Medical conflicts of interest: when a declaration isn't enough

Should a doctor with a commercial interest in a new technology be allowed to lead research trials of the same product? Should researchers with extensive financial interests also be disqualified from parts of the study?

One NHS trust to confront these questions is Great Ormond Street Hospital in London. With Brexit looming and the UK looking increasingly to capitalise on research innovation in the health sector, the hospital has turned to the US for inspiration and updated its policies.

Although investigators are required to declare conflicts related to their research, the emphasis has traditionally been on transparency rather than the management of those conflicts.1

In what is thought to be a UK first, Great Ormond Street’s policy excludes people with a “significant” investment in the product from being in charge of relevant product evaluation. This investment might include holding the patent of the technology or having a stake in the company developing the technology. Any individual with a financial conflict of interest may also be excluded from certain parts of the research process.2

These have been “red lines in the sand,” in the US for a long time, and the UK is now taking notice, says David Goldblatt, the hospital’s director of clinical research and development.

“There is so much emphasis now in the NHS on innovation, we need to make sure that our policies are fit for purpose in relation to protecting patients and staff,” says Goldblatt.

There is a tension, he says, between academic contributions and innovation, and universities have tended to take a liberal approach, giving academics a lot of autonomy. Academic clinicians also need research publications …