversight is needed with regard to assuring conflict of interest policies at U.S. research institutions are adequate. As stewards of public funds, HHS should require a minimum standard which institutional conflict of interest policies should meet, beyond current regulatory requirements, before granting funding.     

COI Policies: Tax Dollars Should Not Be Used to Fund U.S. Institutions Not Making the Grade

Over two billion dollars was awarded by the U.S. Department of Health and Human Services (HHS) in research funding from 2010 to March 2012 to institutions receiving a grade of "C," "D," or "F" on their conflict of interest policies, as determined by the American Medical Student Association's scorecard on conflict of interest policies. More institutional oversight is needed with regard to assuring conflict of interest policies at U.S. research institutions are adequate. As stewards of public funds, HHS should require a minimum standard which institutional conflict of interest policies should meet, beyond current regulatory requirements, before granting funding.     

Conflicts of interest in academic research: policies, processes, and attitudes

Few studies have examined academic researchers' understandings or attitudes toward conflict of interest policies even though these understandings and attitudes represent a crucial component of both compliance and educational efforts. This study reports the results of a large-scale, cross-sectional survey of research faculty at the nine campuses of the University of California regarding their understandings of and attitudes toward campus conflict of interest policies. We gathered information on their general assessments of investigators with financial ties to industry sponsors and reactions to the process of implementing conflict of interest policies at their respective campuses. We surveyed 1,971 faculty members from the nine-campus University of California system and had 779 responses (39% response rate). The sampled faculty were in the ten departments with the most number of financial disclosures at each campus. We utilized the WebSurveyor software to create a secure, online, 21-item survey. Our study reveals faculty with complex, sometimes contradictory, feelings about academic-industry relationships and highlights perceived gaps in policy and process. Most respondents were concerned about unlimited financial relationships, but a sizable number also viewed campus policies as irrelevant. Some expressed considerable anger over the process of policy implementation, rejecting the policies on the basis of professional and individual self-determination and moral integrity. Our study suggests the need for renewed efforts to encourage awareness of the relevance of conflict of interest policies for all faculty, new efforts to increase understanding of the situational nature of conflicts of interest, and reexamination of the processes of policy implementation at the campus level.     

Conflicts of Interest in Academic Research: Policies,Processes, and Attitudes

Few studies have examined academic researchers' understandings of or attitudes toward conflict of interest policies even though these understandings and attitudes represent a crucial component of both compliance and educational efforts. This study reports the results of a large-scale, cross-sectional survey of research faculty at the nine campuses of the University of California regarding their understandings of and attitudes toward campus conflict of interest policies. We gathered information on their general assessments of investigators with financial ties to industry sponsors and reactions to the process of implementing conflict of interest policies at their respective campuses. We surveyed 1,971 faculty members from the nine-campus University of California system and had 779 responses (39% response rate). The sampled faculty were in the ten departments with the most number of financial disclosures at each campus. We utilized the WebSurveyor software to create a secure, online, 21-item survey. Our study reveals faculty with complex, sometimes contradictory, feelings about academic-industry relationships and highlights perceived gaps in policy and process. Most respondents were concerned about unlimited financial relationships, but a sizable number also viewed campus policies as irrelevant. Some expressed considerable anger over the process of policy implementation, rejecting the policies on the basis of professional and individual self-determination and moral integrity. Our study suggests the need for renewed efforts to encourage awareness of the relevance of conflict of interest policies for all faculty, new efforts to increase understanding of the situational nature of conflicts of interest, and a reexamination of the processes of policy implementation at the campus level.     

Attempts to redefine conflicts of interest

The traditional legal concept of conflict of interest is a practical tool to regulate conduct. In recent years several medical authors have defined conflicts of interest in ways that stray from its original legal meaning. The new definitions cause conceptual confusion and will result in policies that cannot be implemented effectively. We should not follow recent attempts to redefine conflicts of interest because doing so deviates from the legal concept and will lead to deregulation of financial conflicts and overregulation of so-called intellectual conflicts.     

