Tuesday, July 6, 2010
The Michigan Daily - michigandaily.com
CME FUNDING
From Page 1
Woolliscroft said leaders in the med-
ical school community looked at lit-
erature detailing the psychological
effects of commercially supported
education and relationship-building
in marketing, ultimately concluding
that accepting CME funding from
commercial industries simply "was
not the right thing to do."
"We were concerned that we don't
want there to be even a perception of
bias in what is being communicated
to physicians," he said.
In an interview with The New York
Times last month, Rafael Fonseca,
who teaches 20 to 30 CME courses a
year and is the deputy director of the
Mayo Clinic Cancer Center in Scotts-
dale, Arizona, said CME classes keep
doctors up to date in their fields and
that bias is not an issue.
"We present what we think is the
state-of-the-art of the management
of the disease," he said in the inter-
view. "The accusation that there is
bias is not substantiated."
The January edition of the Jour-
nal of Academic Medicine pub-
lished a study from the Cleveland
Clinic Foundation, which reported
that "prospective analysis found no
evidence that commercial support
results in perceived bias in CME
activities."
The study looked at evaluations
from 95,429 participants in 346 CME
activities at the Cleveland Clinic. The
evaluations asked participants to
rate how well the activities met the
ACCME standards for commercial
support and whether the activities
were free from commercial bias.
Depending on the activity, only 1.0
to 6.8 percent of respondents gave a
"fair" or "poor" rating on how well
their activities met the ACCME stan-
dards, and 97.3 to 99.2 percent of par-
ticipants said they felt the activities
were free from commercial bias.
Of the activities under investiga-
tion, 56.9 percent were not commer-
cially funded, but the study showed
no statistically significant difference
in perceived bias between the com-
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mercially funded activities and the
others.
A similar study from the Univer-
sity of California, San Francisco,
published in the same issue of the
Journal of Academic Medicine, found
that "rates of perceived bias were low
for the vast majority of CME activi-
ties in the sample and did not differ
by the degree of industry support or
other event characteristics."
The UCSF study reported that
95 to 99 percent of participants in
213 CME activities said they did
not perceive commercial bias in the
activities, and as in the Cleveland
Clinic study, there was no correlation
between level of commercial support
and perceived commercial bias.
Both studies concluded that under
the ACCME regulations, commer-
cially funded CME activities can
be free from bias. They both added,
however, that the institutions under
investigation, the Cleveland Clinic
and UCSF, might have more rigor-
ous screening processes for indus-
try supporters than other accredited
CME institutions and recommended
further investigation at other institu-
tions.
Both studies also suggested that
a more subtle, undetectable form of
bias could be present.
The UCSF study, for example,
mentioned that speakers might sub-
consciously tailor their presenta-
tions for commercial benefit. Dean
Woolliscroft said he agreed that
such studies may not uncover certain
biases because participants can't per-
ceive them.
"None of us feel that we can be
influenced," Woolliscroft said, "but
yet all of us, if we step back, realize
that the whole marketing industry
clearly is successful."
Woollistroft added that whether
the bias is real or not, doctors have a
"social covenant" with their patients
and owe it to them to not even allow
the question of bias.
Tom Sullivan, president of Rock-
pointe Corporation, a medical edu-
cation company based in Columbia,
Maryland, criticized the University
for making this decision without evi-
dentiary support that commercially
funded CMA classes are biased,
especially when the Cleveland Clinic
and UCSF have published extensive
reports that suggest the contrary.
Sullivan said it's not necessary to
take commercial funding away from
CME, and in fact, the University's
decision will ultimately hurt the
CME courses offered at the medical
school.
Funding from pharmaceutical and
device companies, he said, allows
CME providers to organize smaller
class sizes that create a more person-
al environment where doctors can
get direct instruction on new treat-
ments and technologies.
"There's a need for people to be
able to discuss in forums practical
applications," Sullivan said. "You
want your doctor educated on how
something works ... you don't want
him reading the book while he's
doing the operation."
Sullivan warned that without
commercial funding, such intimate
atmospheres would "not be as readily
available," adding that he wouldn't be
surprised if the University changed
its mind after two or three years.
Woolliscroft said, come January,
class participants can expect a sud-
den disappearance of company rep-
resentatives and advertisements, but
the classes themselves will remain
the same.
Woolliscroft also said in the long
run, Sullivan's concern about lecture
quality will become obsolete because
he and others in the medical school
hope to entirely revolutionize the
CME program by moving away from
lecture-style classes and instead
toward technology-aided education.
"It's been recognized that lectures
are not a very effective way to change
care for patients, that physicians
oftentimes do not incorporate into
their practice patterns what they've
learned," he said.
The loss of personal interaction is
a potential downside to technologi-
cally-driven education, Woolliscroft
admitted, but by the same token, doc-
tors will be able to have virtual con-
versations with colleagues not only
throughout the U.S., but throughout
the world.
"We're in a time of change, so we
haven't migrated fully away from a
lecture format to some new way of
enhancing learning, soit's going to be
a time of transition when other reve-
nue sources are also constrained," he
said. "It's really actually a very excit-
ing time, and we're just in the begin-
ning of a big change in education, not
just in medicine."
Recognizing the immediate need
to compensate for lost funding,
Woolliscroft said the medical school
will have to increase class registra-
tion fees and host classes in less
expensive venues. Departments and
divisions in the medical school have
also offered to help compensate for
the loss, he said.
Online at MichiaanDailveom
announces new
merchandiser
By SUZANNE JACOBS
Daily StaffReporter
0
The University Athletic Depart-
ment announced last week that The
M-Den will once again be the offi-
cial merchandiser for University
athletics.
When M-Den's 10-year contract
expired in June 2009, the Texas-
based apparel company eSports
Partner Inc. outcompeted M-Den
and other companies to become the
University's new merchandiser for
the next decade.
Jason Winters, the chief finan-
cial officer for the athletic depart-
ment, told The Michigan Daily at
the time that eSports Partners Inc.
promised to make $1.5 million dol-
lars in its first year as merchandis-
er. According to Winters, M-Den
typically generated $500,000 to
$600,000 per year.
"There were a number of enti-
ties interested," Winters said at the
time. "We were looking for better
royalty rates, economic perfor-
mance (and the) ability to grow and
respond to consumers."
The athletic department has ter-
minated its contract with eSports
Partners Inc. after one year, Win-
ters said, because the company
failed to meet performance stan-
dards set in the contract.
"There were several issues that
allowed us to terminate the agree-
ment and get out of it. There was a
general service element that was
missing as well as a financial ele-
ment," he said. "In general terms,
they failed to reach their guaran-
teed sales and royalty levels."
He added that the athletic
department was pleased with the
company's performance during
football game days last fall, but as
the year went on, product availabil-
ity became an issue and the e-com-
merce side of business was not up to
par.
i] For the rest of thisstory, visit
CORRECTIONS
0 Please report any error in
the Daily to corrections@
michigandaily.com.
M-Den to
be official
'U' retailer
University athletics
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