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WILL NEW CME STANDARDS INHIBIT PHARMA INFLUENCE?

The Accreditation Council for Continuing Medical Education (ACCME) has adopted revised standards for industry influence in CME classes, in part to keep doctors with financial relationships with drug companies from designing or teaching courses.

AAN members won't be seeing any changes in Academy-sponsored classes, however – AAN CME is already fully in compliance to the new standards, owing to strict conflict-of-interest policies, said AAN Education Committee Chair Ralph Jozefowicz, MD. The new standards, mentioned in June's News and Views column, page 32, were reviewed by the ACCME's seven member organizations over the summer before being adopted at the end of September. They took effect upon approval of the member organizations.

The standards address the role that industry sponsorship and those with industry ties play in designing and delivering CME – or rather they seek to keep industry and education as separate as possible, while acknowledging the role that industry sponsorship and advertising play in financing CME. For example, the standards dictate where advertising messages can and cannot appear at CME activities, what subjects and therapies are appropriate for CME, and what financial ties constitute a conflict of interest. Physicians who have had a financial relationship – of any dollar amount – with a commercial interest in the past year should not be in a position to influence CME courses on products and services of that commercial interest, ACCME asserts. Financial relationships include a salary, consulting fee, honorarium, board membership, and contracted research.

Dr. Jozefowicz, Professor of Neurology and Medicine at the University of Rochester School of Medicine and Dentistry in New York, noted that, “the AAN has always not only followed the rules, but has also worked to avoid even the perception of conflict of interest. We are known in the world of industry for being extremely strict with our policy.” However, he does believe the ACCME update was necessary, “based on what was happening in certain other specialties.” He said: “This is a very difficult area … industry is motivated by profit, which is at times at odds with the interests of patients. It is important to have a firewall to avoid a conflict – or perception of conflict.”

Information about the new standards, including a frequently asked question section, is available on the ACCME Web site: www.accme.org. Look for a more in-depth discussion of CME and potential conflicts of interest in an upcoming issue of Neurology Today.

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NEURO RESEARCH KEY FOR BIOMEDICAL CENTER

The NIH is collaborating with Johns Hopkins University to build a new intramural research center, which will house neurology-related research projects. The new biomedical research center will be located on the Hopkins Bayview campus and will host components of the National Institute on Aging (NIA) and the National Institute on Drug Abuse (NIDA).

The center will be home to about 1,000 scientists and support staff, who will conduct both basic and clinical research. Among other projects, the NIDA is planning to develop and use neuroimaging techniques – such as PET and MRI – to study the neurological components of addiction and other compulsive disorders, according to a NIH press release. The NIA – which already has research facilities on the Bayview campus – will continue its work on a range of age-related disorders – including Alzheimer disease, Parkinson disease, and stroke – as well as studying the determinants of healthy aging.

The new research facility is scheduled to open in the fall of 2006.

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HEALTH INFORMATION TECHNOLOGY GRANTS ANNOUNCED

The Department of Health & Human services (HHS) has taken the next step in encouraging the implementation of electronic medical records and other medical technologies by awarding $139 million in grant and contract money. The multi-year grants and contracts were awarded to 40 states for terms of three or five years, and are the next step in the current administration's goal for all Americans to have electronic medical records within 10 years.

Much of the funding is focused on small community or rural hospitals that may not be able to afford the technology otherwise. Additionally, five states are charged with developing secure statewide networks for sharing health information. Even those not participating in a grant or contract will benefit from the program. The HHS is creating a National Health Information Technology Resource Center, which will serve as a centralized resource to share best practices, receive technical assistance, and collaborate with others.

Some of the expected benefits of the grant programs are improved patient safety; smoother information-sharing among health care players, including doctors, labs, and pharmacies; and fewer duplicate or unnecessary tests.

“These projects will encourage real world laboratories for innovation and provide models for other organizations as we move forward in developing an electronic health record,” said David J. Brailer, MD, PhD, HHS National Coordinator for Health Information Technology, in a news release.

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GENOTYPING CENTER COULD SPEED RISK GENE IDENTIFICATION

Neurology investigators trying to track down genes that cause or contribute to neurologic conditions such as Parkinson disease, migraine, muscular dystrophies, and even Alzheimer disease will soon have a new resource to speed their hunt. The NIH is creating a national center for high-throughput genotyping of single nucleotide polymorphisms (SNPs), which will make it faster and more affordable for researchers to find risk genes in large study populations. A SNP is a single DNA base pair, and the most common variation in the human genome. Some SNP variations predispose the carrier to certain diseases.

The five-year, $14-million venture will be located at the Broad Institute of the Massachusetts Institute of Technology and Harvard University in Boston, and will be headed by Stacey Gabriel, PhD, who currently oversees the genetic analysis platform there. Part of the center's yearly budget will also furnish grants for compelling genotyping projects. The NIH expects to begin genotyping studies at the center early next year. Costs at the center are estimated to be on the order of pennies per genotype, an expense likely to drop as technology improves. In addition to rapid genotyping, the center will provide several software platforms to help researchers manage and analyze their data.

Andrew Clark, PhD, Professor of Molecular Biology and Genetics at Cornell University in Ithaca, NY, said that the new center “will make high-throughput SNP genotyping feasible for many labs that would otherwise not have access to it. The hope is that there will be adequate support for analysis as well, since this seems to be the bottleneck in a lot of association studies.” As for possible disease targets for the new center, he said: “The best place to apply these technologies is to disorders with high heritability, and to those that appear to be homogeneous in etiology.”

For more information on the center, the research services offered there, and future grant opportunities, visit www.broad.mit.edu.

©2004 American Academy of Neurology

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