Exhibit 4Example of personal beliefs exerting an undue influence

Ms. Alomar is a nurse practitioner who is asked to work on a project evaluating the comparative benefits and harms of physician assistant care versus nurse practitioner care in patients with hypertension. She attended college for 4 years to become a registered nurse, worked in practice for 5 years, and then went back to school for 2 years to become a nurse practitioner. Upon graduation, she struggled for acceptance in her medical center but has now established a successful primary care practice that sees patients with hypertension. Ms. Alomar believes that physician assistants cannot substitute for the care and nurturing nurses provide, that physician assistants’ training is substandard to provide quality care, and that findings showing that physician assistants provide quality care will harm her and the profession she loves. She is included in the team and does not reveal that the proposed literature search excludes some relevant journals that frequently publish articles by physician assistants; however, she explicitly recommends searching a nursing-specific database. The report finds insufficient information to evaluate the quality of care provided by physician assistants.

From: Identifying, Measuring, and Managing NFCOI

Cover of Identifying and Managing Nonfinancial Conflicts of Interest for Systematic Reviews
Identifying and Managing Nonfinancial Conflicts of Interest for Systematic Reviews [Internet].
Viswanathan M, Carey TS, Belinson SE, et al.

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