1. Managing Conflicts of Interest © 2004-2005 ACCME

2. Three fundamental values 1.The CME industry’s interest in the health and well being of the public is more important then any economic interest. 2.Some economic interests of CME providers, or their agents, are substantial enough to be in conflict with this public interest. 3.If a conflict of interest is present it must be managed in a manner that is in the best interest of the public.

3. Process STANDARD 2:Resolution of Personal Conflicts of interest The provider must have implemented a mechanism to identify and resolve all conflicts of interest prior to the education activity being delivered to learners. Process STANDARD 2:Resolution of Personal Conflicts of interest The provider must have implemented a mechanism to identify and resolve all conflicts of interest prior to the education activity being delivered to learners. The ACCME considers financial relationships to create actual conflicts of interest in CME when individuals have both and 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. 

4. Process STANDARD 2:Resolution of Personal Conflicts of interest The provider must have implemented a mechanism to identify and resolve all conflicts of interest prior to the education activity being delivered to learners. Process STANDARD 2:Resolution of Personal Conflicts of interest The provider must have implemented a mechanism to identify and resolve all conflicts of interest prior to the education activity being delivered to learners. The ACCME considers financial relationships to create actual conflicts of interest in CME when individuals have both and 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.  Any amount … within the past 12 months … Salary Royalty Intellectual property rights Consulting fee Honoraria Ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds) Other financial benefit 

5. Resolving Resolving the conflict means making sure that the content of the activity is aligned with the interests of the public. Alter the relationship … so that the individual no longer has the financial relationship Insert safeguards against bias … when the content is relevant to the commercial interest

6. Resolving Resolving the conflict means making sure that the content of the activity is aligned with the interests of the public. Alter the relationship … so that the individual no longer has the financial relationship Insert safeguards against bias … when the content is relevant to the commercial interest

7. Safeguards against bias … An individual ’ s Role / Assignment Role / Assignment Accountability / Use of external validation Accountability / Use of external validation several ways can be managed in several ways …..when the opportunity to affect content related to the products and services of a commercial interest exists.

8. Providers’ choice of mechanism(s) may be: “ We chose someone else to control that part of the content” “We limited the content to a report without recommendations.” “We had the content of the person’s assignment not relate to the COI.” “We focused the CME activity away from the COI.” Role Assignment “ We utilize ‘peer review’ of CME.” “We asked faculty to limit sources of their recommendations.” “We had oversight and asked faculty to reference the ‘best available evidence’ when making recommendations.” Accountability/ Use of external validation Accountability/ Use of external validation