Recognizing that professional education is a lifelong endeavor, the purpose of the American Society of Breast Surgeons (ASBrS) CME activities are to continually improve the quality of care for breast disease by keeping practicing surgeons current in knowledge and skills, including evolving technologies, by developing and delivering relevant educational programming in a variety of formats to our target audience. The Society is charged with ensuring its CME activities are balanced, independent, objective, and scientifically rigorous, through, but not limited to, the appropriate disclosure and management of financial conflict of interests.
Circumstances create a conflict of interest when an individual has an opportunity to affect CME content about products or services of a commercial interest with which he/she has a financial relationship. The ACCME considers financial relationships* to create actual conflicts of interest in CME when individuals have both a financial relationship (or non-financial/strategic business relationship or partnership) with a commercial interest* and the opportunity to affect the content of CME about the products or services of that commercial interest.
As a continuing medical education provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), the ASBrS requires anyone in a position to control the content of a CME activity (CME planners and contributors), including but not limited to course chairs, speakers, moderators, panelists, discussants, oral presenters, authors, planning committees, and ASBrS staff, to disclose financial and non-financial/strategic business relationships or partnerships with ACCME-defined commercial interests, relative to the educational content.
Participants must review and adhere to the ASBrS CME policy and disclosure process, and they must complete ASBrS Disclosure Forms so that any identified conflicts of interest can be managed prior to the start of their CME activities.
To assist all CME planners and contributors in identifying their potential conflicts, ASBrS staff provides a sample list of typical conflicts and possible corresponding resolutions–as well as examples of noncompliant actions. However, this list is not an exhaustive list of all scenarios. Participants are required to disclose all possible competing interests, both financial and non-financial, that could interfere with, or could reasonably be perceived as interfering with, their ability to provide objective and valuable contributions to the ASBrS CME activity.
All identified conflicts of interest are resolved through management strategies prior to the education activity being delivered to learners per ACCME Standards. The inability to resolve an identified conflict of interest results in the participant’s withdrawal from participation in the CME activity.
A list of disclosures from all CME planners and contributors, as well as all potential and actual conflict of interest resolutions (including any instances of noncompliance), are documented and maintained by ASBrS staff. This list is made available to all CME activity planners.
Anyone in a position to control the content of a CME activity that fails or refuses to disclose before the start of the CME activity results in the withdrawal to participate in the CME activity.
When applicable, anyone in a position to control the content of a CME activity who fails or refuses to disclose during the CME activity initiates the noncompliance process: the Board of Directors, CME Committee, and Ethics Committee will discuss the act of noncompliance and agree upon a resolution.
All relevant financial or non-financial/strategic business relationships or partnerships with ACCME-defined commercial interests are disclosed to learners before start of the CME activity in accordance with ACCME standards. Additionally, participants with no relevant commercial relationship(s) must inform learners that no relevant commercial relationship(s) exist before the start of the CME activity.
The CME Committee and Ethics Committees ensure that there is no commercial bias or influence in ASBrS CME activities. They work together to ensure proper conflict management. Members of these committees serve as additional oversight, participating and observing ASBrS CME activities to look for any evidence of bias and ensure compliance with the ASBrS policies.
Participants of any ASBrS CME activity may report any improprieties on the applicable evaluation form and to the CME and Ethics Committee at firstname.lastname@example.org.
Please contact the Ethics Committee or CME Committee at email@example.com if you have any questions.
Glossary of Terms
A commercial interest is any entity producing, marketing, re-selling, or distributing health care goods or services used by medical providers or consumed by, or used on, patients. The ACCME does not consider providers of clinical service directly to patients to be commercial interests.
*Relevant financial or Non-financial/strategic Business Relationships or Partnerships
ASBrS focuses on financial and non-financial strategic business relationships or partnerships with commercial interests in the 12-month period preceding the time that the individual assumes a volunteer or staff role.
Relevant Financial Relationships
ASBrS defines “relevant’ financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. ASBrS has not set a minimal dollar amount for financial relationships to be considered significant. Inherent in any amount is the incentive to maintain or increase the value of the relationship.
Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (eg, stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities from which remuneration is received, or expected. ACCME considers relationships of the person involved in the CME activity to include financial relationships of a spouse or partner.
The ACCME has not set a minimum dollar amount for relationships to be significant. Inherent in any amount is the incentive to maintain or increase the value of the relationship. With respect to personal financial relationships, contracted research includes research funding where the institution gets the grant and manages the funds and the person is the principal or named investigator on the grant.
Non-financial and Strategic Business Relationships or Partnerships
ASBrS recognizes that some non-financial relationships with ACCME-defined commercial interests have the potential to cloud objectivity and foster institutional loyalty, allowing for possible conflicts of interest to arise. Therefore, participants are required to disclose all sources of secondary competing interests that may impact their impartiality, including those of a spouse or partner.
For example, if a presenter serves on a commercial interest’s advisory board or is involved in its lobbying group, the content of the presenter’s CME activity could be impacted even if no honoraria was received. Furthermore, an individual may benefit from a commercial interest by receiving non-financial incentives, including equipment, disposable supplies, paid trainings, paid vacations, etc. These types of potential non-financial conflicts must be listed on the ASBrS Disclosure Form so that a designated meeting or CME official can determine which, if any, necessitate a conflict of interest management plan.
*Conflict of Interest
Circumstances create a conflict of interest when an individual has an opportunity to affect CME content about products or services of a commercial interest with which he/she has a financial relationship. The ACCME considers financial relationships to create actual conflicts of interest in CME when individuals have both a financial relationship with a commercial interest and the opportunity to affect the content of CME about the products or services of that commercial interest. The ACCME considers “content of CME about the products or services of that commercial interest” to include content about specific agents/devices, but not necessarily about the class of agents/devices, and not necessarily content about the whole disease class in which those agents/devices are used.
With respect to financial relationships with commercial interests, when a person divests themselves of a relationship it is immediately not relevant to conflicts of interest, but it must be disclosed to the learners for 12 months.
In addition, ASBRS recognizes that some non-financial/strategic business relationships or partnerships have the potential to cloud objectivity and foster institutional loyalty, resulting in conflicts of interest.
The American Society of Breast Surgeons is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.