Institutional Conflicts of Interest in Human Health Research – a Scoping Review

Abstract Background Conflict of interests (CoIs) can influence decision making in health research, raising concerns about transparency and integrity. Institutional CoIs (iCoIs) can arise for individuals and institutions alike when holding any interest affects the research process or its outcome. While progress has been made in research on individual CoIs, iCoIs remain largely unexplored. Objectives This scoping review aims to understand how iCoIs have been studied and discussed in the literature on human health research, and highlight gaps in the literature. Methods We registered a protocol of the review before commencing a systematic search in three databases in July 2024. We considered many publications types addressing iCoIs within healthcare organisations (e.g., hospitals and medical schools) published in English or German. Abstracts, policy descriptions, and papers focusing solely on review boards were excluded. Two reviewers screened abstracts, full texts, and extracted data. Results A total of 49 reports were included in the analysis. The majority stemmed from the United States and study types diverse (mainly empirical and conceptual work). iCoIs were predominantly discussed in relation to universities (57%), hospitals, medical schools, and research institutes. Involved industries included pharmaceutical companies (57%), biomedical, and medical device companies (20% each). Most studies (59%) focused on financial iCoIs only. Key concerns about iCoIs included distortion of research, threats to research integrity, or downplaying or neglecting risks. Conclusions Included publications focus primarily on financial interests related to universities, hospitals, and medical schools. While a multitude of potential threats to research integrity are identified, non-financial interests are not fully researched. There is need for empirical research of all types of iCoIs beyond case studies, and for evaluating current iCoI management strategies, particularly in other countries than the US. Key messages • Institutional conflicts of interest are largely unexplored. This scoping review shows that most publications focus on the US context and financial interests. • Detailed empirical studies are missing.