CME Spotlight: The numbers game
pharmafile | March 16, 2010 | Feature | Medical Communications | CME, CME Spotlight
We live in a world where people seem to have developed a strange obsession with numbers.
I am still baffled at how the announcement of a 0.1% increase in the UK GDP at the start of this year created the joyous atmosphere and declarations of the end of the recession.
The number was so small that I wonder how many people worried, as I did, that had one of us not bought any Christmas presents we may have single-handedly kept the country in the throws of recession for another quarter?! And how was it so much better than the -0.2% figure for the quarter before? The realisation that many retail figures were only estimated will, I am sure, get the statistically-minded among us muttering about error bars and significance.
Another area for bewilderment is the weather – a few years ago I knew to take an umbrella with me if the weather forecast said it was likely to rain, but what am I supposed to do now when informed that the probability of precipitation is 60 per cent?
There are an increasing number of examples that can be given that prompts the recall of the statement attributed to Einstein: not everything that can be measured is important and not everything that is important can be measured.
However, other than pass marks and adding up totals, what is the relevance of numbers in CME?
There is a part of the CME activity that needs to be completed before the learner may claim their CME certificate: the evaluation process. The evaluation form should ask the learner a number of their opinions relating to the quality and appropriateness of the programme, which is mostly straightforward, but a question about the learners’ perception of whether there was any evidence of bias raises interesting questions itself. How can one measure the level of a perception? It is either present or not, so in this binary situation we can only count the proportion of people who answered yes, or no. Once a total score for the population is gathered we are left with a percentage score for that specific sample. But is a figure of, for example, 5% a ‘good’ or a ‘bad’ score? CME bodies are collating the information, but numbers like this, divorced from their context will continue to mean little.
An interesting situation arose recently where I was involved in a CME accredited satellite symposium that took place during an international medical congress in Europe. It was a successful meeting, raising much positive comments from the faculty and delegates alike. However, when the evaluation forms were analysed the reported perception of bias came in at 23% – a ‘bad’ score in any context. This raised some alarm bells – the programme was developed following all the European standards, completely independently of the supporting company, the speakers were highly reputable, experienced, and with relevant, but not significant conflicts of interest to disclose. Most of the organising group could not recall any aspect of the meeting that may have raised any eyebrows, let alone such an overwhelming response. So what brought this about?
Sometimes its own worst enemy
As the meeting was presented as part of a major European congress the delegates had swipe cards to register for sessions, so it was possible to match the responses to the delegate profiles and to investigate further. It emerged that the overwhelming majority of the comments about bias came from drug company employees. To be specific, people employed by competitor companies. A clear example, as one member of the industry voiced at the recent meeting of the European CME Forum, of how “at times, pharma can be its own worst enemy”.
Spoiling tactics between rivals won’t progress dialogue – and there are lessons from US experience in how over-exuberance in the CME sphere can damage the industry, which should register on this side of the Atlantic too.
There is continued debate among CME accreditation bodies about how far to regulate pharma involvement in European CME. Some exclude pharma outright, but currently most do not, many willingly engage in meaningful and mature relationships.
Many from pharma are also working on how to show their increasingly various customers a new way of engagement, as the industry moves away from traditional business models to one of partnership, accountability and increased transparency. In the UK the ABPI’s Andrew Powrie-Smith is the Director leading the Trust Imperative, and is spearheading an initiative to define how pharma gets involved in CME/CPD and medical education in general, by engaging in dialogue and demonstrable transparency, with the aim of increasing trust in the industry.
Good CME Practice Group
One initiative in Europe specifically looking at how commercially supported CME can be carried out to appropriate standards is the Good CME Practice Group. Following the inaugural meeting at the recent European CME Forum, where a number of Core Principles were proposed for discussion, a dedicated group of education providers – agencies – that are currently, or planning to be, engaging with CME activities in Europe, have covened to define what constitutes good practice in CME. The group is now fleshing out details of the Core Principles which will help guide the various parties on how to work to appropriate operating standards and demonstrable levels of accountability. The group is working with input from individuals from European CME bodies and pharma companies to develop the framework to demonstrate to accreditation bodies and potential supporters of CME activities, that they are competent and suitably qualified to carry out projects in this complex field, that is coming under growing scrutiny from regulatory bodies.
Education providers in Europe will also have an increasing role to play in educating the uninitiated in the European CME sphere, both from pharma and the agency community, as to the appropriate ways to assist the profession in a positive way, as a trustworthy partner, in helping the development of what is rapidly becoming a critical part of a health professional’s activity, which is ultimately for the benefit of patients.
As a famous and successful General once said, on taking command of a rabble of men and women from an antagonistic variety of ethnicities and religions, united only by a common language and past experience: “Let us work on the few things that bring us together, rather than the many that can divide us.”
Information about the Good CME Practice Group can be found at www.gCMEp.eu
Eugene Pozniak is Managing Director of Siyemi Learning and Programme Director of European CME Forum. Email: epozniak@siyemi.org
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