Background: We conducted this study to determine whether and how medical school IRB websites address conflicts of interest during recruitment of research participants.

Methods: We analyzed the content of IRB policies posted on their websites regarding recruitment payments and role conflicts for 121 U.S. medical schools that receive NIH research funding.

Results: The majority of IRB websites discuss conflicts of interest during recruitment, but less than one-half discuss both types of recruitment payments and role conflict. There is considerable variation in IRB approaches to these conflicts. IRBs commonly ban recruitment payments, but few IRBs restrict recruitment when role conflicts exist. IRBs often acknowledge concerns about role conflict without indicating how to respond to such conflicts.

Conclusions: Recruitment payments and role conflicts may compromise study recruitment and potentially harm research participants. Our findings demonstrate how IRBs can strengthen their policies to avoid unnecessary conflicts and minimize risk of harm.