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Conflicts of Interest and Evidence-Based Clinical Medicine

Physicians' financial interests may have an unconscious influence on their interpretation of the scientific evidence relevant to the treatments they choose for their patients. This indirect determinant of physician behavior has not been extensively studied, but the causal process can be sketched using general principles of cognitive and social psychology and of marketing. The influence of financial interests on clinician knowledge is a distinct topic from their influence on clinician action. The latter topic has been the main concern in discussion of conflicts of interest induced by gifts from pharmaceutical or medical device manufacturers, by managed care or insurance rules, or by payments from interested industries to the directors of nonprofit hospitals or accompanying the intrusion of the commercial management of hospitals and clinics into ...

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