Conflicts of Interest and IRB Reviews

I'm reading the AAMC document referenced in a conference call yesterday about the case I discussed here a few days ago. The document clearly lays out the rationale for a rebuttable presumption against doing research where there is an individual or institutional COI. Appendix B gives helpful examples of how and when conflicts might be managed and the research allowed to proceed, and when the presumption should prevail. The document does deal with the early stage research issues I raised during the call.

Overall, the document is helpful -- but it only goes so far. I think it misses one of the most important conflicts of interest, the investigator's interest in publishing. This conflict is well known, is a major cause of misconduct in research, and has existed for a very long time.

Eventually, the COI process needs to grapple with the fact that researchers have vested interests in making findings and publishing their work. Publish or perish is well established. Thus, all researchers have a financial interest in making discoveries that they can publish to ensure their own job security. While job security issues apply most acutely to junior faculty, even tenured faculty have an interest in publishing so that they can get future grant funding and increase their social stature. Therefore, the logical extension of the COI recommendations is that there should be a rebuttable presumption against anyone doing any sort of research which they intend to publish. Only research done for purely personal enjoyment, by persons who are independently wealthy, should be allowed without prior approval of the institutional COIC.