Don’t avoid research bias. Manage it

Phil Cola

Phil Cola

CLEVELAND, Ohio — University Hospitals Vice President Phil Cola thinks it’s an institution’s job — not a researcher’s — to worry about conflicts of interest.

A new study from the University of Michigan found that results from random cancer trials in top medical journals were more likely to favor industry when the industry funded the study. Plus, 29 percent of all cancer research published in the journals — the top five oncology publications and top three general medical journals — disclosed a conflict of interest. The most common conflict (17 percent) was industry funding, while 12 percent of papers included an author who was also an industry employee.

The study’s author suggests disclosure of conflicts isn’t enough and it’s time to take less money from industry sources.

But it is naive to think you can eliminate every bias, said Cola, UH’s vice president for research and technology management and a member of Case Western Reserve University’s Outside Interest Committee who helps manage that school’s new conflicts policy.

Below, he discusses efforts to manage ties to industry and other pressures research projects face.

Q. How does industry funding create bias in research?
A. Industry funding alone is not enough to be a conflict of interest. A conflict involves the combination of the researcher working (privately consulting or educating) for the funding industry while conducting the research.

Q. Why is industry funding important?
A. Imagine you or someone in your family has cancer. Wouldn’t you want all of the money available to fund research to help you or your loved one. Industry funding is a major source of capital. It would simply be a disservice to patients to refuse industry funds. Funding from all sources has the potential to bias – managing the bias is the key.

Q. What is an example of bias in other funding sources?
A. Say for example a cardiac doctor that is on the board of the American Heart Association is also conducting heart research utilizing funds from the AHA. The National Institute of Health (NIH) contracts grant reviewers. These are senior level professors and research conductors –- some of the best in their fields — who could be researching their expertise using funding from the NIH.

Q. How can the bias be mitigated?
A. The money is given to the institution – not the researcher. It’s the academic institution or medical center’s responsibility to manage the relationship between the researcher and the funding source. Developing a consistent, national system to better monitor the relationship is key. The method of disclosing biases should be similar at Yale and Case Western Reserve University, for example.

Q. What steps should the institution follow to manage potential bias?
A. Don’t allow the physician with the research idea lead the study, don’t allow the physician to chose the participating patients, don’t allow researchers to analyze the data for publication and don’t allow them to publish the data. The most important way to deal with potential biases is to disclose any conflict of interest up front. Disclosure is the most important.

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