New York, NY - With the 2006 TCT meeting looming, a feature story appearing online in Business Week explores some of the "tangled" conflicts of interest between physicians and industry, particularly at meetings like the TCT, where cutting-edge and experimental therapies are showcased [1]. The story, by Arlene Weintraub and Amy Barrett, also profiles Dr Martin B Leon (Columbia University, New York, NY), one of the founders of TCT, whose own conflicts of interest epitomize both the requirements for and difficulties inherent in full disclosure.

Recalling the death of a patient during a live case transmission at TCT 2004, as reported by heartwire, Weintraub and Barrett point out that the Leon's "anguish" over the event is still palpable, but that he also, as a founder of the company that originally made the device being used in the broadcast, stood to benefit from its success. Leon, they write, receives milestone payments in addition to the original $6 million he made from the sale of the company.

"Did Leon's financial stake in the experimental device play a role in its being promoted at an important conference where he is the most prominent figure?" Weintraub and Barrett ask in their story. "Absolutely not," Leon is quoted, adding that the question "borders on being offensive."

Weintraub and Barrett explore some of the reasons why physicians have been drawn to collaborations with industry; they also point out that institutions, journals, and organizations are coming down harder on conflicts of interest and insisting on full disclosure. The problem, they note, is that a deluge of disclosures doesn't necessarily translate into full transparency.

"As the volume of disclosure rises, some fear the ritual will become a mere formality, attracting only cursory attention," they write, quoting Dr Ezekiel J Emanuel (National Institutes of Health), who said, "If everyone is disclosing, it's as if no one is disclosing."

As well, even the fact that new and evolving devices are being used in live cases and being spotlighted at the meeting increases their use, Weintraub and Barrett write: "TCT undeniably stirs excitement about devices. When new products perform well in the live cases . . . a crowd of animated doctors and investors typically gathers around the booths of the relevant manufacturers."

Leon is quoted in the story saying that he is "extremely sensitive to potential conflicts of interest" and tends to be "overprotective and careful about making sure there is no undue bias." This year's TCT program and presenter disclosures are actually being reviewed by two doctors who are not members of the Cardiovascular Research Foundation, which puts on the meeting. As well, the meeting program will for the first time include a 30-minute panel discussion on conflicts of interest, the story notes.