Institutional review boards are getting better at dealing with conflicts of interest, survey shows

Progress has been made in the reporting and management of conflicts of interest among people who serve on the institutional review boards of medical schools and teaching hospitals in the United States, shows a survey published in JAMA Internal Medicine.1

In the past, attention has focused mainly on researchers and their relations with the industry, with little written on the potential conflicts of interest among the members of institutional review boards, which oversee study protocols in academic health centers.

Researchers contacted a random sample of members of institutional reviews boards at the 100 medical schools and 15 independent hospitals that received the most funding from the National Institutes of Health. The final dataset in 2014 included responses from 493 members, and this was compared with the previous survey of 439 members in 2005.

The percentage of board members with a relation to industry of any type did not change significantly from 2005 to 2014 (from 37.2% to 32.1%). But fewer members in 2014 reported being compensated for work with a speakers’ bureau and attending professional events. Members of institutional review boards were more likely in 2014 to report that their board had a formal written definition of what constituted a conflict of interest. And the percentage of board members who believed that another member had not properly disclosed their financial relationships in the past year fell from 10.8% in 2005 to 6.7% in 2014.

The survey also found that the proportion of board members who felt under pressure from their institution or department to approve a protocol they believed was not ready fell from 18.6% in 2005 to 10% in 2014. The proportion of members who believed that another board member had presented a protocol in a biased manner because of their industry relationship fell from 13.5% in 2005 to 8.4% in 2014.

A greater proportion of board members with conflicts of interest reported always disclosing their industry relationships: 80% in 2014, up from 54.9% in 2005. However, the proportion who voted on a protocol with which they had a conflict of interest did not decrease significantly (35.2% in 2005 and 24.9% in 2014). The authors said that this finding was “troubling” and was in violation of federal policy.

“The good news is that during the past decade, significant progress has been made in disclosing and managing conflicts of interest among IRB [institutional review board] members,” the authors wrote. “Nevertheless, there is still work to be done, including educating members about what constitutes a conflict of interest, stopping IRB members with conflicts of interest from voting on protocols with which they have a conflict, and researching bias in the presentation of industry-sponsored protocols.”