1
|
Abstract
Micro- or minimally invasive glaucoma surgeries (MIGS) have been the latest addition to the glaucoma surgical treatment paradigm. This term refers not to a single surgery, but rather to a group of distinct procedures and devices that aim to decrease intraocular pressure. Broadly, MIGS can be categorized into surgeries that increase the trabecular outflow [Trabectome, iStent (first and second generations), Hydrus microstent, Kahook Dual Blade and gonioscopy-assisted transluminal trabeculotomy], surgeries that increase suprachoroidal outflow (Cypass microstent and iStent Supra), and conjunctival bleb-forming procedures (Xen gel stent and InnFocus microshunt). Compared to traditional glaucoma surgeries, such as trabeculectomy and glaucoma drainage device implantation (Ahmed, Baerveldt, and Molteno valves), MIGS are touted to have less severe complications and shorter surgical time. MIGS represent an evolving field, and the efficacy and complications of each procedure should be considered independently, giving more importance to high-quality and longer-term studies.
Collapse
Affiliation(s)
- David J Mathew
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario M5T 2S8, Canada;
| | - Yvonne M Buys
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario M5T 2S8, Canada;
| |
Collapse
|
2
|
Steffens ANV, Langerhuizen DWG, Doornberg JN, Ring D, Janssen SJ. Emotional tones in scientific writing: comparison of commercially funded studies and non-commercially funded orthopedic studies. Acta Orthop 2021; 92:240-243. [PMID: 33263445 PMCID: PMC8158288 DOI: 10.1080/17453674.2020.1853341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background and purpose - There is ongoing debate as to whether commercial funding influences reporting of medical studies. We asked: Is there a difference in reported tones between abstracts, introductions, and discussions of orthopedic journal studies that were commercially funded and those that were not commercially funded?Methods - We conducted a systematic PubMed search to identify commercially funded studies published in 20 orthopedic journals between January 1, 2000 and December 1, 2019. We identified commercial funding of studies by including in our search the names of 10 medical device companies with the largest revenue in 2019. Commercial funding was designated when either the study or 1 or more of the authors received funding from a medical device company directly related to the content of the study. We matched 138 commercially funded articles 1 to 1 with 138 non-commercially funded articles with the same study design, published in the same journal, within a time range of 5 years. The IBM Watson Tone Analyzer was used to determine emotional tones (anger, fear, joy, and sadness) and language style (analytical, confident, and tentative).Results - For abstract and introduction sections, we found no differences in reported tones between commercially funded and non-commercially funded studies. Fear tones (non-commercially funded studies 5.1%, commercially funded studies 0.7%, p = 0.04), and analytical tones (non-commercially funded studies 95%, commercially funded studies 88%, p = 0.03) were more common in discussions of studies that were not commercially funded.Interpretation - Commercially funded studies have comparable tones to non-commercially funded studies in the abstract and introduction. In contrast, the discussion of non-commercially funded studies demonstrated more fear and analytical tones, suggesting them to be more tentative, accepting of uncertainty, and dispassionate. As text analysis tools become more sophisticated and mainstream, it might help to discern commercial bias in scientific reports.
