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McCambridge J, Golder S. Alcohol, cardiovascular disease and industry funding: A co-authorship network analysis of epidemiological studies. Addict Behav 2024; 151:107932. [PMID: 38103279 DOI: 10.1016/j.addbeh.2023.107932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION Alcohol's effects on cardiovascular disease (CVD) are controversial. Alcohol industry actors have shown particular interest in this subject, and been extensively involved through research funding, and in other ways, generating concerns about bias, particularly in reviews. MATERIAL & METHODS We conducted a co-authorship network analysis of the primary studies included within a previous co-authorship study of 60 systematic reviews on the impact of alcohol on CVD. Additionally, we examined the relationships between declared alcohol industry funding and network structure. RESULTS There were 713 unique primary studies with 2832 authors published between 1969 and 2019 located within 229 co-authorship subnetworks. There was industry funding across subnetworks and approximately 8% of all papers declared industry funding. The largest subnetwork dominated, comprising 43% of all authors, with sparse evidence of substantial industry funding. The second largest subnetwork contained approximately 4% of all authors, with largely different industry funders involved. Harvard affiliated authors who at the review level formed co-authorship subnetworks with industry funded authors were seen at the primary study level to belong to the largest epidemiological subnetwork. A small number of key authors make extensive alcohol industry funding declarations. CONCLUSIONS There was no straightforward relationship between co-authorship network formation and alcohol industry funding of epidemiological studies on alcohol and CVD. More fine-grained attention to patterns of alcohol industry funding and to key nodes may shed further light on how far industry funding may be responsible for conflicting findings on alcohol and CVD.
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Affiliation(s)
- Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington York YO10 5DD, United Kingdom.
| | - Su Golder
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington York YO10 5DD, United Kingdom
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Etzel RA, Abbas NH, Anastario MP, Mustapha A, Osuolale O, Sarkar A, Soyiri IN, Whaibeh E, Soskolne CL. Ethics guidelines for environmental epidemiologists: 2023 revision. Environ Epidemiol 2024; 8:e299. [PMID: 38617426 PMCID: PMC11008652 DOI: 10.1097/ee9.0000000000000299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 02/12/2024] [Indexed: 04/16/2024] Open
Abstract
Recognition of the importance to environmental epidemiology of ethical and philosophical deliberation led, in 1996, to the establishment of Ethics Guidelines for the profession. In 1999, these guidelines were adopted by the International Society for Environmental Epidemiology. The guidelines were revised in 2012 and again in 2023 to ensure continued relevance to the major issues facing the field. Comprising normative standards of professional conduct, the guidelines are structured into four subsections: (1) obligations to individuals and communities who participate in research; (2) obligations to society; (3) obligations regarding funders/sponsors and employers; and (4) obligations to colleagues. Through the 2023 revision of the Ethics Guidelines, the International Society for Environmental Epidemiology seeks to ensure the highest possible standards of transparency and accountability for the ethical conduct of environmental epidemiologists engaged in research and public health practice.
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Affiliation(s)
- Ruth A. Etzel
- Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia
| | - Nivine H. Abbas
- Public Health Department, Faculty of Health Sciences, University of Balamand, Balamand, Lebanon
| | | | | | - Olayinka Osuolale
- Department of Biological Sciences, Elizade University, Ilara Mokin, Nigeria
| | - Atanu Sarkar
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland and Labrador, St. John’s, Newfoundland and Labrador, Canada
| | - Ireneous N. Soyiri
- Faculty of Health Sciences, Hull York Medical School, Institute for Clinical and Applied Health Research, University of Hull, Hull, United Kingdom
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García G, Pérez-Ríos M, Ruano-Ravina A, Candal-Pedreira C. Assessing conflict of interest reporting and quality of clinical trials on infant formula: a systematic review. J Clin Epidemiol 2024; 169:111313. [PMID: 38432526 DOI: 10.1016/j.jclinepi.2024.111313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/16/2024] [Accepted: 02/25/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVES This study aims to assess the quality, risk of bias, and conflicts of interest (COIs) of clinical trials conducted on the effects of fortified infant formula. STUDY DESIGN AND SETTTING Systematic review including all randomized clinical trials targeting healthy children and using three arms: fortified infant formula; standard formula; and breastfeeding. We performed a descriptive analysis of the studies reviewed, assessed their quality using the "Risk of Bias 2- RoB 2" tool, and identified COIs. RESULTS A total of 40 studies were included. All showed a high overall risk of bias, with this being especially noteworthy in the "deviations from intention to treat" and "missing outcome data" domains. Of the total included studies, 29 reported conclusions in favor of the fortified formula; 15 studies reported multiple conclusions that were either contradictory or not in line with the results. COIs with industry were identified in 33 studies, and in 17 studies, these conflicts were not declared in the appropriate section. CONCLUSION From a methodological perspective, studies on fortified infant formula display low quality, made evident by the high risk of bias. Additionally, there are frequent COIs. These aspects must be considered by health professionals and the population when drawing up recommendations for the use of this product.
