Where is the Beef?
This is the question that was answered by a study commissioned by the Accreditation Council for Continuing Medical Education (ACCME): The Relationship between Commercial Support and Bias in Continuing Medical Education Activities: A Review of the Literature to determine if there is bias in commercially supported CME and what does that mean for patient care.
The study was conducted by:
Researchers in the Department of Lifelong Education, Administration, and Policy at The University of Georgia.
The answer was a resounding We have no evidence here to support the claims that that industry support of CME produces bias and that patients are in any way harmed.
We searched Medline, LexisNexis, and Business Source Complete databases with very general terms of “education” and “industry or commercial” and “influence or support”. Our literature search identified more than 2,000 article titles. We then narrowed down the search to “continuing medical education” to reduce to 165 articles. These articles then were sorted into evidence-based studies and commentaries or conceptual articles on the topic. We ended with 10 evidence-based articles that addressed the relationship between commercial support and CME, which are listed in Table 1 and annotated in the Appendix.
We found no studies that directly addressed the question of whether commercial support produces bias in accredited CME activities. The 10 studies were then grouped into three categories: 1) four studies that examined the impact of commercially supported CME on prescribing practices, 2) four studies that examined physician opinions about bias in commercially supported CME, and 3) two studies about instruments to measure bias in commercially supported CME.
They recommended additional research:
It is necessary at this time to initiate rigorous scientific studies to address important questions about the relationship between commercial support and bias in CME. The research could focus on several questions:
• Does commercial support produce bias in CME activities?
• What are the mechanisms by which bias is produced?
• Are accreditation guidelines or other strategies effective in preventing bias?
• In what ways does commercial support of CME contribute to physicians’ adoption of the sponsor’s product in the context of the other influences on their clinical decision-making?
• As a result of commercially-supported CME, does physicians’ adoption of the sponsor’s product lead to better patient care?
Doing more research will answer these questions in time.
Groups like the AMA CEJA, Institute of Medicine and others should take a step back and consider what would be the benefit of changing a system of education without evidence that the change will benefit patients.