Collapse
Affiliation(s)
- Anath N V Steffens
- Department of Orthopaedic Surgery, Amsterdam, Amsterdam Movement Sciences (AMS), Amsterdam University Medical Centre, The Netherlands;
| | - David W G Langerhuizen
- Department of Orthopaedic Surgery, Amsterdam, Amsterdam Movement Sciences (AMS), Amsterdam University Medical Centre, The Netherlands; ,Correspondence:
| | - Job N Doornberg
- Department of Orthopaedic & Trauma Surgery, Flinders University, Adelaide, Australia, Flinders Medical Centre;
| | - David Ring
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Stein J Janssen
- Department of Orthopaedic Surgery, Amsterdam, Amsterdam Movement Sciences (AMS), Amsterdam University Medical Centre, The Netherlands;
| |
Collapse
|
3
|
Nithianandan H, Kuriyan AE, Venincasa MJ, Sridhar J. <p>Analysis of Funding Source and Spin in the Reporting of Studies of Intravitreal Corticosteroid Therapy for Diabetic Macular Edema: A Systematic Review</p>. Clin Ophthalmol 2020; 14:2383-2395. [PMID: 32903959 PMCID: PMC7445525 DOI: 10.2147/opth.s262085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 07/28/2020] [Indexed: 01/05/2023] Open
Affiliation(s)
- Harrish Nithianandan
- Department of Ophthalmology & Visual Sciences, McGill University, Montreal, Quebec, Canada
| | - Ajay E Kuriyan
- Retina Service, Wills Eye Hospital, Philadelphia, PA, USA
| | - Michael J Venincasa
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jayanth Sridhar
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
- Correspondence: Jayanth Sridhar Email
| |
Collapse
|
4
|
Alonso-Arroyo A, Tarazona-Alvarez B, Lucas-Dominguez R, Peñarrocha-Oltra D, Vidal-Infer A. The funding sources of implantology research in the period 2008-2017: A bibliometric analysis. Clin Implant Dent Relat Res 2019; 21:708-714. [DOI: 10.1111/cid.12810] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/07/2019] [Accepted: 05/16/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Adolfo Alonso-Arroyo
- Department of History of Science and Information Science; School of Medicine and Dentistry, University of Valencia; Valencia Spain
| | - Beatriz Tarazona-Alvarez
- Department of Stomatology; School of Medicine and Dentistry, University of Valencia; Valencia Spain
| | - Rut Lucas-Dominguez
- Department of History of Science and Information Science; School of Medicine and Dentistry, University of Valencia; Valencia Spain
| | - David Peñarrocha-Oltra
- Department of Stomatology; School of Medicine and Dentistry, University of Valencia; Valencia Spain
| | - Antonio Vidal-Infer
- Department of History of Science and Information Science; School of Medicine and Dentistry, University of Valencia; Valencia Spain
| |
Collapse
|
5
|
Adherence to World Glaucoma Association Guidelines for Surgical Trials in the Era of Microinvasive Glaucoma Surgeries. ACTA ACUST UNITED AC 2019; 2:78-85. [DOI: 10.1016/j.ogla.2019.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 12/24/2018] [Accepted: 01/17/2019] [Indexed: 11/22/2022]
|
6
|
Venincasa MJ, Kuriyan AE, Sridhar J. Effect of funding source on reporting bias in studies of intravitreal anti-vascular endothelial growth factor therapy for retinal vein occlusion. Acta Ophthalmol 2019; 97:e296-e302. [PMID: 30232841 DOI: 10.1111/aos.13917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/14/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE To examine the relationship between industry funding and outcome reporting bias in high-quality studies investigating the use of intravitreal anti-vascular endothelial growth factor (VEGF) agents for patients with macular oedema secondary to branch or central retinal vein occlusion (RVO). METHODS This systematic review in PubMed and Ovid MEDLINE examined all randomized clinical trials and meta-analyses published in journals with impact factor of ≥2 that investigated effectiveness of intravitreal anti-VEGF therapy in patients with RVO. The main outcome measure was correspondence between statistical outcome and abstract conclusion wording. RESULTS Forty-five studies met inclusion criteria; 38 (84%) showed correspondence between outcome and abstract conclusion without difference between industry-funded and nonindustry-funded publications (p = 0.39) or between publications in journals with impact factor ≥3 versus <3 (p = 0.96). CONCLUSION In high-quality studies of intravitreal anti-VEGF therapy for RVO, neither industry funding nor journal impact factor affected the rate of outcome reporting bias.
