April 6th, 2011
ACC Will Eliminate Current Model of Satellite Symposia at Future Meetings
Larry Husten, PHD
The ACC announced yesterday that it plans to eliminate the current model of satellite symposia at future meetings. The decision “was prompted in part by ongoing concerns about real and/or perceived bias in interactions with industry, specifically related to non-independence of certified satellite symposia.”
The ACC has not worked out the details of the new plan, but mentioned two broad changes:
- First, the ACC will integrate “a limited number of ACC-developed CME-/CE-certified ‘in-depth focused sessions’ into the overall ACC/i2 Scientific Session planning framework. These in-depth focused sessions will be planned and developed by the Annual Scientific Session planning committees as enhanced options to the structured sessions.”
- Second, the ACC’s Business Development Division will manage non-certified satellite symposia sponsored by industry.
“This move is important because it will allow for transparency in the two separate approaches and meet the educational needs of our members,” said Rick Nishimura, co-chair of the 2012 ACC’s Annual Scientific Session, in an ACC press release.
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9 Responses to “ACC Will Eliminate Current Model of Satellite Symposia at Future Meetings”
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The rollback of industry supported symposium is reaching the level of ridiculousness. In the context of the current ACC scientific sessions, as much bias based of the personal beliefs and and prejudiced interpretation of data on the part of clinician scientists existed in the credentialed CME certified sessions as occurred in he satellite events that I attended in the present and the past. The cursory COI declaration at the beginning of the presentation serves no purpose in distilling or dissolving any such inherent bias. The attendee must take every bit of data and information in context and with a grain of salt, and insert it or dis card it in the “moving picture” of evolving clinical data.
Xavier’s right. The perfunctory conflict of interest (COI) disclosure is perfunctory, short (blink and you miss it), and inadequate. If you were running the scientific sessions what would you do to improve their integrity?
As an attendee/learner, the onus is upon that individual to come prepared. That necessitates an appropriate level of scrutiny of older, tried concepts and newly formulated and proposed strategies or therapies. We should teach ourselves or be taught as to how to abstract new information in whatever format, with objectivity and transparency(whatever that means) not being the sole obligation of the presentor. The maxim “trust but verify” applies here.
As we cannot legislate integrity in society, similarly, in this scholarly context, it cannot be done. In such daunting meetings selection of faculty should be based on proven scientific/clinical objectivity and continued review of their competence and performance is necessary.
So integrity is the province of both attendee and faculty.
I think there’s an important distinction that’s being missed in this discussion. Bias exists everywhere and can never be completely eliminated. We all have conscious and unconscious biases. In reviewing any kind of scientific/medical presentation or paper it’s always a good idea to think about all the different biases that might be important. But I don’t think you can point to the overall ACC scientific sessions as a whole, or even the vast majority of individual sessions, as representing a systemic bias toward a particular company or product. But this is precisely the problem with satellite symposia. There is a clear incentive on the part of all the participants to deliver for the sponsor. This is what needs to be eliminated. It remains to be seen if what replaces it is any better.
This change in satellite programs may indeed be inappropriate. There seems to be more concern with the superficial, easily visible manifestations of the perceived infractions, and not with the more serious, pervasive, large-scale ones. Is this a continuation of the elimination of the pens and note pads, an “acknowledged major source” of bias, while enormous contributions continue in other areas. Betty Crocker and Coke sponsoring the revamped Cardiosmart National Healthcare Initiative and health screens, as well as research grants, et al… Please.
Point well made by Larry and precisely countered by Richard. The incentive of a honorarium for faculty at a satellite symposium is no more or less of an incentive to bias than a research or grant(or other honorarium) support declared at the beginning of a presentation in an “official” session of the scientific sessions of any professional society. The incentive to bias is equal in both domains and is not remedied by a COI slide. The remedy, as dictated by ACCME guidelines, is that symposium content(ie slides) be reviewed by the program director and any real or perceived conflict be resolved prior to the presentation- a virtual impossibility given the size and scope of such meetings.
And, what about guidelines? Who amongst us can discern a bias from a particular guideline recommendation by “connecting the dots” to a writer, his/her declaration of industry association/support( and, therefore potential conflict) to his/her research endeavor in that field and the guideline? Another virtual impossibility.
Regarding the above, the source for the CardioSmart health fair sponsorship is Shelley Wood’s piece at http://tinyurl.com/6h7su55
I suspect the new enhanced sessions will come at a price, with more tuition money going into ACC’s pockets. The rubber chicken sandwich will be $15. I think everyone, including the ACC, has to look at the price structure for education/CME. One thought is to open the ACC scientific sessions to internet access so people can attend the meetings on-line at a reduced rate without airfare, hotel, etc. Also less indigestion from the New Orleans gumbo prepared in filthy vats.
An interesting perspective in March 31 2011 NEJM issue by Jerry Avorn(Teaching Physicians About Drugs….) rekindles the half century question of “Who shall educate the physician?” and espouses the concept of “academic detailing”- leveraging the successful marketing strategies of industry without sales oriented commercial influence. That academic detailing is the charge of our professional societies and faculty.