• Commercial Bias: An undue influence promoting the proprietary interests of a Commercial Interest
• Commercial Interest: [From the ACCME] A commercial interest is any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.  (Revised August 2007) The ACCME does not consider providers of clinical service directly to patients to be commercial interests.
• Conflict of Interest (COI): The ACCME considers financial relationships to create actual conflicts of interest in CME when individuals have both a financial relationship with a commercial interest and the opportunity to affect the content of CME about the products or services of that commercial interest.
• Financial Disclosure (FD): The process of providing public access to financial information

• Standards for Commercial Support (SCS): 1) The ACCME Standards for Commercial Support (SCS). 2) Standards to ensure the independence of CME activities from Commercial Interests.

The following information is provided assist with collecting Financial Disclosures, and managing Conflict of Interest to prevent bias.

Tools:

• Financial Disclosure form - A recommended template to use when collecting financial disclosures from planners and faculty.
• Conflict of Interest Resolution and Management form - To be used when someone in a position to influence content has a perceived conflict of interest. [SCS 2.3]
• Faculty letter template - A rough guide to outline initial communications with selected faculty.

Resources:

• AAO policy: Identification and Resolution of Conflicts of Interest. (August, 27, 2010) [SCS1.1, 2.1, 2.2, 2.3]

Regulations:

• ACCME Standards for Commercial Support (SCS)
• CMSS Code for Interactions with Companies

• Societies will commit that their educational activities, scientific programs, products, services and advocacy positions are independent of Company influence, and will develop and adopt policies and procedures that foster independence.

  As an initial signor of the CMSS Code, the American Academy of Ophthalmology abides by the recommendations herein. Principles for interaction begin on page 11.

 Study conducted by Jean K. Cornish, Rph; and James C. Leist, EdD, FACME (see suggested reading for more in-depth analysis)

• Focusing on 1 agent, device, or procedure when others exist
• Not providing a balanced presentation of the benefits and adverse effects for all agents, methods, or procedures in an activity
• Most of the faculty have relationships with the grantor sponsoring the activity
• References to inappropriate studies (promotional, bad design, etc.)
• Inconsistent use of brand names
• Misleading title
• Lack of appropriate scientific references
• Misleading learning objectives
• Misleading overview statement
• Endorsement of a particular product or practice by a respected and well-known expert in the field

• If content will focus on only one agent, device, or procedure, acknowledge competing options and explain how & why they fall outside of this activity.
• Have policies in place not only for the collection of financial disclosures, but for review of the submitted forms: Review these materials relevant to the content of the activity, and any commercial supporters providing resources to the activity. [SCS 1.1, 2.1, 2.2, 2.3, 6.1, 6.2, 6.5]
• The person completing a financial disclosure does not get to determine if a relationship is 'relevant'. A determination of 'relevancy' is made by the reviewer(s).[SCS 2.1, 2.2, 2.3, 6.1, 6.2, 6.4]
• Relevant disclosures must be made to learners prior to the start of the activity. [SCS 6.1, 6.2, 6.5] This is often accomplished by publishing disclosures in activity-accompanying material, and listing relationships on the first slide of presentations.

Conflict of Interest in Medical Research, Education, and Practice. Institute of Medicine Report. 2009, April

Drug Companies & Doctors: A Story of Corruption, by Marcia Angell 

Cornish, J. K. and Leist, J. C. (2006), What constitutes commercial bias compared with the personal opinion of experts?. Journal of Continuing Education in the Health Professions, 26: 161–167. doi: 10.1002/chp.64