An International Study of Research Misconduct Policies

Research misconduct is an international concern. Misconduct policies can play a crucial role in preventing and policing research misconduct, and many institutions have developed their own policies. While institutional policies play a key role in preventing and policing misconduct, national policies are also important to ensure consistent promulgation and enforcement of ethical standards. The purpose of this study was to obtain more information about research misconduct policies across the globe. We found that twenty-two of the top forty research and development funding countries (55%) had a national misconduct policy. Four countries (18.2%) are in the process of developing a policy, and four (18.2%) have a national research ethics code but no misconduct policy. All twenty-two countries (100%) with national policies included fabrication, falsification, and plagiarism in the definition of misconduct, but beyond that there was considerable diversity. Unethical authorship was mentioned in 54.6% of the misconduct definitions, followed by unethical publication practices (36.4%), conflict of interest mismanagement (36.4%), unethical peer review (31.8%), misconduct related to misconduct investigations (27.3%), poor record keeping (27.3%), other deception (27.3%), serious deviations (22.7%), violating confidentiality (22.7%), and human or animal research violations (22.7%). Having a national policy was positively associated with research and development funding ranking and intensiveness. To promote integrity in international research collaborations, countries should seek to harmonize and clarify misconduct definitions and develop procedures for adjudicating conflicts when harmonization does not occur.     

Policy Stable States in the Graph Model for Conflict Resolution

A new approach to policy analysis is formulated within the framework of the graph model for conflict resolution. A policy is defined as a plan of action for a decision maker (DM) that specifies the DM’s intended action starting at every possible state in a graph model of a conflict. Given a profile of policies, a Policy Stable State (PSS) is a state that no DM moves away from (according to its policy), and such that no DM would prefer to change its policy given the policies of the other DMs. The profile of policies associated to a PSS is called a Policy Equilibrium. Properties of PSSs are developed, and a refinement is suggested that restricts DMs to policies that are credible in that they are in the DM’s immediate interest. Relationships with existing stability definitions in the graph model for conflict resolution are then explored.     

Ten Steps to Developing a National Agenda to Address Financial Conflicts of Interest in Industry Sponsored Clinical Research

Financial liaisons between clinical researchers, research institutions, and industrial sponsors have gained momentum in recent years. In the process, it has been argued by many that trust in the research infrastructure is being eroded by the financial conflicts of interest that emerge from these arrangements. Yet, the financial resources of industry are needed to continue technology transfer from the bench to the bedside. Policy makers and government regulators are currently struggling to determine how to best manage financial conflicts of interest that emerge from these liaisons. Various organizations and governmental entities have proposed different strategies. This paper explores the limitations of existing measures and recommends that a unified national agenda is needed. We propose 10 steps to develop an agenda to address financial conflicts of interest in industry-sponsored clinical research.     

Ten steps to developing a national agenda to address financial conflicts of interest in industry sponsored clinical research

Financial liaisons between clinical researchers, research institutions, and industrial sponsors have gained momentum in recent years. In the process, it has been argued by many that trust in the research infrastructure is being eroded by the financial conflicts of interest that emerge from these arrangements. Yet, the financial resources of industry are needed to continue technology transfer from the bench to the bedside. Policy makers and government regulators are currently struggling to determine how to best manage financial conflicts of interest that emerge from these liaisons. Various organizations and government entities have proposed different strategies. This paper explores the limitations of existing measures and recommends that a unified national agenda is needed. We propose 10 steps to develop an agenda to address financial conflicts of interest in industry-sponsored clinical research.     

