We are once again gearing up for our annual SOBP meeting, this year in Super Bowl City, NY, NY. Hopefully, by the time of our meeting it will have warmed up a bit.   In this issue you will find many of the pertinent details to help you plan for your meeting.  Meeting registration and hotel reservations are now open.  Remember, if you can make it there, you can make it anywhere!

Also in this issue, I'm please to introduce Dr. Caleb Adler, one of our newsletter editorial board members and senior faculty at the University of Cincinnati. Cal serves on our university conflict of interest committee and has been carefully thinking about how to best manage COI without completely abandoning important industry/university relationships. Consequently, I am pleased to turn over the editorial page to his thoughts and would ask you to please consider responding to initiate a discussion in this important area.

Best Wishes

UC Health Vice President for Research

Professor and Chair, Department of Psychiatry & Behavioral Neuroscience       

       Those are lines from the website of the Committee on Ethics for the U.S. House of Representatives, one of the most powerful legislative bodies in the world, describing their view that potential conflicts-of-interest are inevitable and to a degree, acceptable. Concern with conflicts-of-interest has reached something of a fever pitch over the past decade and touched most neuroscientists to at least some degree. Of course we're not subject to congressional ethics rules; rather, we're bound by conflict-of-interest regulations promulgated by our individual academic institutions. So unlike my local congressman, I can't accept a pen that says "Zyprexa."
       Most universities maintain staff devoted to monitoring and limiting potential conflicts, while university conflict-of-interest committees rigorously enforce policies often designed to go well beyond preventing actual conflict to encompass even the "perception" of conflict-of-interest. Unfortunately, perceived conflict has followed the path trod by "dignity" in ethics; a reasonable-sounding notion that, as Ruth Macklin observed in 2003, is so vague on closer examination as to be a "useless concept" in application. Whose perception is relevant, that of colleagues, the general public, an anonymous blogger in Wisconsin?
       As a member of our university conflict of interest committee I'm certainly aware that efforts to address real conflict are necessary -- to a point. There is no question that investigators may benefit materially from certain research outcomes, and there have been several high profile incidents over the past few years in which data were found to have been faked. Few if any of those cases though, would have been prevented by the kind of conflict-of-interest regulations that have been put into place by many institutions. The pay-off to offending investigators was not a quid pro quo from a specific institution or corporation, it came in the form of academic advancement and access to research money-the coin of the realm for most academic researchers. Typical university regulations cannot police investigators determined to commit research fraud; instead, many institutions appear to operate with an implicit assumption that all investigators are only a few extra dollars away from bias.
       When questioned, the keepers of the regulatory flame point to a body of research suggesting that physicians can be influenced clinically by a cheap tchotchke, or free lunch; the inference being that bias can be unconscious and subvert even strongly held values. Putting aside the observation that these clinical findings are not necessarily applicable to a research setting, and eschewing the easy dig at the relative venality of physicians compared with PhD investigators, the studies on which this assertion is based rarely stand much scrutiny. Minor inducements, like a pharmaceutically-labeled pen that were found to influence purely theoretical prescriptive decisions by medical trainees are much less likely to influence clinicians with actual experience prescribing the relevant medications. Another study, describing increased use of a complicated medication regimen by physicians who attended a free weekend conference, didn't address the possibility that the training received might have driven the increase rather than gratitude for the getaway. In the aggregate, these often limited studies have created an echo chamber in which calls for more "action" put pressure on university conflict management departments to guard against increasingly implausible sources of bias.
       These efforts are not without consequence. Overly stringent limitations on investigators' interaction with industry have the potential to hamper important industry-academic collaborations. Given the straitened financial circumstances of granting agencies, industry funding has become increasingly important, and academic consultants can help steer research efforts in directions with the most promise for both the company and our patients. Even the much maligned speakers' bureaus can help promote contact with industry liaisons while giving community prescribers access to prominent clinician-researchers. Potential conflicts-of-interest are certainly real, and neuroscience researchers have a responsibility to the sources of our funding and to the public at large to ensure that the work we do always reflects the highest standards of probity. Punishment for those who tarnish the reputation of our field is essential, as are efforts to keep research methodologies transparent; I've met few investigators who don't agree that "sunlight is...the best of disinfectants." Nonetheless, we will not improve either our reputation or the quality of our research by acquiescing to the canard that we can be bought for a pen.

 
Caleb M. Adler, MD
Professor of Psychiatry and Behavioral Neuroscience
Co-Director of the Division of Bipolar Disorders Research

Disclaimer:  The opinions expressed in these editorials are those of the individual authors and do not necessarily reflect the position of the Society of Biological Psychiatry, its officers, or members.  The Society does not accept money from commercial sources, other than our business partners.