Collapse
Affiliation(s)
- Michael J Venincasa
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Ajay E Kuriyan
- Department of Ophthalmology, Flaum Eye Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Jayanth Sridhar
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA
| |
Collapse
|
7
|
Lundh A, Lexchin J, Mintzes B, Schroll JB, Bero L. Industry sponsorship and research outcome: systematic review with meta-analysis. Intensive Care Med 2018; 44:1603-1612. [DOI: 10.1007/s00134-018-5293-7] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 06/29/2018] [Indexed: 02/07/2023]
|
8
|
Li F, Huang W, Zhang X. Efficacy and safety of different regimens for primary open-angle glaucoma or ocular hypertension: a systematic review and network meta-analysis. Acta Ophthalmol 2018; 96:e277-e284. [PMID: 29144028 PMCID: PMC5947254 DOI: 10.1111/aos.13568] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Accepted: 07/22/2017] [Indexed: 12/01/2022]
Abstract
Purpose To assess the efficacy and safety of different regimens, including monotherapy and double therapy, for primary open‐angle glaucoma (POAG) or ocular hypertension. Methods We searched PubMed, EMBASE and clinicaltrials.gov for studies that fit our inclusion criteria in this network meta‐analysis. Randomized controlled trials that report data on efficacy and safety of medications for POAG or ocular hypertension are included. Data on intra‐ocular pressure (IOP) lowering effect and incidence of adverse events including hyperaemia and ocular discomfort were extracted and used in mixed‐comparison analysis. Results This study includes 72 randomized trials. Data were available on 12 medical treatments of POAG or ocular hypertension. Of 66 possible comparisons of outcome efficacy, 15 treatments were compared directly. Compared to prostaglandin analogues (PGA), beta‐blockers (BB) showed relatively weaker ability to lower IOP, followed by α2‐adrenergic agonists (AA) and carbonic anhydrase inhibitors (CAI). For dual therapy, regimens composed of a combination of PGA with another treatment demonstrated more powerful IOP lowering efficacy, while the combination of two non‐PGA drugs had lower efficacy in controlling IOP than PGA alone. There was no statistical significance in combinations that did not include PGA on efficacy of IOP control. In terms of tolerance, PGA alone leads to more severe hyperaemia than any other monotherapy regimen, while BBs have the lowest effect on the incidence of hyperaemia. Most dual therapy regimens containing PGA also lead to serious hyperaemia, with the exception of PGA + AA. Compared to regimens containing PGA, those with BB are less likely to cause hyperaemia. Conclusion Our network meta‐analysis showed that PGAs provide best IOP lowering effect among all the monotherapy regimen. Combination of PGA and other category of drugs leads to better IOP decrease. Combination of BB and another non‐PGA drug may have less ocular side‐effects than PGA alone.
Collapse
Affiliation(s)
- Fei Li
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center; Sun Yat-sen University; Guangzhou China
| | - Wenbin Huang
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center; Sun Yat-sen University; Guangzhou China
| | - Xiulan Zhang
- State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center; Sun Yat-sen University; Guangzhou China
| |
Collapse
|
9
|
'Spin' in published biomedical literature: A methodological systematic review. PLoS Biol 2017; 15:e2002173. [PMID: 28892482 PMCID: PMC5593172 DOI: 10.1371/journal.pbio.2002173] [Citation(s) in RCA: 148] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 07/27/2017] [Indexed: 12/17/2022] Open
Abstract
In the scientific literature, spin refers to reporting practices that distort the interpretation of results and mislead readers so that results are viewed in a more favourable light. The presence of spin in biomedical research can negatively impact the development of further studies, clinical practice, and health policies. This systematic review aims to explore the nature and prevalence of spin in the biomedical literature. We searched MEDLINE, PreMEDLINE, Embase, Scopus, and hand searched reference lists for all reports that included the measurement of spin in the biomedical literature for at least 1 outcome. Two independent coders extracted data on the characteristics of reports and their included studies and all spin-related outcomes. Results were grouped inductively into themes by spin-related outcome and are presented as a narrative synthesis. We used meta-analyses to analyse the association of spin with industry sponsorship of research. We included 35 reports, which investigated spin in clinical trials, observational studies, diagnostic accuracy studies, systematic reviews, and meta-analyses. The nature of spin varied according to study design. The highest (but also greatest) variability in the prevalence of spin was present in trials. Some of the common practices used to spin results included detracting from statistically nonsignificant results and inappropriately using causal language. Source of funding was hypothesised by a few authors to be a factor associated with spin; however, results were inconclusive, possibly due to the heterogeneity of the included papers. Further research is needed to assess the impact of spin on readers’ decision-making. Editors and peer reviewers should be familiar with the prevalence and manifestations of spin in their area of research in order to ensure accurate interpretation and dissemination of research. In the scientific literature, spin refers to reporting practices that distort the interpretation of results and mislead readers so that results are viewed in a more favourable light. The presence of spin in biomedical research can negatively impact the development of further studies, clinical practice, and health policies. We conducted a systematic review to explore the nature and prevalence of spin in the biomedical literature. We included 35 reports, which investigated spin in clinical trials, observational studies, diagnostic accuracy studies, systematic reviews, and meta-analyses. The nature of spin varied according to study design. The highest (but also greatest) variability in the prevalence of spin was present in trials. Some of the common practices used to spin results included detracting from statistically nonsignificant results and inappropriately using causal language. Source of funding was hypothesised by a few authors to be a factor associated with spin; however, results were inconclusive, possibly due to the heterogeneity of the included papers. Further research is needed to assess the impact of spin on readers’ decision-making. Editors and peer reviewers should be familiar with the prevalence and manifestations of spin in their area of research in order to ensure accurate interpretation and dissemination of research.
