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Elsamadicy AA, Freedman IG, Koo AB, Reeves BC, Havlik J, David WB, Hong CS, Kolb L, Laurans M, Matouk CC, DiLuna M. Characteristics of Reported Industry Payments to Neurosurgeons: A 5-Year Open Payments Database Study. World Neurosurg 2020; 145:e90-e99. [PMID: 33011357 DOI: 10.1016/j.wneu.2020.09.137] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to characterize the payments made by medical industry to neurosurgeons from 2014 to 2018. METHODS A retrospective study was performed from January 1, 2014 to December 31, 2018 of the Open Payments Database. Collected data included the total number of industry payments, the aggregate value of industry payments, and the mean value of each industry payment made to neurosurgeons per year over the 5-year period. RESULTS A total of 105,150 unique surgeons, with 13,668 (12.99%) unique neurosurgeons, were identified to have received an industry payment during 2014-2018. Neurosurgeons were the second highest industry-paid surgical specialty, with a total 421,151 industry payments made to neurosurgeons, totaling $477,451,070. The mean average paid amount per surgeon was $34,932 (±$936,942). The largest proportion of payments were related to food and beverage (75.5%), followed by travel and lodging (14.9%), consulting fees (3.5%), nonconsulting service fees (2.1%), and royalties or licensing (1.9%), totaling 90.4% of all industry payments to neurologic surgeons. Summed across the 5-year period, the largest paid source types were royalties and licensing (64.0%; $305,517,489), consulting fees (11.8%; $56,445,950), nonconsulting service fees (7.3%; $34,629,109), current or prospective investments (6.8%, $32,307,959), and travel and lodging (4.8%, $22,982,165). CONCLUSIONS Our study shows that over the most recent 5-year period (2014-2018) of the Centers for Medicare and Medicaid Services Open Payments Database, there was a decreasing trend of the total number of payments, but an increasing trend of the total amount paid to neurosurgeons.
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Affiliation(s)
- Aladine A Elsamadicy
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut.
| | - Isaac G Freedman
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut
| | - Andrew B Koo
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut
| | - Benjamin C Reeves
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut
| | - John Havlik
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut
| | - Wyatt B David
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut
| | - Christopher S Hong
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut
| | - Luis Kolb
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut
| | - Maxwell Laurans
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut
| | - Charles C Matouk
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut
| | - Michael DiLuna
- Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut
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de Lotbiniere-Bassett MP, Riva-Cambrin J, McDonald PJ. Conflict of interest policies and disclosure requirements in neurosurgical journals. J Neurosurg 2019; 131:264-270. [DOI: 10.3171/2018.4.jns172751] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 04/02/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVEAn increasing amount of funding in neurosurgery research comes from industry, which may create a conflict of interest (COI) and the potential to bias results. The reporting and handling of COIs have become difficult, particularly as explicit policies themselves and definitions thereof continue to vary between medical journals. In this study, the authors sought to evaluate the prevalence and comprehensiveness of COI policies among leading neurosurgical journals.METHODSThe authors conducted a cross-sectional study of publicly available online disclosure policies in the 20 highest-ranking neurosurgical journals, as determined by Google Scholar Metrics, in July 2016.RESULTSOverall, 89.5% of the highest-impact neurosurgical journals included COI policy statements. Ten (53%) journals requested declaration of nonfinancial conflicts, while 2 journals specifically set a time period for COIs. Sixteen journals required declaration from the corresponding author, 13 from all authors, 6 from reviewers, and 5 from editors. Four journals were included in the International Committee of Medical Journal Editors (ICMJE) list of publications that follow the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (currently known as Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals). Five journal policies included COI declaration verification, management, or enforcement. The neurosurgery journals with more comprehensive COI policies were significantly more likely to have higher h5-indices (p = 0.003) and higher impact factors (p = 0.01).CONCLUSIONSIn 2016, the majority of, but not all, high-impact neurosurgical journals had publically available COI disclosure policies. Policy inclusiveness and comprehensiveness varied substantially across neurosurgical journals, but COI comprehensiveness was associated with other established markers of individual journals’ favorability and influence, such as impact factor and h5-index.
