Chapter 25 Conflict of Interest Jennifer Tseng and Peter Angelos A conflict of interest is a source of bias. Conflicts of interest have been defined as “a set of conditions in which professional judgment concerning a primary interest tends to be unduly influenced by a secondary interest” [1]. They erode public trust in the medical researcher. The most commonly perceived conflict of interest per- tains to financial support for the researcher. NIH funding has declined recently in support of clinical trials, and as a result, clinical trials are increasingly launched and supported by pharmaceutical companies. The physician or researcher thus gains monetarily by being an investigator on a drug trial [2]. Presentations and publi- cations require declaration of industry financial backing for transparency regarding these conflicts of interest. In some extreme cases, study sponsors have tried to change results or stop publication [3, 4]. In academic settings, promotion and ambition toward tenure and professional standing can be just as influential as monetary support. The dual role of physician–scientist may create conflicts as the physician’s duty as a healer sometimes contradicts the scientist’s role as a researcher. Conflicts of interest are not inherently unethical but the physician–scientist’s actions can cause concerns [2]. The Association of American Medical Colleges (AAMC) released guidelines to help ameliorate these conflicts of interest: full disclosure, aggressive monitoring and misconduct management [5]. Full disclosure applies to both indi- vidual and family financial and professional interests. Institutional review boards (IRBs) play a key role in research monitoring and determining if and to what extent conflicts of interest exist. J. Tseng (&) Á P. Angelos Department of Surgery, The University of Chicago Medicine, 5841 S. Maryland Avenue, 60637 Chicago, IL, USA e-mail: jennifer.tseng@uchospitals.edu P. Angelos e-mail: pangelos@surgery.bsd.uchicago.edu © Springer International Publishing AG 2017 K.M.F. Itani and D.J. Reda (eds.), Clinical Trials Design in Operative and Non Operative Invasive Procedures, DOI 10.1007/978-3-319-53877-8_25 215