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I. Application & Definition.

This Relationships & Conflicts of Interest Policy (“Policy”) applies to individuals serving the American Academy of Neurology (“AAN”) and the American Academy of Neurology Institute (“AANI”) (collectively, “Academy”), in capacities including: AAN members or nonmembers serving as officers, committee members, faculty members, clinical practice guideline (and related products) or quality measure developers, authors, consultants, or other positions of official responsibility or leadership for the Academy, its publications or education programs (“Person”). A Person has a conflict of interest if that Person has a private interest that may interfere with the Person’s responsibilities or service to the Academy.

 

II. Importance

Conflicts of interest are a matter of concern for the Academy. Persons serving in official capacities have a fiduciary duty to exercise impartial judgments for the best interests of the Academy and AAN members. The presence of a private interest may impair their ability to exercise competent judgment and objectivity in their official capacity. Conflicts of interest may also diminish the confidence of members and the public in the quality of the Academy’s publications, programs and operations.

 

III. Resolution of Conflicts

Conflicts of interests can be resolved or lessened through several strategies.

  1. Avoidance. Serious conflicts should be avoided altogether by not serving in the selected capacity for the Academy in situations in which there is a serious conflict of interest.
  2. Withdrawal. Persons with serious conflicts wishing to retain their official Academy responsibility can divest the conflicting interest or withdraw from the conflicting relationship.
  3. Disclosure. Disclosure does not eliminate the conflict but mitigates it insofar as it permits others to become aware of the conflict, to monitor the Person’s performance, and to consider its effect when interpreting the Person’s judgments, publications or presentations. Disclosure is the appropriate remedy for mitigating most instances of conflicts of interest. 

The appropriate Board of Directors (AAN or AANI) has the ultimate responsibility of determining what limitations or actions may be necessary to protect the organization.

 

IV. Relationship Disclosures

Disclosure of conflicts of interest to responsible officials of the Academy is an ethical responsibility of the Person having the conflict. However, Persons may be uncertain whether a relationship constitutes a conflict of interest for purposes of the Academy role, program, product or activity. Therefore, at the beginning of a Person’s term of service for the Academy, including on the Board of Directors, committee, subcommittee, task force, clinical practice guideline (and related products) and quality measure development panels, or before a Person gives an educational presentation at an Academy meeting, or authors an article in an Academy publication or product, the Person must complete an appropriate relationship disclosure form. This form requires Persons’ providing service to the Academy in various capacities to disclose all relationships with certain entities in certain contexts, including those the Person believes may constitute a conflict of interest. This general disclosure allows the Academy’s appropriate Reviewing Authority (defined below) to determine which relationships, if any, constitute a conflict of interest. 

The Academy Boards have approved the relationship disclosure form, available below (“Relationship Disclosure Form”), with the understanding that certain activities may need to adjust or add to the language of the Relationship Disclosure Form to meet their specific disclosure requirements. Whenever possible, the Relationship Disclosure Form will be used across Academy activities to minimize the need for Persons to complete a separate form for each activity.

 

V. Administrative Review & Action.

The following is the process for reviewing relationships for conflicts of interest. Academy activities requiring additional procedural steps for conflicts of interest review may do so with approval by the appropriate Board of Directors.

  1. The following table provides who is responsible for reviewing submitted Relationship Disclosure Forms:
Person Submitting Disclosure Forms Reviewing Authority
AAN/AANI Boards of Directors (including Executive Director) President/Chair
President/Chair AAN/AANI Boards of Directors
Appointees to outside organizations President/Chair
Editors-in-Chief of Academy publications and products   President/Chair
 Associate editors of Academy publications and products   Applicable Editor-in-Chief
 Authors and co-authors submitting works to Academy publications and products   Associate editors of applicable publications and products 
 Chairs of standing committees, task forces, and ad hoc committees  President/Chair
 Members of standing committees, task forces, and ad hoc committees  Chair of applicable standing committees, task forces, and ad hoc committees
 Chair of subcommittees and workgroups  Chair of applicable standing committee
 Members of subcommittees and workgroups  Chair of applicable subcommittees and workgroups
Annual Meeting education program directors  Conference Subcommittee 
Annual Meeting education program faculty  Conference Subcommittee 
Annual Meeting scientific program directors Science Committee 
Annual Meeting scientific program faculty  Science Committee 
Authors of Clinical Practice Guidelines and related products  Chair, Guideline Development, Dissemination, and Implementation Subcommittee, and Lead Methodologist  
Guideline Methodologists  Chair, Practice Committee 
 Authors of Performance Measures   Chair, Quality and Safety Subcommittee 
Executive Staff Executive Director/CEO
  1. Copies of completed Relationship Disclosure Forms will be provided to the Reviewing Authority and the appropriate Executive Staff member, for review before the Person begins their work for the Academy.
  2. Possible courses of action the Reviewing Authority (which may vary to meet the specific needs of the Academy activity) may take with respect to each Relationship Disclosure Form include:
    1. There are no relationships noted, then no action is required.
    2. There are relationships noted, but no conflicts of interest found. The relationships may be disclosed to fully inform the audience/readers.
    3. There are relationships noted, and possible conflicts of interest found:
      1. The severity of the conflict is such that it is compatible with concurrent maintenance of the Person’s official Academy capacity and the conflicting interest or relationship. The situation should be monitored carefully and the relationship must be disclosed to fully inform the audience/readers.
      2. The severity of the conflict is such that the Person must be removed from the official Academy capacity (e.g., must not serve as an Academy committee member, author, or faculty member), must divest the conflicting interest, or must withdraw from the conflicting relationship.
  3. Any disagreement between a Person and the Reviewing Authority may be submitted to the appropriate Executive Committee (AAN or AANI) for resolution. The Executive Committee may consult with the Ethics, Law and Humanities Committee concerning any submitted dispute.


VI. Organizational Conflicts with Commercial Interests

A complex set of conflicts may accompany relationships of the Academy with commercial interests (“Commercial Interests” include any entity developing, producing, marketing, re-selling, or distributing health care goods or services, including drugs, devices, services or therapies, consumed by, or used on, patients to diagnose, treat, monitor, manage, and alleviate health conditions). This Policy seeks to recognize and protect the benefits of these relationships while avoiding conflicts of interest that may arise. The Academy has functioning policies in several areas where these relationships with Commercial Interests, otherwise designated in Academy policy as “Industry,” exist, including the Principles Governing Academy Relationships with External Sources of Support (“Principles”).

Policy History: Initially approved by the AAN Ethics and Humanities Subcommittee April 13, 1997; approved by the AAN Practice Committee August 24, 1997; approved by the AAN Board of Directors October 4, 1997, and published in Neurology (1998;50:332-334).  Amended by the AAN and AANPA Executive Committees on February 21, 2008; ratified by the AAN and AANPA Boards of Directors on March 7, 2008 (AAN Policy 2008-06; AANPA Policy 2008-05). Amended by the AAN and AANI Boards of Directors on September 7, 2017.


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