Non-Financial Conflicts of Interest in Academic Grant Evaluation: A Qualitative Study of Multiple Stakeholders in France

Abstract

BackgroundPeer review is the most widely used method for evaluating grant applications in clinical research. Criticisms of peer review include lack of equity, suspicion of biases, and conflicts of interest (CoI). CoIs raise questions of fairness, transparency, and trust in grant allocation. Few observational studies have assessed these issues. We report the results of a qualitative study on reviewers’ and applicants’ perceptions and experiences of CoIs in reviews of French academic grant applications.Methodology and Principal FindingsWe designed a qualitative study using semi-structured interviews and direct observation. We asked members of assessment panels, external reviewers, and applicants to participate in semi-structured interviews. Two independent researchers conducted in-depth reviews and line-by-line coding of all transcribed interviews, which were also subjected to Tropes® software text analysis, to detect and qualify themes associated with CoIs. Most participants (73/98) spontaneously reported that non-financial CoIs predominated over financial CoIs. Non-financial CoIs mainly involved rivalry among disciplines, cronyism, and geographic and academic biases. However, none of the participants challenged the validity of peer review. Reviewers who felt they might be affected by CoIs said they reacted in a variety of ways: routine refusal to review, routine attempt to conduct an impartial review, or decision on a case-by-case basis. Multiple means of managing non-financial CoIs were suggested, including increased transparency throughout the review process, with public disclosure of non-financial CoIs, and careful selection of independent reviewers, including foreign experts and methodologists.ConclusionsOur study underscores the importance of considering non-financial CoIs when reviewing research grant applications, in addition to financial CoIs. Specific measures are needed to prevent a negative impact of non-financial CoIs on the fairness of resource allocation. Whether and how public disclosure of non-financial CoIs should be accomplished remains debatable.

Conflicts of interest: new thinking, new processes

“…They encompass family loyalties, personal goals and ambitions, and political, religious or social commitments. Even if they are sometimes less obvious than financial interests, non‐financial interests are often more potent drivers of behaviour …”

“…Even if they are sometimes less obvious than financial interests, non-financial interests are often more potent drivers of behaviour. 5,[7][8][9][10] While people might at times have only one interest in relation to a social role or practice, it is far more common for people to have many coexisting interests. Such circumstances are common and do not in themselves imply that there is any problem.…”

Should we try to manage non-financial interests?

“…For example, evidence shows that non-financial interests may “call into question the impartiality of [systematic] reviews”10 and negatively affect the equitable allocation of health resources in grant funding procedures 11…”

Dangers of neglecting non-financial conflicts of interest in health and medicine

“…Viswanathan et al investigated strategies for identifying and managing non-financial interests in systematic reviews, concluding that ‘non-financial conflicts of interest, when ignored, can call into question the impartiality of a review’ (Viswanathan  et al , p. 1236) 22. Similarly, a qualitative study by Abdoul et al 29 explored the impact of non-financial COIs in the evaluation of academic grants and highlighted the need for specific measures to prevent the harmful influence of non-financial COIs on the equitable allocation of health resources 29. Of course, steps would need to be taken to ensure that any requirements for declaration of non-financial COI do not lead to an influx in which notifications of significant financial COI are lost, but this simply means that care and discretion should be exercised regarding when and how non-financial COIs are declared.…”