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The Effect of Industry Support on Participants' Perceptions of Bias in Continuing Medical Education

Kawczak, Steven MA; Carey, William MD; Lopez, Rocio MPH, MS; Jackman, Donna

doi: 10.1097/ACM.0b013e3181c42f80
Academia-Industry Relationship

Purpose To obtain prospective evidence of whether industry support of continuing medical education (CME) affects perceptions of commercial bias in CME activities.

Method The authors analyzed information from the CME activity database (346 CME activities of numerous types; 95,429 participants in 2007) of a large, multispecialty academic medical center to determine whether a relationship existed among the degree of perceived bias, the type of CME activity, and the presence or absence of commercial support.

Results Participants per activity ranged from 1 to 3,080 (median: 276). When asked the yes/no question, “Overall, was this activity satisfactorily free from commercial bias?” 97.3% to 99.2% (mean: 98.4%) of participants answered “yes.” In responding on a four-point scale to the request, “Please rate the degree to which this activity met the Accreditation Council for Continuing Medical Education requirement that CME activities must be free of commercial bias for or against a specific product,” 95.8% to 99.3% (mean: 97.2%) of participants answered “excellent” or “good.” When analyzed by type of funding relative to commercial support—none (149), single source (79), or multiple source (118)—activities were deemed to be free of commercial bias by 98% (95% CI: 97.3, 98.8), 98.5% (97.5, 99.5), and 98.3% (97.4, 99.1) of participants, respectively. None of the comparisons showed statistically significant differences.

Conclusions This large, prospective analysis found no evidence that commercial support results in perceived bias in CME activities. Bias level seem quite low for all types of CME activities and is not significantly higher when commercial support is present.

Mr. Kawczak is associate director, Center for Continuing Education, Cleveland Clinic, Cleveland, Ohio, and a PhD candidate, University of Akron, Akron, Ohio.

Dr. Carey is director, Center for Continuing Education, Cleveland Clinic, Cleveland, Ohio.

Ms. Lopez is a member, Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio.

Ms. Jackman is associate director, Center for Continuing Education, Cleveland Clinic, Cleveland, Ohio.

Correspondence should be addressed to Mr. Kawczak, Cleveland Clinic, 9500 Euclid Avenue, KK31, Cleveland, OH 44195; telephone: (216) 444-2572; fax: (216) 445-9406; e-mail:

© 2010 Association of American Medical Colleges