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Affiliation(s)
- Guadalupe García
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Galicia, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain.
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Galicia, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
| | - Cristina Candal-Pedreira
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Galicia, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Galicia, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
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Bagheri H. Patient's reporting of adverse drug reactions: Which added value in 2023? Therapie 2024; 79:155-159. [PMID: 38036329 DOI: 10.1016/j.therap.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/04/2023] [Indexed: 12/02/2023]
Abstract
Several studies were focused on the qualitative and quantitative analysis of serious adverse drug reactions (ADRs) leading to hospitalisation or death. These figures do not take into account ADRs in ambulatory patients affecting their quality of life. Patient reporting has the advantages of bringing novel information about ADRs. It provides a more detailed description of ADRs, and reports about different drugs and system organ classes when compared with health care professional (HCP) reporting. A certain amount of information is crucial in order to determine the drug-reaction relationship. European regulation and patient support programs have contributed widely to increased patient reporting but the quality of ADR reports is still unequal from one country to another. Patient reports of ADRs have contributed enormously to pharmacovigilance signal detection in a number of ways. Over the last decades, countries have developed dedicated websites for direct patient reporting. The increasing involvement of patients in ADR reporting activities facilitated by a web portal was confirmed by some studies. Patients are now recognised as having a legitimate part to play in the decision-making process. The contribution of patient reports to drug safety was acknowledged and consolidated by European Union (EU) PV legislation in 2012 aiming to involve patients more actively, nowadays called "patient centricity in pharmacovigilance". Patient organisations are involved in regulatory issues and collaborate with health institutions on the development of guidelines. However, some studies suggested that a substantial number of patient organisations have potential financial conflicts of interest but limited disclosure practices. Pharmaceutical companies integrate into patient associations, particularly for chronic diseases by different strategies: educational therapeutic or observance support programs. The question of conflict of interest of patient associations is important requiring better transparency.
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Affiliation(s)
- Haleh Bagheri
- Service de pharmacologie médicale, Centre de pharmacovigilance de Toulouse, CIC1436, CHU de Toulouse, Faculté de Médecine, 31000 Toulouse, France.
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Tacconelli E, Visentin A, Kahlmeter G. Handling conflicts of interest in infectious diseases. Clin Microbiol Infect 2024; 30:279-282. [PMID: 37741623 DOI: 10.1016/j.cmi.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/11/2023] [Accepted: 09/17/2023] [Indexed: 09/25/2023]
Affiliation(s)
- Evelina Tacconelli
- Infectious Diseases Unit, Department of Diagnostic and Public Health, University of Verona, Verona, Italy.