Playing with conflict: a longitudinal study of varieties of spontaneous verbal conflict during mother-child interaction at home

Although conflict is central to major developmental theories, relatively little is known about the ways in which young children and caregivers argue at home. The existing psychological research focuses narrowly on serious, ‘problem-solving’ conflicts. In contrast, this in-depth longitudinal study describes varieties of spontaneous conflict talk occurring at home between nine middle-class Caucasian American mothers and their 2- to 4-year-old children. All dyads produced conflicts with nonse-rious, imaginary and/or ritual markings for a mean of 31% (± 2.8%) of all mother-child conflicts. Overall, most mother-child marked conflicts were nonserious, but the percentage of marked conflicts that were imaginary increased with age. Mothers used marked conflicts to manage ongoing problematic interactions with their children, while children apparently introduced marked conflicts primarily during play. Available data on child-child conflicts showed that some of these conflicts also were marked and were introduced primarily during play. Implications for how varieties of conflict may contribute to social competence within the family and peer group are discussed.     

Differing Domains of Actual Sibling Conflict Discussions and Associations with Conflict Styles and Relationship Quality

Four types of sibling conflict were identified in actual adolescent sibling discussions: equality and fairness, invasion of the personal domain, intrinsic harm, and relationships. Older [M = 14.97, standard deviation (SD) = 1.69 years] and younger siblings (M = 12.20, SD = 1.90 years) from 144 dyads discussed conflicts during a semi‐structured conflict task. Trained observers coded the topics discussed, and separate observers rated their conflict styles, whereas siblings rated their relationship quality. The proportion of conflicts of each domain differed by dyadic gender composition. Equality and fairness conflicts (and invasion of the personal domain conflicts for sister–sister pairs) were discussed the most frequently whereas intrinsic harm conflicts were associated with destructive conflict styles. Siblings' discussions of conflicts involving intrinsic harm were associated with older siblings' reports of negative relationship quality. The associations between these conflict topics and negative relationship quality were mediated by the siblings discussing the conflicts in destructive ways.     

Safe Harbors or Free Frontiers? Privacy and Transborder Data Flows

This article explores the issues surrounding the harmonization of privacy or data protection during the last 30 years. It begins with a history of the conflict over transborder data flows and then proceeds to analyze current national and regional policy debates about the feasibility of policy solutions to address problems that are integral to global communications and economic networks. Ongoing discussions between the European Union and the United States over Safe Harbor Principles provide data for exploring these issues. The article concludes with an analysis of whether harmonization of privacy and data protection policies is likely to evolve through existing processes and institutions .     

Reported Peer Conflicts of Children in the United States and Indonesia

U.S. and Indonesian 9‐ to 11‐year‐old children (N=147) reported on multiple occasions conflicts that they experienced with peers. The precursors of conflict, behavior during conflict episodes, and resolutions were coded. Teacher ratings of aggression and social preference were obtained. The conflicts of children in both countries most often occurred between friends, were short, amicably settled, and solved without aggression. Indonesian children reported disengaging from conflict more often than did U.S. children, whereas U.S. children more frequently reported using negotiation. Reports of aggression during conflict were associated with U.S. and Indonesian children's teacher‐rated aggression, whereas reports of disengagement were associated with Indonesian children's teacher‐rated social preference and aggression.     

How We Can Promote Behavior That Serves All of Us in the Future

The health and vitality of relationships, groups, and society at large is strongly challenged by social dilemmas or conflicts between short-term self-interest and long-term collective interest. Pollution, depletion of natural resources, and intergroup conflict can be characterized as examples of urgent social dilemmas. This article advances a conceptual framework in which we analyze social dilemmas in terms of social and temporal concerns relevant to the social (individual vs. collective) and temporal (short-term vs. long-term) conflicts underlying social dilemmas. We discuss the plasticity of social orientations (altruism, cooperation, egalitarianism, individualism, competition, aggression) and temporal orientations (short-term orientation, future orientation), and illustrate their "logical effects" and "paradoxical effects" on behavior that supports collectively desired outcomes. This analysis enables us to suggest a set of novel recommendations for policy and intervention to help solve various social dilemmas in contemporary society.     