Collapse
|
10
|
Wells EM. Evidence Regarding the Impact of Conflicts of Interest on Environmental and Occupational Health Research. Curr Environ Health Rep 2017; 4:109-118. [PMID: 28397095 DOI: 10.1007/s40572-017-0139-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE OF REVIEW This review describes published literature providing evidence for financial conflicts of interest in environmental and occupational health research. Secondary goals were to describe evidence that (a) utilized quantitative methods to evaluate the association of conflicts with study outcomes, and (b) assessed undisclosed as well as disclosed conflicts of interest. RECENT FINDINGS Forty-three studies were identified which contained descriptions of the impact of financial conflicts of interest on research results; 11 of these conducted quantitative analyses to demonstrate these relationships. All 11 articles which quantified associations identified significant associations of the presence of financial conflicts of interest with study findings. In studies which measured undisclosed conflicts, these comprised a substantial proportion of all conflicts. Suggestions for improving understanding and interpretation of research results are presented.
Collapse
Affiliation(s)
- Ellen M Wells
- School of Health Sciences, Purdue University, 550 Stadium Mall Drive, West Lafayette, IN, 47907, USA.
| |
Collapse
|
11
|
Van Norman GA, Eisenkot R. Technology Transfer: From the Research Bench to Commercialization: Part 2: The Commercialization Process. JACC Basic Transl Sci 2017; 2:197-208. [PMID: 30167567 PMCID: PMC6113541 DOI: 10.1016/j.jacbts.2017.03.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 03/14/2017] [Indexed: 11/27/2022]
Abstract
Technology transfer (TT) encompasses a variety of activities that move academic discoveries into the public sector. Part 1 of this 2-part series explored steps in acquisition of intellectual property (IP) rights (e.g., patents and copyrights). Part 2 focuses on processes of commercialization, including the technology transfer office, project development toward commercialization, and licensing either through the establishment of startup companies (venture capital-backed or otherwise) or directly to industry. In private industry, TT often occurs through the sale of IP, products, or services, but in universities, the majority of TT occurs through the licensing of IP.
Collapse
Key Words
- COI, conflict of interest
- CRADA, cooperative research and development agreement
- IP, intellectual property
- MTA, materials transfer agreement
- NIH, National Institutes of Health
- SBIR, small business innovation research (grant)
- SRA, sponsored research agreement
- STTR, small business technology transfer research (grant)
- TT, technology transfer
- TTO, technology transfer office
- VC, venture capital
- commercialization
- licensing
- technology transfer
- venture capital
Collapse
Affiliation(s)
- Gail A. Van Norman
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington
| | - Roï Eisenkot
- CoMotion, University of Washington, Seattle, Washington
| |
Collapse
|
12
|
Abstract
BACKGROUND Clinical research affecting how doctors practice medicine is increasingly sponsored by companies that make drugs and medical devices. Previous systematic reviews have found that pharmaceutical-industry sponsored studies are more often favorable to the sponsor's product compared with studies with other sources of sponsorship. A similar association between sponsorship and outcomes have been found for device studies, but the body of evidence is not as strong as for sponsorship of drug studies. This review is an update of a previous Cochrane review and includes empirical studies on the association between sponsorship and research outcome. OBJECTIVES To investigate whether industry sponsored drug and device studies have more favorable outcomes and differ in risk of bias, compared with studies having other sources of sponsorship. SEARCH METHODS In this update we searched MEDLINE (2010 to February 2015), Embase (2010 to February 2015), the Cochrane Methodology Register (2015, Issue 2) and Web of Science (June 2015). In addition, we searched reference lists of included papers, previous systematic reviews and author files. SELECTION CRITERIA Cross-sectional studies, cohort studies, systematic reviews and meta-analyses that quantitatively compared primary research studies of drugs or medical devices sponsored by industry with studies with other sources of sponsorship. We had no language restrictions. DATA COLLECTION AND ANALYSIS Two assessors screened abstracts and identified and included relevant papers. Two assessors extracted data, and we contacted authors of included papers for additional unpublished data. Outcomes included favorable results, favorable conclusions, effect size, risk of bias and whether the conclusions agreed with the study results. Two assessors assessed risk of bias of included papers. We calculated pooled risk ratios (RR) for dichotomous data (with 95% confidence intervals (CIs)). MAIN RESULTS Twenty-seven new papers were included in this update and in total the review contains 75 included papers. Industry sponsored studies more often had favorable efficacy results, RR: 1.27 (95% CI: 1.17 to 1.37) (25 papers) (moderate quality evidence), similar harms results RR: 1.37 (95% CI: 0.64 to 2.93) (four papers) (very low quality evidence) and more often favorable conclusions RR: 1.34 (95% CI: 1.19 to 1.51) (29 papers) (low quality evidence) compared with non-industry sponsored studies. Nineteen papers reported on sponsorship and efficacy effect size, but could not be pooled due to differences in their reporting of data and the results were heterogeneous. We did not find a difference between drug and device studies in the association between sponsorship and conclusions (test for interaction, P = 0.98) (four papers). Comparing industry and non-industry sponsored studies, we did not find a difference in risk of bias from sequence generation, allocation concealment, follow-up and selective outcome reporting. However, industry sponsored studies more often had low risk of bias from blinding, RR: 1.25 (95% CI: 1.05 to 1.50) (13 papers), compared with non-industry sponsored studies. In industry sponsored studies, there was less agreement between the results and the conclusions than in non-industry sponsored studies, RR: 0.83 (95% CI: 0.70 to 0.98) (six papers). AUTHORS' CONCLUSIONS Sponsorship of drug and device studies by the manufacturing company leads to more favorable efficacy results and conclusions than sponsorship by other sources. Our analyses suggest the existence of an industry bias that cannot be explained by standard 'Risk of bias' assessments.
Collapse
Affiliation(s)
- Andreas Lundh
- Odense University Hospital and University of Southern DenmarkCenter for Evidence‐Based MedicineSdr. Boulevard 29, Entrance 50 (Videncentret)OdenseDenmark5000
| | - Joel Lexchin
- York UniversitySchool of Health Policy and Management121 Walmer RdTorontoONCanadaM5R 2X8
| | - Barbara Mintzes
- The University of SydneyCharles Perkins Centre and Faculty of PharmacyRoom 6W75, 6th FloorThe Hub, Charles Perkins Centre D17SydneyNSWAustralia2006
| | - Jeppe B Schroll
- Herlev HospitalDepartment of Obstetrics and GynaecologyHerlev Ringvej 75HerlevDenmark2730
| | - Lisa Bero
- Charles Perkins Centre and Faculty of Pharmacy, University of Sydney6th Floor (6W76)The University of SydneySydneyNew South Wales 2006Australia
| | | |
Collapse
|
13
|
Flacco ME, Manzoli L, Boccia S, Puggina A, Rosso A, Marzuillo C, Scaioli G, Gualano MR, Ricciardi W, Villari P, Ioannidis JPA. Registered Randomized Trials Comparing Generic and Brand-Name Drugs: A Survey. Mayo Clin Proc 2016; 91:1021-34. [PMID: 27402583 DOI: 10.1016/j.mayocp.2016.04.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 03/25/2016] [Accepted: 04/28/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To evaluate the research agenda of registered randomized trials comparing generic and brand-name drugs in terms of who sponsors them, whether they are published promptly, and whether they find favorable results. METHODS We included randomized trials comparing the safety or efficacy of brand-name vs generic medications that were registered in ClinicalTrials.gov or other registries from January 1, 2000, through July 31, 2015. To identify published articles or results generated from such trials, we searched PubMed, Scopus, Google, and registry databases. Data were compared across sponsorship categories ("inbred" if the compared drugs were owned by the same company or its partners/subsidiaries, "competitive" if the compared drugs were owned by competing companies, and "apparently nonprofit"), and time to publication was evaluated with Cox analysis. RESULTS We found 207 registered protocols reporting on 186 completed trials. Among those trials, 37 had published their results and another 56 had posted results in registries, for a total of 93 trials with available results. Four years after trial completion, results were available for 64 of 138 trials (46.4%), with substantial differences by sponsor: 70.8% (34 of 48), 28.1% (18 of 64), and 46.2% (12 of 26) of the inbred, competitive, and nonprofit trials, respectively. In multivariate modeling, inbred trials had a 1.73-fold risk of having results available compared with competitive trials (P=.04). Almost all trials reported favorable results, with the exception of 4 (4.3% of the 93 trials with results). CONCLUSION Despite the importance of generic drugs, relatively few registered randomized trials have compared the health effects of generic vs brand-name medicines, and there is an associated unsatisfactory publication rate and almost ubiquitous favorable results. The overall literature on the topic is at high risk of bias, possibly in favor of generic drugs. Higher nonprofit funding and stronger pressure to register trials and publish results are needed.
