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- $100 OFF Mention This AD And Receive $100 Off. Now is the A perfect time to prep with one of the nation's leaders in test preparation. -Small Classes +GMAT -Expert Instructors -Free Extra Help + MCAT re A The Princeton Review fl-H,, 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 The Fourth: Nationwide, the Daily's photographers capture American pride.