| | - Alessandro Visentin
- Infectious Diseases Unit, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
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Gharebaghi R, Heidary F, Pourezzat AA. Lessons Learned from COVID-19 Pandemic Management in Iran; a Commentary. Arch Acad Emerg Med 2024; 12:e24. [PMID: 38572222 PMCID: PMC10988177 DOI: 10.22037/aaem.v12i1.2241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Affiliation(s)
| | | | - Ali Asghar Pourezzat
- Department of Public Administration, Faculty of Management and Faculty of Governance, University of Tehran, Tehran, Iran
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Chen T, Lee M, Constantin E, Gurberg J, Nguyen LH. Home sleep apnea tests: Conflicts of interest and funding. Int J Pediatr Otorhinolaryngol 2024; 176:111755. [PMID: 37979252 DOI: 10.1016/j.ijporl.2023.111755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/06/2023] [Accepted: 10/11/2023] [Indexed: 11/20/2023]
Abstract
OBJECTIVE Pediatric otolaryngologists rely on HSAT literature to guide their diagnostic methods related to obstructive sleep apnea (OSA). Our objectives were to review the rates of presence of funding and/or potential conflict of interest (COI), as well as its relationship to the overall quality of HSAT publications in the literature over the last two decades. DATA SOURCES Medline, Web of Science and Embase databases. REVIEW METHODS A review was performed reviewing publications from January 2000 to December 2021. Oxford Level of Evidence (OLE) was used as a quality metric. COI and funding were recorded verbatim as self-declared in the text of the manuscript. RESULTS Literature search yielded 4257 articles with 400 articles included in final analysis. The odds of higher quality studies (LOE 1 or 2) were higher in the last five years from 2016 to 2021 (OR, 3.6; 95% CI 1.4 to 6.9). Nearly half of all articles (43.0%) lacked a statement regarding funding or COI. There was a positive correlation between level of evidence and industry funding. The largest source of funding was from industry, comprising 39.6% of all studies that had a funding statement. Of these industry-funded studies, 37.5% reported no COI or lacked a COI statement. CONCLUSION Despite a growing interest in HSATs for OSA evaluation, there is heterogeneity in reporting of COI and high prevalence of industry funding and COI. Re-evaluation and consensus amongst journals on guidelines for reporting disclosures are needed. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Tanya Chen
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Melissa Lee
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada
| | - Evelyn Constantin
- Department of Pediatrics, Pediatric Sleep Medicine, Montreal Children's Hospital, Montreal, Canada; Research Institute of the McGill University Health Centre, Canada
| | - Joshua Gurberg
- Department of Pediatric Otolaryngology-Head and Neck Surgery, Montreal Children's Hospital, Montreal, Canada
| | - Lily Hp Nguyen
- Department of Pediatric Otolaryngology-Head and Neck Surgery, Montreal Children's Hospital, Montreal, Canada.
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Snellman A, Carlberg S, Olsson L. Conflict of interest and risk of bias in systematic reviews on methylphenidate for attention-deficit hyperactivity disorder: a cross-sectional study. Syst Rev 2023; 12:175. [PMID: 37752560 PMCID: PMC10521496 DOI: 10.1186/s13643-023-02342-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/01/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Systematic reviews (SRs) are pivotal to evidence-based medicine, yet there is limited research on conflicts of interest in SRs. Our aim was to investigate financial conflicts of interest and risk of bias (RoB) in SRs of a well-defined clinical topic. METHODS A librarian searched Medline, Cochrane Library, Embase, and PsycINFO for SRs investigating the effect of methylphenidate on ADHD in December 2020. The selection process adhered to the PRISMA guidelines. Two blinded reviewers independently searched open websites, including other publications, for information on financial conflicts of interest of all authors of the included SRs. A time limit of 3 years before or after the index SR was adopted. Declarations on conflict of interest were extracted from the included SRs for comparison. ROBIS was used for RoB assessment. RESULTS Out of 44 SRs included, 15 (34%) declared conflict of interest, 27 (61%) did not, and a declaration of conflict of interest was missing for 2 (5%). On open websites, conflict of interest was found for at least one author of 23 (52%) SRs: disclosed in 15 (34%) and not disclosed in 8 (18%) SRs. Seven (16%) SRs had low, 36 (82%) had high, and 1 (2%) had unclear RoB. Among SRs with financial conflict of interest found in open sources, 6/22 (27%) had low RoB compared to 1/21 (5%) if no such conflict of interest was identified. Among SRs with financial conflict of interest identified, 1/6 (17%) at low RoB did not disclose their conflict of interest, whereas the corresponding proportion among SRs at high RoB was 7/16 (44%). Eight (18%) SRs presented conflict of interest disclosed in the included primary studies. Four of them (50%) had low RoB, compared to 3/36 (8%) for SRs not reporting on this aspect. CONCLUSION Financial conflict of interest was underreported in 18% of the SRs using our reference standard, and overall it was present for every second SR. This group embraced both SRs at low RoB disclosing conflict of interest and SRs at high RoB not disclosing their conflict of interest. Further studies to explore this heterogeneity are warranted.