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Affiliation(s)
| | - Jay Riva-Cambrin
- 5Division of Neurosurgery, Department of Clinical Neurosciences, and
- 6Alberta Children’s Hospital, University of Calgary, Alberta, Canada
| | - Patrick J. McDonald
- 1Faculty of Medicine and
- 1Faculty of Medicine and
- 1Faculty of Medicine and
- 4Department of Surgery, University of British Columbia, Vancouver, British Columbia; and
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de Lotbiniere-Bassett MP, McDonald PJ. Industry Financial Relationships in Neurosurgery in 2015: Analysis of the Sunshine Act Open Payments Database. World Neurosurg 2018; 114:e920-e925. [DOI: 10.1016/j.wneu.2018.03.116] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/15/2018] [Accepted: 03/16/2018] [Indexed: 10/17/2022]
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Cepeda MS, Berlin JA, Glasser SC, Battisti WP, Schuemie MJ. Use of adjectives in abstracts when reporting results of randomized, controlled trials from industry and academia. Drugs R D 2015; 15:85-139. [PMID: 25749803 PMCID: PMC4359185 DOI: 10.1007/s40268-015-0085-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective Accurate representation of study findings is crucial to preserve public trust. The language used to describe results could affect perceptions of the efficacy or safety of interventions. We sought to compare the adjectives used in clinical trial reports of industry-authored and non-industry-authored research. Methods We included studies in PubMed that were randomized trials and had an abstract. Studies were classified as “non-industry-authored” when all authors had academic or governmental affiliations, or as “industry-authored” when any of the authors had industry affiliations. Abstracts were analyzed using a part-of-speech tagger to identify adjectives. To reduce the risk of false positives, the analysis was restricted to adjectives considered relevant to “coloring” (influencing interpretation) of trial results. Differences between groups were determined using exact tests, stratifying by journal. Results A total of 306,007 publications met the inclusion criteria. We were able to classify 16,789 abstracts; 9,085 were industry-authored research, and 7,704 were non-industry-authored research. We found a differential use of adjectives between industry-authored and non-industry-authored reports. Adjectives such as “well tolerated” and “meaningful” were more commonly used in the title or conclusion of the abstract by industry authors, while adjectives such as “feasible” were more commonly used by non-industry authors. Conclusions There are differences in the adjectives used when study findings are described in industry-authored reports compared with non-industry-authored reports. Authors should avoid overusing adjectives that could be inaccurate or result in misperceptions. Editors and peer reviewers should be attentive to the use of adjectives and assess whether the usage is context appropriate.
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Affiliation(s)
- M Soledad Cepeda
- Janssen Research & Development, LLC, 1125 Trenton Harbourton Road, Titusville, NJ, 08560, USA,
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Footnotes, Acknowledgments, and Authorship: Toward Greater Responsibility, Accountability, and Transparency. Ophthalmology 2014; 121:2297-8. [DOI: 10.1016/j.ophtha.2014.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 09/08/2014] [Indexed: 11/20/2022] Open
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Liesegang TJ, Bartley GB. Footnotes, acknowledgments, and authorship: toward greater responsibility, accountability, and transparency. Am J Ophthalmol 2014; 158:1103-4. [PMID: 25457700 DOI: 10.1016/j.ajo.2014.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 09/05/2014] [Indexed: 10/24/2022]
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Alfonso F, Timmis A, Pinto FJ, Ambrosio G, Ector H, Kulakowski P, Vardas P. Conflict of interest policies and disclosure requirements among European Society of Cardiology National Cardiovascular Journals. Neth Heart J 2012; 20:279-87. [PMID: 22653813 DOI: 10.1007/s12471-012-0277-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Disclosure of potential conflicts of interest (COI) is used by biomedical journals to guarantee credibility and transparency of the scientific process. COI disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for COI disclosure. This paper provides a comprehensive editorial perspective on classical COI-related issues. New insights into current COI policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardised questionnaire, are discussed.
