Research Conflicts of Interest. May Jodi Edelstein Manager, Conflicts of Interest Office of Research Compliance

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Research Conflicts of Interest May 2012 Jodi Edelstein Manager, Conflicts of Interest Office of Research Compliance

Our Team Office of Research Compliance (the ORC) Ara Tahmassian Associate VP Research Compliance BU/ BMC Kate Mellouk Executive Director Research Integrity BU/ BMC Jodi Edelstein Compliance Manager Conflicts of Interest BU/ BMC Leilani Hernandez Compliance Coordinator Conflicts of Interest BU/ BMC BU Charles River Campus Faculty Committee on Research Conflicts of Interest BUMC Faculty Committee on Research Conflicts of Interest

The Core of What We Do Protect the Objectivity of Research by Reviewing and Managing Conflicts of Interest in Research ~ Conflict of Interest - when a private interest could unduly affect a professional decision e.g., You get royalties for your invention, and are about to conduct research to test how effective it is. Private financial interest in royalties might cause one to make personally favorable decisions with regard to the design, conduct or reporting of research, even unconsciously! Conflict of Interest Research X Research X Conflict of Interest

What We re Looking For Of the many, many causes of bias (i.e., conflicts) in research, we look for: - Payments for professional services - Patents, copyrights (IP) and related royalties - Equity holdings (stock) - Honorarium - Gifts but only where they could directly and significantly affect the design, conduct, or reporting of Research at BU or BMC.

What We Do 1) Policy Write, refine and implement it Keep up-to-date on latest developments in the field 2) Handle FCOI (financial conflict of interest) Cases Gather and review financial disclosures Decide on conflict of interest management plans Monitor compliance with management plans Reporting FCOIs and plans to sponsors 3) Educate and Advise Faculty and staff, as requested Via presentations in the community Research Conflicts of Interest

Policy COIs exist People care Federal Gov t cares Institutions care COI policies at Boston University and Boston Medical Center Investigator Conflicts of Interest Private interests held by research project investigators, their spouse and dependent kids Institutional Conflicts of Interest only Boston University s interests, as an institution Private interests and roles of key individuals

Institutional Conflicts of Interest Policy Significant financial interests (which might constitute an FCOI): Boston University s interests: equity, royalties and gifts to BU Key individuals: equity, IP interests, non-bu/bmc compensation, or outside positions relating to research Key individuals = a person who has influence over what research is conducted and also, provides research oversight and review. Provosts, VPs, Deans, Chairpersons, etc. No reporting to the federal government required. Possible pause on research or management plan where FCOI is found.

Investigator Conflicts of Interest Policy Investigator means: Someone responsible for design, conduct or reporting of research Investigators Disclose: a) Salary or other payments for services (consulting fees, sponsored travel, honoraria) b) Stocks, stock options (aka equity) c) Royalties in connection with intellectual property rights (patents, copyrights) Must be related to institutional responsibilities Includes holdings of spouse and dependent children Research included: a systematic investigation, study or experiment designed to develop or contribute to generalizable knowledge designed, conducted or reported by BU or BMC Investigators, regardless of funding source. Not student projects for credit or non-federally funded dissertations Reporting FCOIs to NIH for PHS-sponsored research, including those of subrecipients No funds disbursed until COI review is complete, and FCOI is reported to NIH, if needed

Investigator Conflicts of Interest Policy Fed Reg 1995 BU Policy 1997, 2001, 2003 and BMC 2004 Fed Reg 2011 BU & BMC Policy 2012 New policy will be launched August 24, 2012! Applies where the Notice of Award Date is 8/24/12 or later. Lots of research Lots of People Lots of Conflicts? Over concern that our institutions were missing the COIs, the government revised it s policies to capture more of them.