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Affiliation(s)
- Alexandra Snellman
- Centre for Assessment of Medical Technology in Örebro, Örebro University Hospital, Örebro, Sweden.
- School of Medical Sciences, Örebro University, Örebro, Sweden.
| | - Stella Carlberg
- Centre for Assessment of Medical Technology in Örebro, Örebro University Hospital, Örebro, Sweden
- Department of Surgery, Lindesberg Hospital, Lindesberg, Sweden
| | - Louise Olsson
- Centre for Assessment of Medical Technology in Örebro, Örebro University Hospital, Örebro, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
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Di Lorenzo G, Melluso M, Rodolico A. What Evidence-based Medicine (EBM) Doesn't Say About Allergen-specific Immunotherapy (AIT). Transl Med UniSa 2023; 25:1-10. [PMID: 38143507 PMCID: PMC10740709 DOI: 10.37825/2239-9747.1040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 07/20/2023] [Indexed: 12/26/2023] Open
Abstract
Evidence-based allergology for the treatment of allergic rhinitis with allergen-specific immunotherapy (AIT) has been used in publications by the companies manufacturing AIT. The purpose of randomized controlled trials (RCTs) is to provide physicians, health authorities, patients, and their families with the best evidence upon which to base treatment decisions. However, some RCT results may do more harm than good because they serve the commercial interests of the companies producing and marketing AIT more than the interests of patients. Allergic rhinitis is a trivial disease that is not life-threatening and is easily controlled by drugs. In this paper, we analyze some of the more controversial points underlying the EBM supporting the use of AIT. The paradox behind RCT-based practice is that AIT is based on the results of incorrectly interpreted RCTs. International scientific societies and drug regulatory bodies should analyze trials more carefully, considering potential conflicts of interest.
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Affiliation(s)
- Gabriele Di Lorenzo
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo,
Italy
| | | | - Alessandro Rodolico
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania,
Italy
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Xia X, Yang YN. Why are there conflicts of interest? Investigation of teacher exchange within Arts Education Group in China. Heliyon 2023; 9:e18985. [PMID: 37609393 PMCID: PMC10440518 DOI: 10.1016/j.heliyon.2023.e18985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 07/21/2023] [Accepted: 08/04/2023] [Indexed: 08/24/2023] Open
Abstract
The introduction of the collectivized school management mode marks a turning point for teacher exchange, however, it also brings numerous challenges. Whether or not breakthroughs can be achieved in teacher exchange hinges on the outcome of stakeholder negotiations. This study employs a qualitative approach through case analysis. Based on interviews with 15 members of the Education Group, game theory was employed to investigate conflicts of interest between exchange teachers and original teachers during teacher communication. This study aimed to stimulate backbone teachers' motivation to transfer to branch schools while providing a broader space for free exchange. The conflicts of interest in teacher exchange within educational groups were found to be closely associated with various interest subjects, objects, and institutional arrangements in the teacher exchange system.
