填空题 The best way to calm down concerns about doctors' and researchers' financial conflicts of interest is to require full disclosure, according to an expert report that adds its voice to a growing chorus. A panel of the National Academies' Institute of Medicine (IOM) says faculty members at medical institutions should be required to report all industry money they receive from outside their institution to special committees.
{{U}} {{U}} 1 {{/U}} {{/U}}But IOM's mostly voluntary plan has an important selling point, some say: It could head off more-intrusive federal regulations. Panel members agreed that some action is called for. "Many relationships between researchers and industry are very constructive, but it has to be overseen and kept in bounds," says panel chair Bernard Lo, a bioethicist at the University of California, San Francisco.
{{U}} {{U}} 2 {{/U}} {{/U}}Similar concerns resulted in a ban on all such payments to scientists at National Institutes of Health, Lo notes. More recently, as part of an ongoing investigation, Senator Chuck Grassley has identified several psychiatrists who allegedly failed to disclose hundreds of thousands of dollars in consulting income.
Disclosure is "a critical but limited first step" toward addressing conflicts of interest, the IOM panel concludes. {{U}} {{U}} 3 {{/U}} {{/U}}Companies should also disclose money given to institutions, scientific societies, patient groups, and basic researchers, the report says, because their work can lead to clinical trials.
Three of the 17 panel members recommended that physicians and researchers themselves also be required to publicly report their financial ties with companies, including stock.{{U}} {{U}} 4 {{/U}} {{/U}}
As a rule, the report says, institutions should ensure that if a significant conflict exists, a researcher "may not conduct research with human participants" unless his or her role is essential to the research.{{U}} {{U}} 5 {{/U}} {{/U}}
Many of these steps have been recommended in past reports from the Association of American Medical Colleges (AAMC), which has also endorsed the company payments database. But not all schools have followed AAMC's advice. "We give a pretty clear warning," Lo says. "If the institutions don't get their act together, they're really inviting the legislators to step in."
A. It urges research and physician organizations to develop a standard reporting format. And it endorses a proposal similar to one from Grassley to require that drug and device companies report payments to physicians in a public database.
B. That, he warns, could lead to "very, very blunt" regulations and "a risk that valuable relationships will be cut in ways that will hurt patients."
C. The policy recommended by IOM would be far more intrusive than current U.S. rules, which require National Institutes of Health grantees to report to their own institutions outside income of more than ＄10,000 per year.
D. The report also recormnends that institutions ban faculty members from accepting drug company gifts, serving as a spokesperson for a company, and authoring articles ghost-written by industry.
E. Such payments would also have to be reported publicly by the companies.
F. But the others disagreed partly because they felt it would be expensive, could intrude on privacy, and would not add much to the company database.
G. IOM decided to undertake the study two years ago amid growing concerns that academic researchers who took drug company payments were withholding data from publication or otherwise biasing results.