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Alfonso F, Timmis A, Pinto FJ, Ambrosio G, Ector H, Kulakowski P, Vardas P. Conflicts of interest policies and disclosure requirements among European Society of Cardiology national cardiovascular journals. J Cardiovasc Med (Hagerstown) 2012; 13:386-94. [DOI: 10.2459/jcm.0b013e328354a803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Alfonso F, Timmis A, Pinto FJ, Ambrosio G, Ector H, Kulakowski P, Vardas P. Conflict of interest policies and disclosure requirements among European Society of Cardiology national cardiovascular journals. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2012. [DOI: 10.15829/1728-8800-2012-2-4-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Conflict of interest policies and disclosure requirements among European Society of Cardiology National Cardiovascular Journals. Rev Esp Cardiol 2012; 65:471-8. [PMID: 22464101 DOI: 10.1016/j.recesp.2012.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 02/03/2012] [Indexed: 11/24/2022]
Abstract
Disclosure of potential conflicts of interest is used by biomedical journals to guarantee credibility and transparency of the scientific process. Conflict of interest disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for conflicts of interest disclosure. This paper provides a comprehensive editorial perspective on classical conflict of interest-related issues. New insights into current conflicts of interest policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardised questionnaire, are discussed.
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Alfonso F, Timmis A, Pinto FJ, Ambrosio G, Ector H, Kulakowski P, Vardas P, Editors’ Network members:, Antoniades L, Ahmad M, Apetrei E, Arai K, Artigou JY, Aschermann M, Böhm M, Bolognese L, Bugiardini R, Cohen A, Edes I, Elias J, Galeano J, Guarda E, Haouala H, Heras M, Höglund C, Huber K, Hulin I, Ivanusa M, Krittayaphong R, Kuo CT, Lau CP, Lyusov VA, Marinskis G, Márquez MF, Masic I, Pinho Moreira LF, Mrochek A, Oganov RG, Raev D, Rogava M, Rødevand O, Sansoy V, Shimokawa H, Shumakov VA, Tajer CD, van der Wall EE, Stefanadis C, Videbæk J, Lüscher TF. Conflict of interest policies and disclosure requirements among European Society of Cardiology National Cardiovascular Journals. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2012. [DOI: 10.1016/j.repce.2012.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Alfonso F, Timmis A, Pinto FJ, Ambrosio G, Ector H, Kulakowski P, Vardas P, Editors' Network members:, Antoniades L, Ahmad M, Apetrei E, Arai K, Artigou JY, Aschermann M, Böhm M, Bolognese L, Bugiardini R, Cohen A, Edes I, Elias J, Galeano J, Guarda E, Haouala H, Heras M, Höglund C, Huber K, Hulin I, Ivanusa M, Krittayaphong R, Kuo CT, Lau CP, Lyusov VA, Marinskis G, Márquez MF, Masic I, Pinho Moreira LF, Mrochek A, Oganov RG, Raev D, Rogava M, Rødevand O, Sansoy V, Shimokawa H, Shumakov VA, Tajer CD, van der Wall EE, Stefanadis C, Videbæk J, Lüscher TF. Conflict of interest policies and disclosure requirements among European Society of Cardiology National Cardiovascular Journals. Rev Port Cardiol 2012; 31:329-36. [DOI: 10.1016/j.repc.2011.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Accepted: 12/23/2011] [Indexed: 11/26/2022] Open
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Alfonso F, Timmis A, Pinto FJ, Ambrosio G, Ector H, Kulakowski P, Vardas P, Antoniades L, Ahmad M, Apetrei E, Arai K, Artigou JY, Aschermann M, Bohm M, Bolognese L, Bugiardini R, Cohen A, Edes I, Elias J, Galeano J, Guarda E, Haouala H, Heras M, Hoglund C, Huber K, Hulin I, Ivanusa M, Krittayaphong R, Kuo CT, Lau CP, Lyusov VA, Marinskis G, Marquez MF, Masic I, Moreira LFP, Mrochek A, Oganov RG, Raev D, Rogava M, Rodevand O, Sansoy V, Shimokawa H, Shumakov VA, Tajer CD, van der Wall EE, Stefanadis C, Videbaek J, Luscher TF. Conflict of interest policies and disclosure requirements among European Society of Cardiology National Cardiovascular Journals. Eur Heart J 2012; 33:587-94. [DOI: 10.1093/eurheartj/ehr464] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Myers EF, Parrott JS, Cummins DS, Splett P. Funding source and research report quality in nutrition practice-related research. PLoS One 2011; 6:e28437. [PMID: 22163017 PMCID: PMC3232225 DOI: 10.1371/journal.pone.0028437] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Accepted: 11/08/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The source of funding is one of many possible causes of bias in scientific research. One method of detecting potential for bias is to evaluate the quality of research reports. Research exploring the relationship between funding source and nutrition-related research report quality is limited and in other disciplines the findings are mixed. OBJECTIVE The purpose of this study is to determine whether types of funding sources of nutrition research are associated with differences in research report quality. DESIGN A retrospective study of research reporting quality, research design and funding source was conducted on 2539 peer reviewed research articles from the American Dietetic Association's Evidence Analysis Library® database. RESULTS Quality rating frequency distributions indicate 43.3% of research reports were rated as positive, 50.1% neutral, and 6.6% as negative. Multinomial logistic regression results showed that while both funding source and type of research design are significant predictors of quality ratings (χ2 = 118.99, p≤0.001), the model's usefulness in predicting overall research report quality is little better than chance. Compared to research reports with government funding, those not acknowledging any funding sources, followed by studies with University/hospital funding were more likely to receive neutral vs positive quality ratings, OR = 1.85, P <0.001 and OR = 1.54, P<0.001, respectively and those that did not report funding were more likely to receive negative quality ratings (OR = 4.97, P<0.001). After controlling for research design, industry funded research reports were no more likely to receive a neutral or negative quality rating than those funded by government sources. CONCLUSION Research report quality cannot be accurately predicted from the funding source after controlling for research design. Continued vigilance to evaluate the quality of all research regardless of the funding source and to further understand other factors that affect quality ratings are warranted.