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Affiliation(s)
- Xue Xia
- Northeast Normal University, Faculty of Education, 5268, Renmin Street, Changchun City, Jilin Province, China
| | - Yi-Ning Yang
- Northeast Normal University, Faculty of Education, 5268, Renmin Street, Changchun City, Jilin Province, China
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Zhou Y. The effects of lobbying on the FDA's recall classification. BMC Med Ethics 2023; 24:41. [PMID: 37340417 DOI: 10.1186/s12910-023-00921-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 06/09/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND The US Food and Drug Administration (FDA) regulates goods accounting for 20% of US consumers' total expenditure. The agency's potential susceptibility to corporate lobbying and political influence may adversely affect the its abilities to fulfill its duties as a vital federal agency. This study assesses whether the FDA's product recall classifications in recall scenarios are influenced by firms' lobbying activities. METHODS The universe of all FDA recalls between 2012 and 2019 is obtained from the FDA's website. Firm names are matched to federal-level lobbying data obtained from the Center for Responsive Politics - a non-profit and nonpartisan organization that tracks lobbying expenditures and campaign contributions. Analyses are conducted using ordinary-least-squares regressions, in which the dependent variable is recall classification and independent variables are three different measures of firms' lobbying activities in the one year prior to the recall. RESULTS Firms that engage in lobbying appear more likely to receive favourable classifications from the FDA. When examining the above results by product type, we find that classification of food recalls seems to be subject to lobbying influence, but the same does not appear to be true for drug and device recalls. Evidence is consistent with the conjecture that the distinction between medical and food firms may be a result of medical firms targeting lobbying efforts at FDA approvals, rather than recalls. CONCLUSIONS Between 2012 and 2019, the FDA's product recall classifications seem to be significantly influenced by firms' lobbying activities. Lobbying firms appear to have received more favorable (i.e., less severe) recall classifications compared to non-lobbying firms.
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Affiliation(s)
- Yifan Zhou
- Fanhai International School of Finance, Fudan University, 220 Handan Road, Yangpu District, Shanghai, 200433, China.
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von Kries R, Jank M. [COVID-19 vaccination in children and adolescents]. Monatsschr Kinderheilkd 2023; 171:1-6. [PMID: 37362307 PMCID: PMC10241121 DOI: 10.1007/s00112-023-01759-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 06/28/2023]
Abstract
Background The COVID-19 pandemic posed special challenges for the existing structures for vaccination prevention in Germany with respect to 1) understanding the role and aims of those involved and the interests of the children and 2) the definition of adequate criteria and assessment of the risk of severe diseases in children. Objectives Do the priorities of different groups of interest differ in the recommendations for COVID-19 vaccination? Which data on the pathogenicity of different variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV‑2) are necessary and how did they change during the pandemic? Methods The tasks, objectives and perception of politics and the German national vaccination advisory committee regarding vaccination of children are discussed in the face of summarized recent data on clinical manifestations of pediatric SARS-CoV‑2 infections among children and adolescents in Germany, which could be estimated by combining different German data sources. Results The perspectives of politics and children differ but are legitimate when they are clearly stated. The decisive risk for a severe course or the pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV‑2 (PIMS-TS) per 10,000 SARS-CoV‑2 infections for the decision on vaccination from the perspective of children, decreased during the course of the pandemic with dominance of the omicron variant. Severe courses of COVID-19 still predominantly affect children with underlying diseases. The age-stratified analysis of vaccinated and nonvaccinated children showed that the alterations in the pathogenicity of the virus in the course of the pandemic is particularly reflected in the reduction in the risk of PIMS-TS. The general reduction of severe courses of COVID-19 again can be explained by the characteristics of variants of concern (VOC) as well as increasing vaccination rates and immunity following a SARS-CoV‑2 infection. Conclusion The primary goal of COVID-19 vaccination in children and adolescents is the prevention of severe courses of the disease. In pediatric risk groups the best possible immunity or immune protection by vaccination should be strived for. It is currently unclear whether catch-up vaccination in already infected or vaccinated children or whether forthcoming healthy children will need vaccination, aiming for hybrid immunity.
