Abstract
Background
Professional medical associations (PMAs) have an essential role in advancing medical care and health. PMAs promote skills training, clinical standards, and other important educational activities. Most often, PMAs are not-for-profit entities that rely upon funding from industry to help cover the costs of these valuable activities. Equally important, innovation and progress in surgery require physician collaboration with industry throughout the product development process. SAGES has opined that, with appropriate Conflict of Interest (COI) disclosure and management processes, PMA educational activities can be both scientifically and ethically sound.
Methods
SAGES has developed and implemented comprehensive and stringent processes for managing potential COI within the organization, at the annual meeting, and in developing educational offerings. This document reviews the SAGES COI processes and results 2009–2021.
Results
Implementation of the SAGES COI disclosure and management processes reduced the reported perceived incidence of bias at the annual meeting from 4.4–6.2% (2008–2010) to 1.2–2.2% (2011–2013). Recent comparison of reported disclosures revealed a rise in number of speakers with financial relationships and an increase in reporting of disclosures in presentations without an associated increase in need for conflict resolution by the COI committee. Despite good overall adherence to COI policies, SAGES was recently cited for non-compliance with ACCME standards related to inclusion of faculty with ownership interest. This experience highlighted the potential for discordance in the interpretation of whether disclosures relate to specific CME content. SAGES COI processes have since been updated to reflect the more stringent 2020 ACCME Standards that exclude speakers and planners with ownership interest from any CME activity.
Conclusions
The SAGES experience with disclosure and mitigation of financial relationships highlights the challenges of validating the accuracy of physician disclosures and establishing the relevance of financial relationships to the content of accredited educational activities. SAGES will continue to streamline its COI disclosure process with specific focus on aligning all financial disclosures among the various reporting platforms.
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Acknowledgements
The authors gratefully acknowledge Prashant Sinha, Alex Lois, Brendan Marr, Matt B. Martin, Grace Montenegro, Dang-Tuan Pham, Jenny Shao, Ketan Sheth, Arianne Train, and Yulia Zak (SAGES COI Committee); Liane Feldman, Jeff Marks, John Mellinger, and Christopher Schlachta (SAGES Executive Committee); and Sallie Matthews (SAGES Executive Director).
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Co-first authors, who contributed equally: PS and PS; Conceptualization and drafting of manuscript: PS, ES, PS; Editing of manuscript: All authors.
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P Shadduck discloses consulting fees from Asensus Surgical and Focal Medical Inc; consulting fees, research support, and speaker fees from Heron Therapeutics; and consulting fees and Advisory Board honoraria from Medcura Inc. P Sylla discloses consulting fees from Medtronic, Ethicon, Olympus, Safeheal, Stryker, ColubrisMS, and GI Windows. H Asbun discloses consulting fees from Boston Scientific, Johnson & Johnson, and Olympus; honoraria from Boston Scientific and Stryker; and non-paid leadership role with SAGES, consulting fees from Focal Medical Inc. A Pryor discloses consulting fees from Ethicon; honoraria for speaking/teaching from Gore, Medtronic, and Stryker; meeting support from Intuitive; and leadership roles with SAGES, Fellowship Council, NY ASMBS, ACS ELI Chapter, and WLISS. E Schwarz, P Denk, C Reinke, and S Ginsberg have no conflicts of interest or financial ties to disclose.
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Shadduck, P., Sylla, P., Schwarz, E. et al. SAGES perspective: professional medical associations, commercial interests, and conflicts of interest. Surg Endosc 37, 2517–2527 (2023). https://doi.org/10.1007/s00464-023-09897-9
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DOI: https://doi.org/10.1007/s00464-023-09897-9