Collapse
Affiliation(s)
- Maria Elena Flacco
- Department of Medicine and Aging Sciences, University of Chieti, Chieti, Italy; Regional Healthcare Agency of the Abruzzo Region, Pescara, Italy; Local Health Unit of Pescara, Pescara, Italy
| | - Lamberto Manzoli
- Department of Medicine and Aging Sciences, University of Chieti, Chieti, Italy; Regional Healthcare Agency of the Abruzzo Region, Pescara, Italy; Local Health Unit of Pescara, Pescara, Italy.
| | - Stefania Boccia
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - Anna Puggina
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy
| | - Annalisa Rosso
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Carolina Marzuillo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | | | | | - Walter Ricciardi
- Institute of Public Health, Catholic University of Sacred Heart, Rome, Italy; Italian National Institute of Health, Rome, Italy
| | - Paolo Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - John P A Ioannidis
- Stanford Prevention Research Center, Department of Medicine and Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA; Department of Statistics, Stanford University School of Humanities and Sciences, Stanford, CA; Meta-Research Innovation Center at Stanford (METRICS), Stanford, CA
| |
Collapse
|
14
|
|
15
|
Abstract
BACKGROUND Clinical research affecting how doctors practice medicine is increasingly sponsored by companies that make drugs and medical devices. Previous systematic reviews have found that pharmaceutical industry sponsored studies are more often favorable to the sponsor's product compared with studies with other sources of sponsorship. This review is an update using more stringent methodology and also investigating sponsorship of device studies. OBJECTIVES To investigate whether industry sponsored drug and device studies have more favorable outcomes and differ in risk of bias, compared with studies having other sources of sponsorship. SEARCH METHODS We searched MEDLINE (1948 to September 2010), EMBASE (1980 to September 2010), the Cochrane Methodology Register (Issue 4, 2010) and Web of Science (August 2011). In addition, we searched reference lists of included papers, previous systematic reviews and author files. SELECTION CRITERIA Cross-sectional studies, cohort studies, systematic reviews and meta-analyses that quantitatively compared primary research studies of drugs or medical devices sponsored by industry with studies with other sources of sponsorship. We had no language restrictions. DATA COLLECTION AND ANALYSIS Two assessors identified potentially relevant papers, and a decision about final inclusion was made by all authors. Two assessors extracted data, and we contacted authors of included papers for additional unpublished data. Outcomes included favorable results, favorable conclusions, effect size, risk of bias and whether the conclusions agreed with the study results. Two assessors assessed risk of bias of included papers. We calculated pooled risk ratios (RR) for dichotomous data (with 95% confidence intervals). MAIN RESULTS Forty-eight papers were included. Industry sponsored studies more often had favorable efficacy results, risk ratio (RR): 1.24 (95% confidence interval (CI): 1.14 to 1.35), harms results RR: 1.87 (95% CI: 1.54 to 2.27) and conclusions RR: 1.31 (95% CI: 1.20 to 1.44) compared with non-industry sponsored studies. Ten papers reported on sponsorship and effect size, but could not be pooled due to differences in their reporting of data. The results were heterogeneous; five papers found larger effect sizes in industry sponsored studies compared with non-industry sponsored studies and five papers did not find a difference in effect size. Only two papers (including 120 device studies) reported separate data for devices and we did not find a difference between drug and device studies on the association between sponsorship and conclusions (test for interaction, P = 0.23). Comparing industry and non-industry sponsored studies, we did not find a difference in risk of bias from sequence generation, allocation concealment and follow-up. However, industry sponsored studies more often had low risk of bias from blinding, RR: 1.32 (95% CI: 1.05 to 1.65), compared with non-industry sponsored studies. In industry sponsored studies, there was less agreement between the results and the conclusions than in non-industry sponsored studies, RR: 0.84 (95% CI: 0.70 to 1.01). AUTHORS' CONCLUSIONS Sponsorship of drug and device studies by the manufacturing company leads to more favorable results and conclusions than sponsorship by other sources. Our analyses suggest the existence of an industry bias that cannot be explained by standard 'Risk of bias' assessments.