Conflict of interest reporting in biomedical journals published in China

This study aimed to investigate the current status and policy of Conflict of interest (COI) reporting in biomedical journals in China. Thirty Chinese-language medical journals and 37 English-language biomedical journals indexed by Journal Citation Reports categories were included into this study. These 67 journals were all published in China. All articles published in the most recent two issues were checked for identifying the disclosure statement in the text or not. Twenty-one of 30 (70%) Chinese-language journals required a disclosure of author’s potential COI. No journals require editors or referees to disclose the conflicts of interest to the readers. In total, 1,212 publications in Chinese-language were evaluated. Only two journals reported COI in their publications. For the 37 English-language journals, 32 (86.5%) required author’s potential COI disclosure, and four of them required only research articles or original articles to disclose COI. A total of 1,170 publications were evaluated. Among them, 50% editorials, 79.3% review articles, and 73.6% original articles reported presence or absence of COI. In our studied journals, the percentage of the policies requiring author COI disclosure is still low. Biomedical journals published in China should enforce COI disclosure policies to authors, editors, and referees.     

Dynamics of Young Children's Socially Adaptive Resolutions of Peer Conflict

How do young children negotiate conflicts with peers that result in mutually beneficial resolution and peaceful interaction after conflict? A few studies suggest that when children use conciliatory strategies in conflict, socially adaptive outcomes are more likely to be achieved. The present study explores the relative associations of types of children's conciliatory conflict resolution strategies (i.e., prosocial, compliance‐oriented, solution‐oriented, and verbal clarification/apology) with conflict outcomes to contribute to knowledge of the discrete behaviors that might have salience for conflict resolution training. Socially adaptive conflict outcomes were expected to strongly relate to children's resolution strategies of a prosocial nature as well as to teacher or peer interventions encouraging prosocial behavior or empathy. Sampled conflicts (N = 521) were collected through field observations of 107 ethnically/racially and socioeconomically diverse four‐ to seven‐year‐old children. Logistic regression analyses with bootstrap‐based inference suggested that children's prosocial behaviors in conflict were most strongly tied to mutually beneficial resolution and peaceful postconflict interaction, when controlling for relevant covariates. Other conciliatory strategies varied in their association with socially adaptive outcomes. The hypothesis regarding third‐party interventions encouraging prosociability or empathy could not be examined due to infrequent occurrence. Insights for future research on children's socially adaptive conflict negotiations are discussed.     

Stages of change and engagement in a family intervention

Prochaska and DiClemente's stages of change model facilitate understanding of engagement difficulties in psychosocial intervention processes. We assessed the link between stages of family change and intervention dropout in a sample of 141 families with relational conflicts between parents and adolescent children. Each family member's stage of change was defined according to three criteria: seeing the conflict as a relational problem, assuming part of the responsibility for the dysfunctional relationship, and understanding one's own mental and emotional states and those of the other family members involved in the conflict (mentalization). Our dropout rate for the sample was 41.8% and was higher for immigrant families. We found a strong association between engagement and the contemplation stage of change, particularly the mother's. In family conflict interventions, participation of all the family members is essential so as raise awareness of the relational aspects of the conflict and the shared responsibility for the conflict and its resolution.     

Affective Qualities of Sibling Disputes, Mothers' Conflict Attitudes, and Children's Theory of Mind Development

Preschoolers' theory of mind (ToM) was examined in relation to emotional features of their conflicts with siblings, using mothers as privileged informants. Fifty-four children aged 3 to 5 years and their 54 mothers took part. Children were given 10 standard false belief tasks and a standardized language test. Mothers completed questionnaires, rated vignettes, and kept a conflict diary to provide detailed data on siblings' conflicts, mothers' conflict attitudes, and mothers' use of mental state language to talk about children's disputes. Results revealed that children's ToM scores were significantly correlated with affective dimensions of their sibling disputes, including more frequent expression of positive emotion while disagreeing and less post-conflict distress. Logistic regression showed these associations were independent of age and verbal ability. Mothers' conflict attitudes were significantly correlated with the affective outcome of their children's disputes but not with the preschooler's level of ToM understanding. Findings are discussed in relation to possible reciprocal influences between ToM development and the growth of affectively positive and constructive conflict resolution skills.