Lieb/Klemperer group

Conflicts of interest and bias

Group Leader

Co-Leader

Group members

PD Dr. Nadine Dreimüller

Marlene Stoll, M.Sc.

Former group members

Dr. Cora Koch

Lara Hubenschmid, M.Sc.

Janosch Weißkircher, M.A. 

Research topics

Medical and scientific thinking and action should always be oriented toward the patient's well-being. However, physicians always find themselves in a system of diverging interests and options for action. Direct financial conflicts of interest and indirect conflicts of interest can (un)consciously influence judgment and decision-making and may impair patient welfare. Physicians are exposed to a particularly strong influence by the pharmaceutical industry, which depends on the medical profession for its business success. However, physicians are also exposed to increasing pressure to take financial considerations into account in their medical professional actions, particularly in hospitals.

In everyday clinical practice as well as in research, questions such as the following arise: How do physicians perceive non-medical influence on their actions? Are they aware of conflicts of interest? How do they deal with them? How do they behave when the patient's well-being is endangered by non-medical influences? What is their position on regulations for dealing with conflicts of interest? 

This also raises the question of how the patient's preferences can be clarified and translated into medical action in the process of shared decision-making between physician and patient.

Threats to the integrity of clinical medicine and medical research are the guiding theme of our working group.

Projects

Strategies for dealing with conflicts of interest

The project SoCIReM (Second order effects of Conflict of Interest Regulations in Medicine) is based on the observation that the increasing regulation of conflicts of interest in medicine can have unintended and negative effects on the independence of science and scientific progress.

Conflicts of interest in psychotherapy research

This project focuses on the factors that influence psychotherapy research and the distortions in publications of psychotherapy research.

Conflicts of interest and guidelines

Trustworthiness is an essential quality feature of clinical practice guidelines. Conflicts of interest due to relationships with manufacturers of drugs and medical devices, but also the self-interest of professionals, professional groups, and professional societies increase the risk of bias in clinical practice guidelines. Disclosure and management of conflicts of interest are therefore necessary. This project investigates how different actors perceive, assess and follow conflict of interest policies.

Industry and conflicts of interest 

Manufacturers of pharmaceuticals and medical devices often declare patient welfare as their primary interest. Inevitably, conflicts arise with their obligation to safeguard the financial interests of their shareholders. This project addresses this conflict of interest and possible solutions.

Other research

Our research interest also focuses on the distortions in the prescribing behavior of physicians and how these can be modified through certified continuing education and independent drug studies. 

Funding

• Volkswagen Foundation

Key publications

• Stoll, M., Mancini, A., Hubenschmid, L., Dreimüller, N., König, J., Cuijpers, P., Barth, J., & Lieb, K. (2020). Discrepancies from registered protocols and spin occured frequently in randomized psychotherapy trials–a meta-epidemiologic study. Journal of Clinical Epidemiology, 128, 49-56. https://doi.org/10.1016/j.jclinepi.2020.08.013
• Stoll, M., Hubenschmid, L., Koch, C., & Lieb, K. (2020). Voluntary disclosures of payments from pharmaceutical companies to healthcare professionals in Germany: a descriptive study of disclosures in 2015 and 2016. BMJ Open, 10, Article e037395. https://doi.org/10.1136/bmjopen-2020-037395
• Koch, C., Schleeff, J., Techen, F., Wollschläger, D., Schott, G., Kölbel, R., & Lieb, K. (2020). Impact of physicians’ participation in non-interventional post-marketing studies on their prescription habits: A retrospective 2-armed cohort study in Germany. PLoS medicine, 17(6), Article e1003151. https://doi.org/10.1371/journal.pmed.1003151
• Koch, C., Dreimüller, N., Weißkircher, J., Deis, N., Gaitzsch, E., Wagner, S., Stoll, M., Bäßler, F., Lieb, K., & Jünger, J. (2020). Teaching conflicts of interest and shared decision-making to improve risk communication: a randomized controlled trial. Journal of General Internal Medicine, 35(2), 473-480. https://doi.org/10.1007/s11606-019-05420-w
• Stoll, M. & Lieb, K. (2019). Ethik in der psychotherapeutischen Versorgung: Transparenz, Unabhängigkeit, Interessenkonflikte. In Steger, F & Brunner, J. (Eds.), Ethik in der psychotherapeutischen Praxis: Integrativ-fallorientiert-werteplural (pp. 74-85). Stuttgart: Kohlhammer Verlag.
• Koch, C., Stoll, M., Klemperer, D., & Lieb, K. (2017). Transparency of Conflicts of Interest: A Mixed Blessing? The Patients' Perspective. The American Journal of Bioethics, 17(6), 27-29. https://doi.org/10.1080/15265161.2017.1313338
• Lieb, K., von der Osten-Sacken, J., Stoffers-Winterling, J., Reiss, N., & Barth, J. (2016). Conflicts of interest and spin in reviews of psychological therapies: a systematic review. BMJ Open, 6(4), Article e010606. https://doi.org/10.1136/bmjopen-2015-010606
• Lieb, K., & Brandtönies, S. (2010). A survey of german physicians in private practice about contacts with pharmaceutical sales representatives. Deutsches Ärzteblatt International, 107(22), 392-389. https://dx.doi.org/10.3238/arztebl.2010.0392