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Affiliation(s)
- Rüdiger von Kries
- Institut für Soziale Pädiatrie und Jugendmedizin, Abteilung Pädiatrische Epidemiologie, Ludwig-Maximilians-Universität München, Partenkirchenerstr 17, 81377 München, Deutschland
| | - Marietta Jank
- Kinderklinik, Universitätsmedizin Mannheim, Universität Heidelberg, Mannheim, Deutschland
- Klinik für Kinder- und Jugendchirurgie, Universitätsmedizin Mannheim, Universität Heidelberg, Mannheim, Deutschland
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Haslam A, Prasad V. Cross-sectional analysis of open payments for physicians at designated hemophilia centers in the US (2018-2020). Thromb Res 2023; 227:40-44. [PMID: 37210957 DOI: 10.1016/j.thromres.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/28/2023] [Accepted: 05/01/2023] [Indexed: 05/23/2023]
Abstract
INTRODUCTION Physicians who treat hemophilia, and especially directors at hemophilia centers, are in a position to be unduly influenced by payments from pharmaceutical companies who make costly hemophilia drugs. It is from this perspective that we analyzed payments made to physicians at hemophilia centers in the US, focusing on center directors. MATERIALS AND METHODS In a cross-sectional analysis we searched the CDC's Hemophilia Treatment Center Directory for physicians (2022) and then abstracted general payments for physicians on Open Payments (2018-2020) and calculated one-year average payments. We searched academic websites to determine physician role (hemophilia center director, non-director, or non-center director). RESULTS There were 420 physicians in the hemophilia physician directory - 270 physicians/professors, 103 directors of hemophilia centers, and 47 other directors. Directors of hemophilia centers had higher median one-year general payments, compared to other directors and physician/professors ($4910 vs $79 vs $87, respectively; p < 0.0001). Takeda Pharmaceutical Company Limited, F-Hoffmann La Roche Ltd./Genentech, and Novo Nordisk have the largest hemophilia drug market share and were the three companies with the most payments to physicians. CONCLUSIONS High payments, especially among individuals who have responsibility over the success of hemophilia centers and clinics, may result in competition with the interest of the patients at these centers and clinics.
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Affiliation(s)
- Alyson Haslam
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th St, 2nd Fl, San Francisco, CA 94158, United States of America.
| | - Vinay Prasad
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th St, 2nd Fl, San Francisco, CA 94158, United States of America
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Via GG, Brueggeman DA, Lyons JG, Frommeyer TC, Froehle AW, Krishnamurthy AB. Funding has no effect on studies evaluating viscosupplementation for knee osteoarthritis: A systematic review of bibliometrics and conflicts of interest. J Orthop 2023; 39:18-29. [PMID: 37089621 PMCID: PMC10114245 DOI: 10.1016/j.jor.2023.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/11/2023] [Accepted: 03/30/2023] [Indexed: 04/25/2023] Open
Abstract
Background Viscosupplementation for knee osteoarthritis (OA) may raise concerns regarding conflicts of interest (COI). Evidence of inconclusive study results and publication bias in previous studies has led to concern that financial COI have influenced viscosupplementation outcomes. It is critical to ensure that clinical practice is guided by informed decision making and evidence-based medicine. Methods A systematic review was conducted following PRISMA guidelines. PubMed, MEDLINE, and Web of Science databases were searched for articles pertaining to hyaluronic acid (or similarly derived) injections to native knees with primary OA only. Bibliometric data, financial COI, and study outcomes were assessed. Results 67 studies met inclusion criteria for analysis, 53 of which (79.1%) presented Level I evidence, and 21 of which (31.3%) reported at least one author with COI. All studies reporting COI also disclosed industry funding. There were no relationships between reported COI and study outcomes (Χ 2 = 0.31, P = 0.577), levels of evidence (Χ 2 = 3.48, P = 0.176), or relative citation ratio (RCR) (S = 743, P = 0.591). Studies reporting COIs/industry funding tended to be published in journals with significantly higher impact factors (IF) (reporting COI: IF = 3.5 ± 2.0; no COI: IF = 1.8 ± 1.1; S = 950, P < 0.001). Study outcomes were not related to the probability of being published in an open access journal (Χ 2 = 0.01, P = 0.960), nor to level of evidence (Χ 2 = 2.67, P = 0.263), RCR (S = 618, P = 0.835), or IF (S = 563, P = 0.655). Conclusions Investigator COIs (and commercial funding of studies) have not significantly influenced the frequency of favorable outcomes or study level of evidence regarding contemporary viscosupplementation for the treatment of knee OA. Studies reporting COIs/industry funding tended to be published in journals with significantly higher impact factors. Results overwhelmingly supported using viscosupplementation to treat knee OA. Level of evidence Level V Systematic Review.
