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Conflicts of interest inmedical faculties and hospitals (continued)

● In Belgium, thefirst ranking ofmedical facul ties showed that there was little recognition of the need for a policy to manage conflicts of interest. ● In France, little or no account is being taken of the ethics and professional conduct charter drawn up by the Council of Deans of Medicine and Dentistry in 2017. A wareness around conflicts of interest in med ical faculties and hospitals is improving in some countries (1). There is still much room for improvement, but positive signs are emerging (2). The first ranking of faculties in Belgium. A first ranking of Belgian medical faculties based on their policies for managing conflicts of interest was pub lished in 2021 (3). Doctors who were members of the Groupe de recherche et d’action pour la santé (GRAS) together with a political sciences research er from the Spiral Research Centre at the University of Liège devised this ranking by taking criteria already used in other countries and adapting them to the Belgian context (3). The criteria taken into account in the ranking score included: restriction or prohib ition of gifts, free samples, meals and travel funding; restriction of activities financed by companies on teaching premises; and instruction on marketing practices of companies and conflicts of interest (3). The results of the ranking reveal that little consid eration is being given to the problem of conflicts of interest by academic authorities in the country’s ten medical faculties. The University of Ghent and the Catholic University of Louvain came in first in the ranking, but with a score of only 3 points out of 30, and 6 universities had a score of zero (3). The third ranking of faculties in France. In France, Formindep (a French non-profit organisation advo cating independent medical training and information) published its 3 rd ranking of medical faculties in 2021 (4). Since the second version in 2018, this ranking no longer measures the mere existence or content of any conflict-of-interest policies, but the extent to which faculties are implementing the eth ics and professional conduct charter drawn up by the Council of Deans of Medicine and Dentistry in 2017 (4,5). The criteria taken into account in the ranking score include adoption and roll-out of the charter, and conflict of interest declarations by teaching staff (4).

In comparison to 2018, very few changes were noted, with only one faculty out of 36 obtaining a score above 50% (Lyon-Est, with 18 points out of 34). 11 faculties scored 10 to 14 points, while the other 24 scored less than 10 points out of 34 (4). The changes observed include the appointment of resource persons for “scientific integrity” and the creation of ethics commissions in most of the facul ties. The contribution of the latter is limited, however, because these committees take little or no account of the charter. Some initiatives are to be welcomed, such as the publication of professionalism committee meeting reports by the Tours faculty on its website, or the refusal of the Lyon-Est faculty to accept indus try funding (4). Afirst international review. A systematic review has now examined conflict of interest policies in medical faculties and university hospitals around the world (6). The authors identified 22 studies published up to 2020 involving the United States of America, Canada, Australia, Germany, and France. Overall, most North American institutions have a policy for managing conflicts of interest, in contrast to what is observed in Europe. According to the authors, these results could be explained by the fact that the US was a pioneer in this field (6). This should encourage other countries to adopt, or more effect- ively implement, conflict of interest policies in establishments at which future healthcare profes- sionals are taught. ©Prescrire Selected references from Prescrire’s literature review 1- Prescrire Editorial Staff “Student action reduces industry influence in US medical schools” Prescrire Int 2016; 25 (173): 194-195. 2- Prescrire Editorial Staff “Independence of French medical schools: clear shortcomings” Prescrire Int 2019; 28 (208): 248. 3- Bechoux L et al. “Conflict of interest policies at Belgian medical faculties: cross-sectional study indicates little oversight” PLoS One ; 16 (2):e0245736: 16 pages. 4- Formindep “Nouveau classement 2021 des facultés françaises en matière d’indépendance” 12 April 2021. www.formindep.fr accessed 24 September 2021: 6 pages. 5- Conférence nationale des Doyens de facultés de médecine et de santé “Charte éthique et déontologique des Facultés de médecine et d’odonto- logie” Rev Prescrire 2018; 38 (412): 150 (complete version: 6 pages). 6- Fabbri A et al. “Conflict of interest policies at medical schools and teach ing hospitals: a systematic review of cross-sectional studies” Int J Health Policy Manag 2021; accessed online: 12 pages. ▶ Translated from Rev Prescrire June 2022 Volume 42 N° 464 • Page 465

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