Health professionals appear concerned about bias in commercially funded continuing medical education

A recent report in Archives of Internal Medicine indicates that while health care practitioners are concerned about the commercial funding of continuing medical education and its potential for bias, many are unwilling to pay higher fees to eliminate or offset commercial funding.

Although the role of pharmaceutical and medical device manufacturers in directing continuing medical education (CME) has been reduced, a Journal of the American Medical Association and Archives Journals press release noted the entities “still fund a substantial proportion of costs.”

This has been met with urging from the Institute of Medicine, the American Association of Medical Colleges and the American Medical Association to further decrease — or even eliminate — commercial support for educational activities, according to the release. However, that could potentially mean the funding costs get shifted to attendees.

“Our two main outcome variables were dichotomized as follows: (1) agreed or strongly agreed that raising the registration fees is an effective way to decrease commercial support vs. not, and (2) agreed or strongly agreed that commercial support for live CME should be eliminated vs. not,” the authors wrote.

Unwillingness to pay

The authors surveyed 1,347 participants at a series of five live CME activities. The survey included questions regarding the impact of commercial support on bias, as well as the participants’ willingness to make up for the lack in funding if commercial support were to be eliminated.

With a reported 57% response rate, the authors found 88% of the 770 respondents believed commercial support introduces bias. More support, these respondents added, would indicate a greater risk of bias. However, the authors also found that only 15% of respondents supported the elimination of CME activity commercial support. Furthermore, 42% of respondents were willing to pay increased registration fees in the interest of helping eliminate or decrease commercial support.

“Participants who perceived bias from commercial support more frequently agreed to increase registration fees to decrease such support,” the authors noted. “Participants greatly underestimated the costs of ancillary activities, such as food, as well as the degree of support actually provided by commercial funding. These results highlight the complexities of eliminating or decreasing commercial support for CME at this time.”

“Given the reality that CME learners underestimate the actual costs of live CME activities, the impact of decreases or changes in funding sources needs to be further clarified, and an understanding of the perceptions of these learners and efforts to better inform these clinicians of the true costs of CME needs to be taken into account in the implementation of any policy change,” they added.

Reference:

Tabas JA, Boscardin C, Jacobsen DM, et al. Clinician attitudes about commercial support of continuing medical education: Results of a detailed survey. Arch Intern Med. 2011;171(9):840-846. doi:10.1001/archinternmed.2011.179.

Disclosure: No relevant financial disclosures were reported.

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