AACAP's Operating Principles for Extramural Support of AACAP Meetings and Related Activities

Bennett L. Leventhal, M.D.
AACAP's Member Meetings Manager

AACAP has been a leader in managing disclosures and potential conflicts of interest that can and do interfere with objective conduct of science and clinical practice. By affirmatively developing and using guidelines to govern extramural support for AACAP meetings and the presentations of meeting participants, we are giving meeting attendees the information necessary to make decisions about the nature of scientific and clinical material available at the AACAP meetings. For more than six years, the AACAP has managed its meetings under the Operating Principles for Extramural Support. We are now pleased to give you an update on the Principles, which meet or exceed the standards set by other organizations. The Principles represent a dynamic process designed to serve our patients and profession. As a result, your awareness and participation are essential to their success. While these Principles may prove to be inconvenient, at times, they are serving us well in terms of maintaining our scientific and clinical integrity. We hope you will take pride in our Principles and your participation in the process.

AACAP meetings are designed to provide rich opportunities for learning, scientific exchange, and collegial interaction. In particular, the AACAP Annual Meeting is a special event for professionals in child and adolescent psychiatry and allied disciplines to assemble from around the world with the purpose of advancing understanding of the many facets of child development, developmental biology and psychology, developmental psychopathology, assessment, treatment, prevention, and public policy. Through the efforts of our members and the many presenters and attendees at the Annual Meeting, we are proud to be able to consistently meet these goals.

It has long been important to the AACAP and the Program Committee, as we develop and present our meetings, to keep content and presentations independent from sources of funding or other support. In so doing, we have been able to maintain the integrity of the meetings. In order to codify its intentions and processes for separating content from financial support and to facilitate the fullest transparency and disclosure, in 2003, the AACAP developed the Operating Principles for Extramural Support of American Academy of Child and Adolescent Psychiatry (AACAP) Meetings and Related Activities. These operating principles provide the framework through which members of AACAP, AACAP meeting attendees, and AACAP meeting supporters can preserve the form and substance of AACAP high quality scientific and educational programming in the context of full financial disclosure. As part of the submission process and registration for the meeting, each presenter and other attendees must agree to read and abide by these principles.

In order to keep the Operating Principles current, each January, AACAP invites representatives from the pharmaceutical industry to the AACAP Central Office to discuss the Operating Principles. These meetings have provided an important foundation for an effective working relationship with these and other financial supporters of the AACAP meetings.

The operating principles include policies governing the following areas:

Disclosure of financial relationships/conflicts of affiliation
Acknowledgement of commercial support
Promotional materials
Press-related activities
Off-label use or investigational therapies
Copyright
Exhibits
Enduring materials
Non-AACAP sponsored events

However, the Operating Principles for Extramural Support of American Academy of Child and Adolescent Psychiatry (AACAP) Meetings and Related Activities are only as good as those of uswho adhere to them and assure that their colleagues do thesame. This must begin with the AACAP membership as itis our profession and professional association that are trulyat risk if we fail to meet our stated responsibilities. AACAP membership can assist us in our collective to assure honestyand integrity in our meetings as well as related scientific andclinical activities by becoming familiar with the Operating Principles and monitoring adherence to them. For your reference,the full document is available online at www.aacap.org.

While the Operating Principles is an extensive document that covers many details related to the Annual Meeting, some of the most critical points are:

Commercial enterprises (including pharmaceutical companies) and other entities related to the AACAP Annual Meeting, agree to not have independent presentations during the week of the Annual Meeting at the host hotel or elsewhere in the meeting city.
No corporate logos may be displayed outside the exhibit hall.
No press conferences or briefings may be held prior to presentations at AACAP meetings nor can sponsors represent AACAP meeting content without specific written permission from AACAP.
Companies may not send out any pre-meeting mailings or use hotel door drops.
Companies may not contact meeting attendees before the meeting to promote attendance at sponsored events.

We strongly encourage you to review the Operating Principles. When you register for the AACAP meetings, you agree to abide by these principles and not participate in forbidden activities. The Principles apply to all of AACAP members and meeting attendees. If you learn about an activity that you think might be in conflict with AACAP's Operating Principles, please contact Heidi Fordi, Deputy Executive Director and Senior Director of Meetings, Continuing Medical Education, and Development, at 202.966.7300, ext. 102 or hfordi@aacap.org. Each potential violation of the Operating Principles has been and will be carefully investigated. And, disciplinary actions, including banning from participation in the Annual Meeting have occurred. After all, the Operating Principles are only as good as the level to which we adhere to them.

As a reminder, if you participate in an AACAP meeting in any way, you should disclose any conflicts of affiliations. This ensures that the scientific content of the meeting remains clear of any undisclosed commercial bias. AACAP has the following policies regarding disclosure:

A. Disclosure of real, potential, or perceived affiliations is an important and serious matter.

Disclosure is required and considered to be an obligation of all attendees who present or speak at the Annual Meeting, be it from the podium or the floor. (Those asking questions or making short comments from the floor can fulfill this obligation by a purely verbal disclosure.)
The Program Committee monitors disclosures during the course of the meeting.
Failure to disclose is construed to be an ethical violation that will result in disciplinary action by the AACAP Program Committee.
WE TAKE DISCLOSURE SERIOUSLY!

B. BEFORE beginning your presentation, you have a duty to disclose:

I. Any off-label medication uses recommended.
II. Any real, potential, or perceived commercial, financial, or other affiliations.

C. Full disclosure is a requirement of the AACAP and our accrediting institution, the ACCME.

D. Disclosure must be made:

I. In writing and in advance to the AACAP.
II. On the first content slide in a presentation or prominently at the top right of a poster (All presenters' and authors' disclosures must be located in the top right corner of every poster in a minimum of 12 pt. font size).
III. Verbally at the beginning of each presentation.

E. Use of the Standard Disclosure Format is required.

Presenters are required to use the AACAP Standard Disclosure Slide as the format for disclosure for each presentation if the presentation includes slides; otherwise verbal disclosure is acceptable. The standard slide is available at: www.aacap.org/cs/AnnualMeeting/2009/Presenters.

F. When in doubt, report.

When there are no affiliations, this should be indicated on a slide and verbally or on the poster.
The reporting timeframe is a minimum of the past two years and imminent support. An obligation to report may exist for funds received prior to the last two years if it would be commonly perceived to have impact on that particular presentation, e.g., funding for a study which ended prior to two years ago but is now being reported must be disclosed.
When in doubt about reporting, request guidance from meetings@aacap.org. The Program Committee will respond promptly to questions about disclosure of affiliations.

G. If disclosures were not submitted to AACAP in the response to the Call for Papers, or if there has been a change to your disclosure, email appropriate information immediately to the AACAP with special attention to particularly relevant disclosures for each presentation at meetings@aacap.org.

In addition to AACAP's Operating Principles and policies on disclosure, AACAP's transparency portal on our Web site www.aacap.org/cs/root/AACAP.Transparancy provides expanded information on our commitment to transparency issues. We encourage you to visit the portal and learn more about our rigorous and comprehensive actions on these topics.

In this time of our own careful attention to transparency, disclosure, and integrity, you should be proud to have been at the vanguard of setting and maintaining principles and guidelines for behavior. We hope that you will continue to support our collective effort. Thank you for taking this matter seriously. It is your attention to these details that make us stronger and leaders in the ethical practice of medicine.