Collapse
Affiliation(s)
- Andreas Lundh
- The Nordic Cochrane Centre, Rigshospitalet, Copenhagen, Denmark.
| | | | | | | | | |
Collapse
|
16
|
Jinapriya D, Anraku A, Alasbali T, Trope GE, Buys YM. Evaluation of investigator bias in industry-funded clinical trials of latanoprost. Can J Ophthalmol 2012; 46:531-6. [PMID: 22153642 DOI: 10.1016/j.jcjo.2011.09.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2010] [Revised: 07/08/2011] [Accepted: 09/08/2011] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To determine whether sponsorship of prostaglandin analogue (PGA) clinical trials results in investigator bias in outcomes when studying intraocular pressure (IOP). DESIGN Retrospective, observational cohort study. METHODS A PubMed search was performed for latanoprost or Xalatan, bimatoprost or Lumigan, and travoprost or Travatan, with limits to humans, clinical trials, and English language. Inclusion criteria included randomized controlled trials, open-angle glaucoma, monotherapy with a PGA, baseline IOP ≥ 21 mm Hg, washout period, and minimum 1-month follow-up. Each article was reviewed by 2 independent reviewers. The results of IOP for each PGA were categorized as being sponsored by the parent company (the company manufacturing the PGA); by the competing company (the company manufacturing competing glaucoma therapy); or by a nonindustry source. The mean IOP and changes in IOP from baseline were compared among the 3 categories of sponsorship. RESULTS Only studies involving latanoprost were analyzed because of the low number of studies meeting the inclusion criteria for bimatoprost and travoprost. We found 29 and 13 studies that provided 1- and 3-month data, respectively, for analysis. The mean baseline IOPs in the 3 groups (parent company, competing company, nonindustry) were not significantly different (p = 0.47). The mean IOP at 1 (p = 0.72) and 3 months (p = 0.59) and the change in IOP from baseline (p = 0.83 and 0.90, respectively) were not significantly different in the 3 groups. A random-effects metaregression controlling for the covariates of blinding, naïveté to PGAs, and baseline IOP < 24 mm Hg or ≥ 24 mm Hg did not change the findings. CONCLUSION There was no evidence of investigator bias in determining outcomes for IOP in these clinical trials of latanoprost.
Collapse
Affiliation(s)
- Delan Jinapriya
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario
| | | | | | | | | |
Collapse
|
17
|
Sayo A, Jennings RG, Van Horn JD. Study factors influencing ventricular enlargement in schizophrenia: a 20 year follow-up meta-analysis. Neuroimage 2011; 59:154-67. [PMID: 21787868 DOI: 10.1016/j.neuroimage.2011.07.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Revised: 06/23/2011] [Accepted: 07/04/2011] [Indexed: 12/13/2022] Open
Abstract
A meta-analysis was performed on studies employing the ventricular-brain ratio to compare schizophrenic subjects to that of normal controls. This was a follow-up to a similar meta-analysis published in 1992 in which study-, in addition to clinical-, factors were found to contribute significantly to the reported difference between patients with schizophrenia and controls. Seventy-two (N=72) total studies were identified from the peer reviewed literature, 39 from the original meta-analysis, and 33 additional studies published since which met strict criteria for inclusion and analysis - thus representing ~30 years of schizophrenia ventricular enlargement research. Sample characteristics from schizophrenics and controls were coded for use as predictor variables against within sample VBR values as well as for between sample VBR differences. Additionally, a number of factors concerning how the studies were conducted and reported were also coded. Obtained data was subjected to unweighted univariate as well as multiple regression analyses. In particular, results indicated significant differences between schizophrenics and controls in ventricular size but also the influence of the diagnostic criteria used to define schizophrenia on the magnitude of the reported VBR. This suggests that differing factors of the diagnostic criteria may be sensitive to ventricular enlargement and might be worthy of further examination. Interestingly, we observed an inverse relationship between VBR difference and the number of co-authors on the study. This latter finding suggests that larger research groups report smaller VBR differences and may be more conservative or exacting in their research methodology. Analyses weighted by sample size provided identical conclusions. The effects of study factors such as these are helpful for understanding the variation in the size of the reported differences in VBR between patients and controls as well as for understanding the evolution of research on complex clinical syndromes employing neuroimaging morphometrics.
