Introduction

As in all professions, conflicts of interest are inevitable in health services research and health policy analysis. Conflicts can arise when initiating projects, designing study methods, analyzing data, and disseminating research findings. Conflicts can involve individuals or organizations. The purpose of this
report is to provide guidance to researchers, sponsors, and others to help them anticipate and manage the inevitable conflicts that will arise in the conducting of health services research and policy analysis.

AcademyHealth Ethical Guidelines Committee and Its Objectives

At the request of its Board of Directors, AcademyHealth convened the Ethical Guidelines Committee (“Committee”) composed of individuals from a variety of organizations and reflecting a wide range of disciplines. The overall
objective of the Committee was to provide practical guidance to individuals and
organizations who struggle with the potential for conflicts of interest in the conducting of health services research and health policy analysis.

Understanding that conflicts of interest vary widely both across disciplines and with circumstances, the Committee worked to develop best practice strategies for navigating various situations, including ones in which some parties may not always act in an ethically appropriate manner. According to the Institute of Medicine and the Association for Health Services Research, a predecessor to AcademyHealth, health services research is:

a multidisciplinary field of inquiry using both quantitative and qualitative methodologies that examines the use, costs, quality, accessibility,
delivery, organization, financing, management, and outcomes of health care services to increase knowledge and understanding of the structure, processes, and effects of health services for individuals and populations.

Based on this understanding, health services research encompasses activities ranging from basic research intended to uncover knowledge about health and health care, to applied research assessing current policies, activities, and
organizations, to policy analysis intended to inform new policies and decisions. Because of the diverse aims and objectives of the health services field, there are many manifestations of how this work is carried out that fall along a broad spectrum, encompassing activities ranging from advocacy to research and policy analysis.

While all of the endeavors that fall along this spectrum are integral and vital to the health services field, this AcademyHealth report will maintain a focus primarily on research and policy analysis and will seek to establish ethical guidelines and
management policies for these central activities. In fact, this report will focus on some vital differences between research and advocacy in an attempt to extricate the primary objectives and ethical conduct related to health services research.

Because some important features of health services research, such as methodology, funding, venue, and oversight, often differ from those of clinical
and biomedical research, the types of conflicts that confront health services researchers are also likely to vary. For this reason, the Committee maintained
a focus on the situations and guidelines that are particularly important in the context of health services research, and supplemented such guidelines with those that should be adhered to in other fields relevant to the work being done.

Ethical guidelines cannot be mathematical formulae or computer algorithms; rather they require judgment in order to balance competing values and to take into consideration the wide range of possible facts and circumstances. The guidelines proposed by the Committee should serve to generate dialogue and as a resource for preventing and resolving conflicts of interest in an ethical manner while sustaining viable research programs in diverse organizational environments ranging from academic centers to commercial enterprises.

We urge that individual health services researchers and their home organizations, as well as journals that publish health services research, adopt these guidelines and use them as a starting point for developing their own policies and practices to manage conflicts of interest. Ultimately, we aim to ensure the integrity of health services research findings and the public’s trust in these findings.

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Continue to:

• Executive Summary
• Introduction
• Conflicts of Interest
  • What is a Conflict of Interest?
  • Conducting Research versus Using Research
• Distinctive Characteristics of Health Services Research
• Guiding Values
• Ethical Guidelines
  • Initiation of Research
  • Conducting Research
  • Reporting Research
• Analyzing a Potential Conflict of Interest
• Implementation and Enactment of the Guidelines
• Appendix A – AcademyHealth Ethical Guidelines Committee
• Appendix B – Committee Action
• Appendix C – Conflict of Interest Resources