SMFM Participant Disclosures of Interest Form
SMFM Participant Disclosures of Interest Form
As a volunteer for SMFM, you may be asked to serve in one of several capacities for SMFM (“SMFM participant”) including, but not limited to: as a member or leader of a committee; as a member of a task force; as a member of the SMFM Board of Directors, the Executive Committee, or service in another leadership capacity; or as a contributor to the development of a SMFM clinical content, publications, or other work products. To further trust in the work of SMFM, all SMFM participants must follow a publicly transparent process for disclosing relevant interests and the identification of and management of conflicts of interest.
By definition, a conflict of interest (COI) is any professional or private interest that could affect or might reasonably be perceived to affect objectivity and independence such that the individual’s primary actions on behalf of the Society could be motivated by secondary gain (financial, academic, professional, or otherwise).
COMPLETE DISCLOSURE OF INTEREST FORM NOW > > >
Disclosures of Interest Form Samples
Disclosures of Interest Policy
SMFM's Disclosures of Interest Policy was published in the December 2020 edition of the American Journal of Obstetrics and Gynecology (AJOG). Click here to download and read the policy in its entirety.
Our objective is to provide clear definitions and disclosure practices for SMFM members serving SMFM regarding both financial and nonfinancial COIs.
Broadly, COI can be divided into the following categories:
- Financial COI: Any relationship for which one receives remuneration or in-kind benefits thereby creating a risk that judgements could be influenced by secondary financial gain. This can include employment, founder/board/consultant of health care organization, lecture fee/honoraria, patent received or pending, royalties, consulting or professional review activities, stock or bond ownership or stock options (excluding those in blind trusts, mutual funds), grants or sponsorship, contracted research (public or private funding), or any other financial compensation exceeding $1000 over 3 years.
- Nonfinancial COI: Any activity that could create potential attachment to a point of view and could be perceived to cause bias, commonly specific to a given topic. This can include any unpaid service on advisory committees, review panels, or boards: advocacy or lobbying activity on behalf of a healthcare or disease advocacy organization: or non-monetary support including equipment and gifts.
In order to assess for COI, SMFM participants must submit a Disclosure of Interest (DOI) form.
Who submits Disclosures of Interest (DOI)?
Anyone who serves as a member or leader of an SMFM committee; as a member of an SMFM task force; as a member of the SMFM Board of Directors, the Executive Committee, or service in another leadership capacity; or as a contributor to the development of SMFM clinical content, publications, or other work products is considered an SMFM participant and must report any healthcare-related interests for themselves and their family members (including current spouse, common-law, life partner, dependent children, or persons cohabitating with the SMFM participant greater than or equal to 1 year) using the DOI Part I form.
The DOI form has two parts. Part I is required for all SMFM participants. Part II is only requested at the time a SMFM participant will begin working on an activity regarding a specific topic, such as in the development of a clinical guideline or other publication or participation on a task force about a specific topic.
When are DOI required?
- Prior to joining the Board of Directors or SMFM committee(s)
- Semi-annually for Executive Committee members
- Annually for all ongoing SMFM participants, including BOD
- Prior to publication of a SMFM branded document for contributors
- When a significant new interest arises while serving on behalf of the SMFM that would constitute a new COI for their current SMFM duties (SMFM to be informed within 90 days)
- When the participant takes on a new role/assignment on behalf of SMFM
Time period for DOI:
Look-back period of three years (36 months) prior to participation. Look-forward period of one year (12 months) for known future interests, commitments, or other relationships.
Relevant commercial entity definition:
Organizations external to the Society, including institutions, companies, corporations, partnerships, firms, associations, which might have a financial or business interest in being associated with the Society, its members, or participants.
Other organization definition:
Non-SMFM professional organizations in which SMFM members may participate in a leadership capacity (such as serving on a committee, board of directors, organizer, liaison, task force, or any other specific member capacity).
How to report a conflict:
If you would like to report a suspected conflict, you can do so anonymously through an online form or via email through our COI mailbox. If you would like to be contacted regarding the status of the conflict resolution, please provide your contact information.