Collapse
Affiliation(s)
- Angelo Sayo
- Laboratory of Neuro Imaging (LONI), Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, 635 Charles E. Young Drive SW, Suite 225, Los Angeles, CA 90095-7334, USA
| | | | | |
Collapse
|
18
|
Abstract
Universities and academic medical centers have been increasing their focus on technology transfer and research commercialization. With this shift in focus, academic-industry ties have become prevalent. These relationships can benefit academic researchers and help then to transform their research into tangible societal benefits. However, there also are concerns that these ties and the greater academic focus on commercialization might lead to conflicts of interest, especially financial conflicts of interest. This paper briefly explores some of these conflicts of interest, particularly relating to research and training. This paper also discusses some of the policies that have been, and are being, developed to try to mitigate and manage these conflicts so that academic involvement in technology transfer and commercialization can continue without jeopardizing academic work or the public's trust in them.
Collapse
Affiliation(s)
- Deborah Zucker
- Tufts University School of Medicine, Boston, MA 02111, USA.
| |
Collapse
|
19
|
Current world literature. Curr Opin Anaesthesiol 2010; 23:283-93. [PMID: 20404787 DOI: 10.1097/aco.0b013e328337578e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
20
|
|
21
|
Anraku A, Jin YP, Trope GE, Buys YM. Survey of conflict-of-interest disclosure policies of ophthalmology journals. Ophthalmology 2009; 116:1093-6. [PMID: 19376583 DOI: 10.1016/j.ophtha.2008.12.053] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2008] [Revised: 11/24/2008] [Accepted: 12/19/2008] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To survey the disclosure policy for authors, peer reviewers, and editors in English-language ophthalmology journals. DESIGN Cross-sectional survey. PARTICIPANTS English-language ophthalmology journals. METHODS All indexed English-language ophthalmology journals were identified. The journals' websites were reviewed for published conflict-of-interest disclosure policies for authors, peer reviewers, and editors. In cases where no policy was found, the journal's editor was contacted directly to confirm if a policy existed. MAIN OUTCOME MEASURES The existence of conflict-of-interest policy for authors, peer reviewers, and editors. RESULTS Forty-two English-language ophthalmology journals were identified. Web-based published conflict-of-interest policies were found for authors in 33 (79%), for peer reviewers in 3 (7%), and for editors in 2 (5%) of the 42 journals. After contacting those journals with no published policies, these numbers increased to 37 (100%) of 37 for authors, 18 (60%) of 30 for peer reviewers, and 10 (33%) of 30 for editors. Seven journals with published disclosure policies for authors, but not for peer reviewers or editors, did not respond to the survey, and a further 5 journals without any published disclosure policy did not respond to the survey. Journals with a higher impact factor were more likely to have a web-based published disclosure policy for peer reviewers and a disclosure policy for editors. CONCLUSIONS Most English-language ophthalmology journals have a conflict-of-interest policy for authors; however, they are not publicly available in 21% of journals. Conflict-of-interest policies for peer reviewers and editors are less common and are more likely not to be published compared with those for authors. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Collapse
Affiliation(s)
- Ayako Anraku
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada
| | | | | | | |
Collapse
|
22
|
Liu S. Dealing with publication bias in translational stroke research. JOURNAL OF EXPERIMENTAL STROKE & TRANSLATIONAL MEDICINE 2009; 2:16-21. [PMID: 20431704 PMCID: PMC2860750 DOI: 10.6030/1939-067x-2.1.16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Publication bias has been around for about 50 years. It has become a concern for almost 20 years in the medical research community. This review briefly summarizes the current status of publication bias, potential sources where bias may arise from, and its common evaluation methods. In the field of translational stroke research, publication bias has long been suspected; however, it has not been addressed with sufficient efforts. Its status has remained the same during the last decade. The author emphasizes the important role that publishers might play in addressing publication bias.
Collapse
Affiliation(s)
- Shimin Liu
- Department of Neurology, Mount Sinai School of Medicine, NYU
| |
Collapse
|
23
|
Alward WLM. How I choose a prostaglandin analogue. Am J Ophthalmol 2009; 147:1-2. [PMID: 19100349 DOI: 10.1016/j.ajo.2008.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2008] [Accepted: 08/04/2008] [Indexed: 11/15/2022]
|