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Affiliation(s)
- Esther F Myers
- Research and Strategic Business Development, American Dietetic Association, Chicago, Illinois, United States of America.
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Kressel HY, Olmsted WW. Conflict of interest disclosure in RSNA journals: adoption of the International Council of Medical Journal Editors Uniform Format. Radiology 2010; 256:4-7. [PMID: 20574079 DOI: 10.1148/radiol.10102518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Berman JS, Reich CM. Investigator allegiance and the evaluation of psychotherapy outcome research. EUROPEAN JOURNAL OF PSYCHOTHERAPY & COUNSELLING 2010. [DOI: 10.1080/13642531003637775] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jeffrey S. Berman
- a Department of Psychology , University of Memphis , 38152-3230, Memphis, TN
| | - Catherine M. Reich
- a Department of Psychology , University of Memphis , 38152-3230, Memphis, TN
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Iaboli L, Caselli L, Filice A, Russi G, Belletti E. The unbearable lightness of health science reporting: a week examining Italian print media. PLoS One 2010; 5:e9829. [PMID: 20352089 PMCID: PMC2844412 DOI: 10.1371/journal.pone.0009829] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Accepted: 02/23/2010] [Indexed: 11/27/2022] Open
Abstract
Background Although being an important source of science news information to the public, print news media have often been criticized in their credibility. Health-related content of press media articles has been examined by many studies underlining that information about benefits, risks and costs are often incomplete or inadequate and financial conflicts of interest are rarely reported. However, these studies have focused their analysis on very selected science articles. The present research aimed at adopting a wider explorative approach, by analysing all types of health science information appearing on the Italian national press in one-week period. Moreover, we attempted to score the balance of the articles. Methodology/Principal Findings We collected 146 health science communication articles defined as articles aiming at improving the reader's knowledge on health from a scientific perspective. Articles were evaluated by 3 independent physicians with respect to different divulgation parameters: benefits, costs, risks, sources of information, disclosure of financial conflicts of interest and balance. Balance was evaluated with regard to exaggerated or non correct claims. The selected articles appeared on 41 Italian national daily newspapers and 41 weekly magazines, representing 89% of national circulation copies: 97 articles (66%) covered common medical treatments or basic scientific research and 49 (34%) were about new medical treatments, procedures, tests or products. We found that only 6/49 (12%) articles on new treatments, procedures, tests or products mentioned costs or risks to patients. Moreover, benefits were always maximized and in 16/49 cases (33%) they were presented in relative rather than absolute terms. The majority of stories (133/146, 91%) did not report any financial conflict of interest. Among these, 15 were shown to underreport them (15/146, 9.5%), as we demonstrated that conflicts of interest did actually exist. Unbalanced articles were 27/146 (18%). Specifically, the probability of unbalanced reporting was significantly increased in stories about a new treatment, procedure, test or product (22/49, 45%), compared to stories covering common treatments or basic scientific research (5/97, 5%) (risk ratio, 8.72). Conclusions/Significance Consistent with prior research on health science communication in other countries, we report undisclosed costs and risks, emphasized benefits, unrevealed financial conflicts of interest and exaggerated claims in Italian print media. In addition, we show that the risk for a story about a new medical approach to be unbalanced is almost 9 times higher with respect to stories about any other kind of health science-related topics. These findings raise again the fundamental issue whether popular media is detrimental rather than useful to public health.
