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Volume 27 (2)
Volume 27, Issue 2, Spring 2007
J Contin Educ Health Prof 2007; 27(2):118
RESEARCH ARTICLE
Developing an Instrument to Measure Bias in CME
Takhar J
Dixon D
Donahue J
Marlow B
Campbell C
Silver I
Eadie J
Monette C
Rohan I
Sriharan A
Raymond K
Macnab J
A b s t r a c t
Introduction: The pharmaceutical industry, by funding over 60% of programs in the United States and Canada,
plays a major role in continuing medical education (CME), but there are concerns about bias in such CME programs.
Bias is difficult to define, and currently no tool is available to measure it.
Methods: Representatives from industry and academia collaborated to develop a tool to illuminate and measure
bias in CME. The tool involved the rating of 14 statements (1 = strongly disagree, 4 = strongly agree) and was used
to evaluate 17 live CME events. Cronbach’s alpha was used to assess the internal consistency of the scale.
Results: Cronbach’s alpha for the total score was 0.82, indicating excellent internal consistency. Incomplete or
biased data, data presented in an unbalanced manner, and experience not integrated with evidence-based medicine
were found to correlate strongly with the total score. Use of trade names showed a low correlation with the
total, and nondeclaration of conflict of interest correlated negatively with the total. These associations suggest that
whereas sponsor companies may declare conflicts of interest, such a declaration may not ensure an unbiased presentation.
Discussion: The tool and the data from this study can be used to raise awareness about bias in CME. Policymakers
can use this tool to ensure that CME providers meet the standards for education, and CME providers can
use the tool for conducting random audits of events they have accredited.
Lessons for Practice
- A valid and reliable tool for detecting, monitoring, and controlling bias is important to controlling bias in CME.
- A valid and reliable tool may be used as a screening instrument during accreditation processes.
- CME providers may find the tool useful for conducting random audits of events they have accredited.
Key Words: Continuing medical education, bias, bias assessment tool
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