Mapping conflict of interests: Scoping review Review


Authors: Chimonas, S.; Mamoor, M.; Zimbalist, S. A.; Barrow, B.; Bach, P. B.; Korenstein, D.
Review Title: Mapping conflict of interests: Scoping review
Abstract: Objective To identify all known ties between the medical product industry and the healthcare ecosystem. Design Scoping review. Methods From initial literature searches and expert input, a map was created to show the network of medical product industry ties across parties and activities in the healthcare ecosystem. Through a scoping review, the ties were then verified, cataloged, and characterized, with data abstracted on types of industry ties (financial, non-financial), applicable policies for conflict of interests, and publicly available data sources. Main outcome measures Presence and types of medical product industry ties to activities and parties, presence of policies for conflict of interests, and publicly available data. Results A map derived through synthesis of 538 articles from 37 countries shows an extensive network of medical product industry ties to activities and parties in the healthcare ecosystem. Key activities include research, healthcare education, guideline development, formulary selection, and clinical care. Parties include non-profit entities, the healthcare profession, the market supply chain, and government. The medical product industry has direct ties to all parties and some activities through multiple pathways; direct ties extend through interrelationships among parties and activities. The most frequently identified parties were within the healthcare profession, with individual professionals described in 422 (78%) of the included studies. More than half (303, 56%) of the publications documented medical product industry ties to research, with clinical care (156, 29%), health professional education (145, 27%), guideline development (33, 6%), and formulary selection (8, 1%) appearing less often. Policies for conflict of interests exist for some financial and a few non-financial ties; publicly available data sources seldom describe or quantify these ties. Conclusions An extensive network of medical product industry ties to activities and parties exists in the healthcare ecosystem. Policies for conflict of interests and publicly available data are lacking, suggesting that enhanced oversight and transparency are needed to protect patient care from commercial influence and to ensure public trust. ©
Keywords: adult; outcome assessment; government; occupation; patient care; health practitioner; education; synthesis; conflict of interest; trust; ecosystem; human; article
Journal Title: BMJ: British Medical Journal (International Edition)
Volume: 375
ISSN: 0959-8146
Publisher: BMJ Publishing Group Ltd.  
Date Published: 2021-11-03
Start Page: e066576
Language: English
DOI: 10.1136/bmj-2021-066576
PROVIDER: scopus
PMCID: PMC8565086
PUBMED: 34732464
DOI/URL:
Notes: Article -- Export Date: 1 December 2021 -- Source: Scopus
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  1. Peter Bach
    255 Bach
  2. Maha Mamoor
    15 Mamoor