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Affiliation(s)
- Luca Iaboli
- Department of Emergency Medicine, Santa Maria Nuova Hospital, Reggio Emilia, Italy
| | - Luana Caselli
- Department of Biomedical Sciences and Advanced Therapies, University of Ferrara, Ferrara, Italy
- * E-mail:
| | - Angelina Filice
- Department of Nuclear Medicine, Santa Maria Nuova Hospital, Reggio Emilia, Italy
| | - Gianpaolo Russi
- Department of Transfusion Medicine, Santa Maria Nuova Hospital, Reggio Emilia, Italy
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Lathyris DN, Patsopoulos NA, Salanti G, Ioannidis JPA. Industry sponsorship and selection of comparators in randomized clinical trials. Eur J Clin Invest 2010; 40:172-82. [PMID: 20050879 DOI: 10.1111/j.1365-2362.2009.02240.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Most clinical trials on medical interventions are sponsored by the industry. The choice of comparators shapes the accumulated evidence. We aimed to assess how often major companies sponsor trials that involve only their own products. METHODS Studies were identified by searching ClinicalTrials.gov for trials registered in 2006. We focused on randomized trials involving the 15 companies that had sponsored the largest number of registered trials in ClinicalTrials.gov in that period. RESULTS Overall, 577 randomized trials were eligible for analysis and 82% had a single industry sponsor [89% (166/187) of the placebo-control trials, 87% (91/105) of trials comparing different doses or ways of administration of the same intervention, and 78% (221/285) of other active control trials]. The compared intervention(s) belonged to a single company in 67% of the trials (89%, 81% and 47% in the three categories respectively). All 15 companies strongly preferred to run trials where they were the only industry sponsor or even the only owner of the assessed interventions. Co-sponsorship typically reflected co-ownership of the same intervention by both companies. Head-to-head comparison of different active interventions developed by different companies occurred in only 18 trials with two or more industry sponsors. CONCLUSIONS Each company generates a clinical research agenda that is strongly focused on its own products, while comparisons involving different interventions from different companies are uncommon. This diminishes the ability to understand the relative merits of different interventions for the same condition.
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Affiliation(s)
- D N Lathyris
- General Hospital George Papanikolaou, Thessaloniki, Greece
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Johnson DH, Horn L. Authorship and industry financial relationships: the tie that binds. J Clin Oncol 2010; 28:1281-3. [PMID: 20065171 DOI: 10.1200/jco.2009.26.9753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Resnik DB. Perspective: Disclosing hidden sources of funding. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2009; 84:1226-1228. [PMID: 19707061 PMCID: PMC3954610 DOI: 10.1097/acm.0b013e3181b18835] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In this article, the author discusses ethical and policy issues related to the disclosure of hidden sources of funding in research. The author argues that authors have an ethical obligation to disclose hidden sources of funding and that journals should adopt policies to enforce this obligation. Journal policies should require disclosure of hidden sources of funding that authors know about and that have a direct relation to their research. To stimulate this discussion, the author describes a recent case: investigators who conducted a lung cancer screening study had received funding from a private foundation that was supported by a tobacco company, but they did not disclose this relationship to the journal. Investigators and journal editors must be prepared to deal with these issues in a manner that promotes honesty, transparency, fairness, and accountability in research. The development of well-defined, reasonable policies pertaining to hidden sources of funding can be a step in this direction.
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Affiliation(s)
- David B Resnik
- National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA.
