conflict of interest

[Melissa]

My director just sent this email from another health librarian and I
thought you might be a great group to comment on the issue. Please
let me know your thoughts. Melissa

"We had a med student bring to our attention that Epocrates has
several board members who are either with or were recently with a
pharmaceutical company. While they disclose affiliation, it is still a
concern to me that there could be bias on recommending therapy and
they offer free subscriptions for medical students.



Our student is not happy that we are "endorsing" the product that most
likely has bias by making it available on our Web site (we do not
subscribe). I tend to agree with her and will most likely remove it
from our Web site.



I'm wondering if others have run into conflict of interest or other
ethics problems with this product or others."

[Kathy Fatkin]

Melissa, one of the links listed in the resources for our course is to a
Delicious account with a link to bookmarks including imedical apps. I read
this posting about "free medical apps" which discussed how pharmaceutical
companies are supporting the growth in medical apps to gain access to
physicians and other healthcare providers who use these tools.

http://www.imedicalapps.com/2011/06/hidden-costs-favorite-free-medical-apps-
part-1/

It is important to consider bias in all sources of information, but I don't
think it is inappropriate to share links to products that are useful and
free. Just add a disclaimer that many of the sites are supported by
pharmaceutical companies who are marketing their products and there is no
implied "endorsement" of any product. Critical appraisal of all sources of
evidence is a very important skill.

Kathy Fatkin

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[Jill]

I believe, WebMD has a similar issue. To be honest, I try to use
sources other than Epocrates and WebMD for precisely that reason, the
concern about bias. (Although, I have never actually seen it happen,
and I do have the WebMD app on my iPad).

I do think Kathy is right in stating users need to be aware of the
apps that they are using and vet those resources for potential bias. I
am the library liaison to the nursing programs at my institution and I
always try to remember to mention the need to be aware of who is
producing a resource when I teach my classes.

Jill Turner

[Molly K]

Jill - thanks so much for bringing this up! I was surprised when I
heard about the Epocrates/Pharmaceutical industry connection.

The articles on the medical apps/pharma connection from
imedicalapps.com that Kathy mentioned are good reading. I look at
Skyscape a little differently now. They provide Dynamed access for
Ebscohost users...and since you have to create a SkyScape account in
order to install our library version of Dynamed, aren't we in a way
facilitating the provision of patron information to marketers? Now
there is a can of worms.

http://www.imedicalapps.com/2011/06/hidden-costs-favorite-free-medical-apps-part-1/
http://www.imedicalapps.com/2011/07/hidden-cost-free-apps-part-2/

Kathy's idea for a disclaimer on your suggested sites page is a great
idea - one that i am going to implement immediately!
mk

[Jill]

Yes, Molly, the point you brought up about SkyScape requiring an
account for its users had been brought up in another presentation I
attended on medical mobile apps. The presenter suggested that users
enter the least amount of info that was allowed to initiate the
account, but at this time there does not seem to be a way out of
providing at least some information to SkyScape and whoever else they
may let access the information. At this time there are no other
options, unfortunately.

Jill

On Jul 12, 2:06 pm, Molly K <unchien.anda...@gmail.com> wrote:
> Jill - thanks so much for bringing this up! I was surprised when I
> heard about the Epocrates/Pharmaceutical industry connection.
>
> The articles on the medical apps/pharma connection from
> imedicalapps.com that Kathy mentioned are good reading. I look at
> Skyscape a little differently now. They provide Dynamed access for
> Ebscohost users...and since you have to create a SkyScape account in
> order to install our library version of Dynamed, aren't we in a way
> facilitating the provision of patron information to marketers? Now
> there is a can of worms.
>

> http://www.imedicalapps.com/2011/06/hidden-costs-favorite-free-medica...http://www.imedicalapps.com/2011/07/hidden-cost-free-apps-part-2/

[Melissa McElroy-Elve]

Hi again,
I am glad for the catch-up weeks as I was on vacation last week.

These are all good points and some great suggestions about improving our disclaimers.  Ultimately, I think this supports the need for librarians at all levels to continue to support users' growth with critical information literacy.

Would it be okay if I share this thread with our director?
Thanks,
Melissa

[Molly K]

melissa - that's fine with me! mk

[Alisha764]

This is an excellent and timely discussion. I agree with Kathy and
Melissa McElroy-Elve that you must teach users how to appraise the
literature. Yes Epocrates is supported by pharmaceutical companies, so
is WebMD, eMedicine, Medscape (ask physicians how they get news
updates and this one always seems to come to the top), and many
others. Will physicians stop using these resources because of the
link? Probably not.

Each resource we use has the potential for a link to a pharmaceutical
company or other bias. Every resource has a board of directors,
contributors, editors, etc. Even if each person discloses their
relations and states they are not biased, there recent knowledge of a
new drug because they sit on the board is probably going to have some
influence. We all are influenced by different products, companies,
beliefs, etc. throughout the day. The important thing here is to teach
the clinical staff (all staff, especially students and nurses) how to
appraise the literature or at least to review and understand. I also
think clinicians should always consult more than one resource as a
rule instead of taking 1 resource as the end all be all... hmm I might
be throwing in my own bias here for a particular resource with a green
logo :)

~Alisha

[Amy Blevins]

Ever since this issue was brought to my attention, I've been
mentioning Micromedex when asked for the "free for med students" url
for epocrates and mentioning that there is a potential for bias. I
don't want to keep anyone from a resource they might find useful, but
I do want them to be aware of what they are using and where it's
coming from.