Professor Sir John Tooke reflects on a recent workshop the Academy organised to explore conflicts of interest as part of our work stream on the best use of evidence.
Modern biomedical science has a huge transformative potential for health and social wellbeing. In order to realise this potential, however, it is essential that research and the way it is conducted continues to address the needs and concerns of the public. Given the large public contribution to science funding in the UK, ensuring the trustworthiness of scientific research is key to maintaining this support.
The Academy’s workstream on How can we all best use evidence to judge the potential benefits and harms of medicines? that I am leading explores different forms of evidence and how they are best communicated as well as seeking to address factors influencing the trustworthiness of medical scientific evidence. One such factor is research reproducibility and reliability, as discussed in a symposium hosted last year by the Academy. Another concern is potential bias in experimental design and interpretation arising (although only in part) from conflicts of interest. Such conflicts of interest, real or perceived, pose a significant threat to the integrity, validity and trustworthiness of science.
Our recent Conflicts of interest workshop – held to gather evidence for the workstream - explored multiple facets of this issue. Defining what constitutes a conflict of interest is an important first step: not all interests create conflicts, and not all biases are due to conflicts of interests. Where conflicts of interest distort how priorities are set, how experiments are conducted or how the data are analysed or disseminated, this can clearly compromise the evidence base for policy decisions and undermine public support. Yet blanket avoidance of potential conflicts may not be the answer if it denies access to expertise and knowledge upon which productive science depends. A particular case in point is the relationship between academia and industry.
Increasingly, academics are encouraged to work with the private sector, bringing different sources of expertise together to accelerate translation of research into patient benefits. Drug discovery in its early stages now frequently takes place in universities given their profound capabilities in discovery science and experimental medicine, but relies on pharmaceutical companies to turn such discoveries into drugs for the benefit of patients. As many workshop participants pointed out, we may not wish to eliminate conflicts altogether, but manage them appropriately.
There was agreement amongst participants that any interests must be declared openly, so that any conflicts may be identified, but that declaration alone is not enough. As part of the overall workstream we will explore further what constitutes a conflict of interest in academic-industry relationships and how interests should be managed and reported.
There is clearly a need for scientists to do more to engage the public on the benefits that robust, transparent relationships between industry and academia can bring. We should be honest about the problems conflicts of interest can create, but be in a position to demonstrate the steps that we are taking to address these. We are currently undertaking a programme of dialogue that brings together members of the public, patients and healthcare professionals to discuss these issues in the context of the broader How can we all best use evidence to judge the potential benefits and harms of medicines? workstream to ensure that our conclusions and recommendations are informed by the views of the wider society.
I would like to thank Baroness Onora O’Neill for her excellent work in chairing and contributing to the workshop.
The report of the workshop can be downloaded from the right hand side of this page.
Science is accountable to the public, and these are issues of broad public concern. To reap the benefits of modern medical science we must remain sensitive to the views of patients, citizens and society at large. For these reasons, we welcome feedback at this formative stage of the overarching report, and wish to continue to engage with the public throughout this process. Please contact firstname.lastname@example.org.