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Dubey S, Powell CA. Update in lung cancer 2008. Am J Respir Crit Care Med 2009; 179:860-8. [PMID: 19423719 PMCID: PMC2720086 DOI: 10.1164/rccm.200902-0289up] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Accepted: 02/23/2009] [Indexed: 12/31/2022] Open
Affiliation(s)
- Sarita Dubey
- Division of Hematology and Oncology, University of California, San Francisco, California, USA
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Montero Ruiz E, López Álvarez J. Respuesta de los autores. Med Clin (Barc) 2009. [DOI: 10.1016/j.medcli.2009.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cipriani A, Santilli C, Furukawa TA, Signoretti A, Nakagawa A, McGuire H, Churchill R, Barbui C. Escitalopram versus other antidepressive agents for depression. Cochrane Database Syst Rev 2009; 2016:CD006532. [PMID: 19370639 PMCID: PMC4164382 DOI: 10.1002/14651858.cd006532.pub2] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Although pharmacological and psychological interventions are both effective for major depression, antidepressant drugs remain the mainstay of treatment in primary and secondary care settings. During the last 20 years, antidepressant prescribing has risen dramatically in western countries, mainly because of the increasing consumption of selective serotonin reuptake inhibitors (SSRIs) and newer antidepressants, which have progressively become the most commonly prescribed antidepressants. Escitalopram is the pure S-enantiomer of the racemic citalopram. OBJECTIVES To assess the evidence for the efficacy, acceptability and tolerability of escitalopram in comparison with tricyclics, other SSRIs, heterocyclics and newer agents in the acute-phase treatment of major depression. SEARCH STRATEGY Electronic databases were searched up to July 2008. Trial databases of drug-approving agencies were hand-searched for published, unpublished and ongoing controlled trials. SELECTION CRITERIA All randomised controlled trials comparing escitalopram against any other antidepressant (including non-conventional agents such as hypericum) for patients with major depressive disorder (regardless of the diagnostic criteria used). DATA COLLECTION AND ANALYSIS Data were entered by two review authors (double data entry). Responders and remitters to treatment were calculated on an intention-to-treat basis. For dichotomous data, odds ratios (ORs) were calculated with 95% confidence intervals (CI). Continuous data were analysed using standardised mean differences (with 95% CI) using the random effects model. MAIN RESULTS Fourteen trials compared escitalopram with another SSRI and eight compared escitalopram with a newer antidepressive agent (venlafaxine, bupropion and duloxetine). Escitalopram was shown to be significantly more effective than citalopram in achieving acute response (OR 0.67, 95% CI 0.50 to 0.87). Escitalopram was also more effective than citalopram in terms of remission (OR 0.53, 95% CI 0.30 to 0.93). Significantly fewer patients allocated to escitalopram withdrew from trials compared with patients allocated to duloxetine, for discontinuation due to any cause (OR 0.62, 95% CI 0.38 to 0.99). AUTHORS' CONCLUSIONS Some statistically significant differences favouring escitalopram over other antidepressive agents for the acute phase treatment of major depression were found, in terms of efficacy (citalopram and fluoxetine) and acceptability (duloxetine). There is insufficient evidence to detect a difference between escitalopram and other antidepressants in early response to treatment (after two weeks of treatment). Cost-effectiveness information is also needed in the field of antidepressant trials. Furthermore, as with most standard systematic reviews, the findings rely on evidence from direct comparisons. The potential for overestimation of treatment effect due to sponsorship bias should also be borne in mind.
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Affiliation(s)
- Andrea Cipriani
- Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Policlinico "G.B.Rossi", Piazzale L.A. Scuro, 10, Verona, Italy, 37134.
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Cipriani A, Furukawa TA, Salanti G, Geddes JR, Higgins JP, Churchill R, Watanabe N, Nakagawa A, Omori IM, McGuire H, Tansella M, Barbui C. Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet 2009; 373:746-58. [PMID: 19185342 DOI: 10.1016/s0140-6736(09)60046-5] [Citation(s) in RCA: 1044] [Impact Index Per Article: 69.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Conventional meta-analyses have shown inconsistent results for efficacy of second-generation antidepressants. We therefore did a multiple-treatments meta-analysis, which accounts for both direct and indirect comparisons, to assess the effects of 12 new-generation antidepressants on major depression. METHODS We systematically reviewed 117 randomised controlled trials (25 928 participants) from 1991 up to Nov 30, 2007, which compared any of the following antidepressants at therapeutic dose range for the acute treatment of unipolar major depression in adults: bupropion, citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, milnacipran, mirtazapine, paroxetine, reboxetine, sertraline, and venlafaxine. The main outcomes were the proportion of patients who responded to or dropped out of the allocated treatment. Analysis was done on an intention-to-treat basis. FINDINGS Mirtazapine, escitalopram, venlafaxine, and sertraline were significantly more efficacious than duloxetine (odds ratios [OR] 1.39, 1.33, 1.30 and 1.27, respectively), fluoxetine (1.37, 1.32, 1.28, and 1.25, respectively), fluvoxamine (1.41, 1.35, 1.30, and 1.27, respectively), paroxetine (1.35, 1.30, 1.27, and 1.22, respectively), and reboxetine (2.03, 1.95, 1.89, and 1.85, respectively). Reboxetine was significantly less efficacious than all the other antidepressants tested. Escitalopram and sertraline showed the best profile of acceptability, leading to significantly fewer discontinuations than did duloxetine, fluvoxamine, paroxetine, reboxetine, and venlafaxine. INTERPRETATION Clinically important differences exist between commonly prescribed antidepressants for both efficacy and acceptability in favour of escitalopram and sertraline. Sertraline might be the best choice when starting treatment for moderate to severe major depression in adults because it has the most favourable balance between benefits, acceptability, and acquisition cost.
