Article Text

Download PDFPDF
Ten years later: a review of the US 2009 institute of medicine report on conflicts of interest and solutions for further reform
  1. Trevor Torgerson1,
  2. Cole Wayant1,
  3. Lisa Cosgrove2,
  4. Elie A Akl3,
  5. Jake Checketts1,
  6. Rafael Dal Re4,
  7. Jennifer Gill5,
  8. Samir C Grover6,7,8,
  9. Nasim Khan9,
  10. Rishad Khan6,7,
  11. Ana Marušić10,
  12. Matthew S McCoy11,
  13. Aaron Mitchell12,
  14. Vinay Prasad5,13,14,
  15. Matt Vassar1
  1. 1 Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
  2. 2 Department of Counseling Psychology, University of Massachusetts Boston, Boston, Massachusetts, USA
  3. 3 Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
  4. 4 Epidemiology Unit, Health Research Institute-Fundación Jiménez Díaz University Hospital, Universidad, Autónoma de Madrid, Madrid, Spain
  5. 5 Division of Hematology Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA
  6. 6 Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  7. 7 Division of Gastroenterology, St Michael's Hospital, Toronto, Ontario, Canada
  8. 8 Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
  9. 9 Division of Rheumatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
  10. 10 Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia
  11. 11 Department of Medical Ethics and Health Policy, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
  12. 12 Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
  13. 13 Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, Oregon, USA
  14. 14 Senior Scholar in the Center for Health Care Ethics, Oregon Health & Science University, Portland, Oregon, USA
  1. Correspondence to Mr Trevor Torgerson, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA; trevor.torgerson{at}


Conflicts of interest (COIs) in healthcare are increasingly discussed in the literature, yet these relationships continue to influence healthcare. Research has consistently shown that financial COIs shape prescribing practices, medical education and guideline recommendations. In 2009, the Institute of Medicine (IOM, now the National Academy of Medicine) published Conflicts of Interest in Medical Research, Practice, and Education—one of the most comprehensive reviews of empirical research on COIs in medicine. Ten years after publication of theIOM’s report, we review the current state of COIs within medicine. We also provide specific recommendations for enhancing scientific integrity in medical research, practice, education and editorial practices.

  • conflict of Interest
  • evidence-based practice

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

View Full Text


  • Twitter @ColeWayant_OK, @ana_marusic

  • Contributors All authors were equal contributors in design, writing and editing. All authors are equally the guarantors of the integrity of this review.

  • Funding This study was not funded, but the authors declare the following interests. VP reports receiving royalties from his book Ending Medical Reversal, an advance for the forthcoming book Malignant: How Bad Policy and Bad Evidence Harm People With Cancer; that his work is funded by the Laura and John Arnold Foundation, that he has received honoraria for Grand Rounds/lectures from several universities, medical centres, nonprofit groups, and professional societies, and is a writer for Medscape. VP is host of Plenary Session podcast, which has Patreon backers. AM is the recipient of a 2018 research abstract award from the Conquer Cancer Foundation, which was partially funded by Merck. SG has received research funding from AbbVie, Jansen, Takeda, and Procter and Gamble, consulting fees from AbbVie, Merck and Takeda, and has ownership shares in Volo Healthcare. RK has received research funding from Abbvie, Pendopharm, and Ferring. MV reports receipt of funding from the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, the US Office of Research Integrity, Oklahoma Center for Advancement of Science and Technology, and internal grants from Oklahoma State University Center for Health Sciences—all outside of the present work. MM’s spouse is employed by the Leukemia and Lymphoma Society.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.