How will the process change 8/24/12? 1. Investigators disclose $ and do training online (paperless) 2. Investigators disclose more ($ related to institutional responsibilities) 3. Investigators update interests w/in 30 days of a change, and at least annually a) b) c) Log in to e-module online Train online Disclose online (1x per 4 years) 4. The ORC, not Investigators, decides if $ relates to research, and is an FCOI 5. SFI threshold $10,000 minimum $5,000 + any equity in a private company

How will the process change 8/24/12? 6. More information reported to NIH, and more frequent reporting. Information includes nature and value of financial interest, relation to research and management plan Report Initial FCOI Report Annual COI Report Revised FCOI Report Mitigation Report Required when? Prior to expenditure of funds, or Within 60 days if SFI is found in ongoing research. Annual report due at same time as when submitting annual progress report or at time of extension. After completion of retrospective review, but only if management plan changes, within 120 days after SFI discovery. When bias is found as a result of a retrospective review. Report promptly. Bias = actual harm to the research due to the FCOI

How will the process change 8/24/12? 7. More research is covered by the new policy 8. BU or BMC, if prime recipient for PHS-funded research, will need to report subrecipient FCOIs to NIH. 64.5% of BU sub-awards and 56% of BMC sub-awards are PHS funded 9. ORC post- management plan decision monitoring and annual checkins by conflicted Investigators 10. Backward looking retrospective and noncompliance reviews if old financial conflict of interest (FCOI) in ongoing research is found, or management plan isn t followed 11. Public accessibility anyone can submit requests for information on FCOIs in PHS-funded research. There will be an online form to submit to ORC.

What has stayed the same? 1. Funds can not be disbursed until the COI review process is done. 2. Associate VP for Research Compliance makes final decision. 3. The basic process. 4. Techniques for managing FCOIs. (a) Weighing Factors: Unique qualifications of Investigator? $ nature and magnitude? $ is in close relation to research? Human subjects? Primary site? Public perception? (b) Management Options: Disclosure; Independent monitor/statistician; Modification of the research plan; Change of personnel or responsibilities; and Reduction/elimination of $. (c)

FCOI Case Process Overview Gather disclosures, compare to research Find Financial Conflict of Interest Committee Review and recommendation Final decision by Associate VP for Research Compliance Management plan compliance by Investigators

FCOI Case Process Overview ORC monitors compliance with management plans 4 Submit copy of signed disclosure letters Emails certifying disclosure in presentations, publications Report submitted by non-conflicted data analyst Independent monitor report Audits Interviews Email inquiries

Education and Advising - Conflicts are Natural Expertise - Service on Boards, Panels, Committees - Industry Relationships - Inventions Conflicts of Interest (actual or perceived) (Getting in the way of research)

Educating and Advising If I Disclose, Will I get in Trouble? Disclosing a conflict of interest does not imply wrongdoing or automatically preclude Investigators from receiving research awards. BUT Undisclosed conflicts can result in serious consequences including loss of research funding a other serious penalties.

Scale Almost 4,000 faculty and physicians $550 million in grant & contract awards BU 2,702 full time faculty 1,240 of them are at the Medical school 1,459 full time administrative, clerical and technical staff $425.4 million in grant & contract awards as of 6/30/10 1,787 total awards BMC 1,290 Physicians 791 Residents and Fellows BU Fact Sheet 2010/2011 http://www.bu.edu/oir/files/2011/05/g3b-fact-sheet-fy2011.pdf $126 million in sponsored research funding in 2010 581 research and service projects separate from BUSM. BMC Fact Sheet http://bmc.org/documents/bmc-facts-2010.pdf

Case distribution Disclosure of SFIs related to research (a.k.a. 'Yes' PSDs) by Campus and School BUMC CRC Dental 4% ENG 40% MED 96% CAS 60%

Case distribution CRC research-related SFIs / 'Yes' PSDs by Department Chemistry 30% Mechanical Engineering 40% Economics 10% Physics 20%

May 3, 2012, Front Page In an observational study there is no human intervention. Researchers simply observe what is happening during the course of events, or they analyze previously gathered data and draw conclusions. observational studies in general can be replicated only 20% of the time, versus 80% for large, well-designed randomly controlled trials, says John Ioannidis of Stanford University. You can troll the data, slicing and dicing it any way you want, says S. Stanley Young of the U.S. National Institute of Statistical Sciences. Consequently, a great deal of irresponsible reporting of results is gong on.

BU COI website at: http://www.bu.edu/orc/ Policy Implementation guidelines (coming soon!) Training (coming soon!) Forms Conflict of Interest in Research Resources FAQs (coming soon!) Contact Information NIH COI website at: http://grants.nih.gov/grants/policy/coi/ AAMC COI website at: https://www.aamc.org/initiatives/coi/ Revised PHS Regulation, Responsibility of Applicants for Promoting Objectivity in Research for which PHS funding is sought, http://www.ofr.gov/ofrupload/ofrdata/2011-21633_pi.pdf

Questions?