An Institute of Medicine review of California’s prominent center for stem cell research found organizational flaws and called for sweeping changes to reduce potential conflicts of interest.

The report praised the taxpayer-funded California Institute for Regenerative Medicine for its aggressive pace in awarding grants totaling $1.3 billion to 59 institutions, saying, “CIRM and those it has funded have set in motion a significant scientific enterprise.” However, the IOM found the center’s practices generate concerns about transparency and potential bias that could undermine support for the CIRM.

Reviewers found “far too many” CIRM board members represent organizations that were awarded grants or benefited from the grants. The majority of board members should be independent with no conflicting personal or professional interests, the committee said.

The CIRM definition of conflict of interest should be retooled to “include non-financial interests, such as the potential for personal conflicts of interest to arise from one’s own affliction with a disease or personal advocacy on behalf of that disease,” the report said.

The IOM review called for the CIRM’s day-to-day operations to be separate from its oversight. The report said the 29-member board, the Independent Citizens Oversight Committee, now performs both functions, which clouds critical independent monitoring.

Another recommendation from the IOM: Set up an external scientific advisory board made up mostly of people outside California to ensure that the CIRM is funding the best stem cell science.

Some IOM proposals require legislative action. California voters approved the creation of the CIRM and $3 billion to fund it when they adopted a ballot initiative, Proposition 71, in 2004. The CIRM was established in 2005. Funding is due to run out in 2017.

Marcy Darnovsky, PhD, associate executive director of the Center for Genetics and Society in Berkeley, Calif., applauded the recommendations and said the report is the first to suggest restructuring the CIRM. The nonprofit policy research and advocacy organization has been critical of the CIRM.

“CIRM has not responded in a meaningful way to many previous public interest suggestions or to independent reviews,” Darnovsky said in a statement. “We hope the agency will not continue that pattern.”

Leaders of the CIRM, which commissioned the $700,000 review, said they welcomed the scientific and nonscientific perspectives in the recommendations and were analyzing the report.

“As a public agency, we have a duty to be as open and transparent as possible,” Ellen Feigal, MD, CIRM’s senior vice president for research and development, said in a statement. “This report demonstrates our commitment to that goal.”

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