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Affiliation(s)
- Andrea Cipriani
- Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Italy; Department of Psychiatry, University of Oxford, UK
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Affiliation(s)
- David B Resnik
- National Institute of Environmental Health Sciences, National Institutes of Health, Mail Drop NH 06, Box 12233, Research Triangle Park, NC 27709, USA.
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Cook DA, Bowen JL, Gerrity MS, Kalet AL, Kogan JR, Spickard A, Wayne DB. Proposed standards for medical education submissions to the Journal of General Internal Medicine. J Gen Intern Med 2008; 23:908-13. [PMID: 18612716 PMCID: PMC2517930 DOI: 10.1007/s11606-008-0676-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To help authors design rigorous studies and prepare clear and informative manuscripts, improve the transparency of editorial decisions, and raise the bar on educational scholarship, the Deputy Editors of the Journal of General Internal Medicine articulate standards for medical education submissions to the Journal. General standards include: (1) quality questions, (2) quality methods to match the questions, (3) insightful interpretation of findings, (4) transparent, unbiased reporting, and (5) attention to human subjects' protection and ethical research conduct. Additional standards for specific study types are described. We hope these proposed standards will generate discussion that will foster their continued evolution.
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Affiliation(s)
- David A Cook
- Office of Education Research and Division of General Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA.
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Weinfurt KP, Seils DM, Tzeng JP, Lin L, Schulman KA, Califf RM. Consistency of financial interest disclosures in the biomedical literature: the case of coronary stents. PLoS One 2008; 3:e2128. [PMID: 18461146 PMCID: PMC2330163 DOI: 10.1371/journal.pone.0002128] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2008] [Accepted: 04/03/2008] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Disclosure of authors' financial interests has been proposed as a strategy for protecting the integrity of the biomedical literature. We examined whether authors' financial interests were disclosed consistently in articles on coronary stents published in 2006. METHODOLOGY/PRINCIPAL FINDINGS We searched PubMed for English-language articles published in 2006 that provided evidence or guidance regarding the use of coronary artery stents. We recorded article characteristics, including information about authors' financial disclosures. The main outcome measures were the prevalence, nature, and consistency of financial disclosures. There were 746 articles, 2985 authors, and 135 journals in the database. Eighty-three percent of the articles did not contain disclosure statements for any author (including declarations of no interests). Only 6% of authors had an article with a disclosure statement. In comparisons between articles by the same author, the types of disagreement were as follows: no disclosure statements vs declarations of no interests (64%); specific disclosures vs no disclosure statements (34%); and specific disclosures vs declarations of no interests (2%). Among the 75 authors who disclosed at least 1 relationship with an organization, there were 2 cases (3%) in which the organization was disclosed in every article the author wrote. CONCLUSIONS/SIGNIFICANCE In the rare instances when financial interests were disclosed, they were not disclosed consistently, suggesting that there are problems with transparency in an area of the literature that has important implications for patient care. Our findings suggest that the inconsistencies we observed are due to both the policies of journals and the behavior of some authors.
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Affiliation(s)
- Kevin P Weinfurt
- Duke Clinical Research Institute, Duke Translational Medicine Institute, Duke University School of Medicine, Durham, North Carolina, United States of America.
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Moy B. Medical Integrity Up in Smoke? Conflicts of Interest and the Lung Cancer Screening Controversy. Oncologist 2008; 13:474-6. [PMID: 18515732 DOI: 10.1634/theoncologist.2008-0098] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Beverly Moy
- Massachusetts General Hospital Cancer Center, Gillette Center for Women's Cancers, Boston, Massachusetts 02114, USA.
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