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Affiliation(s)
- Garrhett Glenn Via
- Corresponding author. 30 E. Apple St., Ste 2200, Dayton, OH, 45409, USA.
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Atli Gunnarsson J, Ruskin G, Stuckler D, Steele S. Big food and drink sponsorship of conferences and speakers: a case study of one multinational company's influence over knowledge dissemination and professional engagement. Public Health Nutr 2023; 26:1094-1111. [PMID: 36450363 PMCID: PMC10346015 DOI: 10.1017/s1368980022002506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 08/26/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES Research identifies that multinational corporations, including The Coca-Cola Company ('Coca-Cola'), seek to influence public health research and policy through scientific events, such as academic and professional conferences. This study aims to understand how different forms of funding and sponsorship impact the relationship between Coca-Cola, academic institutions, public health organisations, academics and researchers. DESIGN The study was conducted using Freedom of Information (FOI) requests and systematic website searches. SETTING Data were collected by twenty-two FOI requests to institutions in the USA and UK, resulting in the disclosure of 11 488 pages, including emails and attachments relating to 239 events between 2009 and 2018. We used the Wayback Machine to review historical website data to evaluate evidence from 151 available official conference websites. PARTICIPANTS N/A. RESULTS Documents suggest that Coca-Cola provides direct financial support to institutions and organisations hosting events in exchange for benefits, including influence over proceedings. Coca-Cola also provided direct financial support to speakers and researchers, sometimes conditional on media interviews. Also, indirect financial support passed through Coca-Cola-financed non-profits. Often, such financial support was not readily identifiable, and third-party involvement further concealed Coca-Cola funding. CONCLUSION Coca-Cola exerts direct influence on academic institutions and organisations that convene major public health conferences and events. These events offer Coca-Cola a vehicle for its messaging and amplifying viewpoints favourable to Coca-Cola's interests. Such corporate-sponsored events should be viewed as instruments of industry marketing. Stronger rules and safeguards are needed to prevent hidden industry influence, such as complete disclosure of all corporate contributions for public health conferences and their speakers.
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Affiliation(s)
| | - Gary Ruskin
- U.S. Right to Know, Oakland, California, USA
| | - David Stuckler
- Department of Social and Political Sciences, Bocconi University, Milan, Italy
- Intellectual Forum, Jesus College, Cambridge, UK
| | - Sarah Steele
- Intellectual Forum, Jesus College, Cambridge, UK
- Cambridge Public Health, University of Cambridge, Cambridge, UK
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Martin M, Braillon A. [Comment on: "French Expert advice on the management of valproate in childbearing and pregnant women with bipolar disorder"]. Encephale 2023; 49:323-324. [PMID: 37095050 DOI: 10.1016/j.encep.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/16/2023] [Accepted: 03/30/2023] [Indexed: 04/26/2023]
Abstract
Professor Marlene Freeman of Massachusset General Hospital's answer to the question "How should I prescribe valproic acid (for psychiatric disorders) to women of childbearing age?" is "Don't do it at all."
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17
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Lucasti C, Vallee EK, Scott MM, Baker SC, Das AA, Patel DV. Differences in Financial Conflicts of Interest Among Participants in a National Spine Conference. Global Spine J 2023:21925682231168578. [PMID: 37010029 DOI: 10.1177/21925682231168578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
STUDY Retrospective Study. OBJECTIVE At the North American Spine Society (NASS) conference, participants may influence spine surgery practices and patient care through their contributions. Therefore, their financial conflicts of interest are of notable interest. This study aims to compare the demographics and payments made to participating surgeons. METHODS A list of 151 spine surgeons was created based on those who participated in the 2022 NASS conference. Demographic information was obtained from public physician profiles. General payments, research payments, associated research funding, and ownership interest were collected for each physician. Descriptive statistics and two-tailed t-tests were used. RESULTS In 2021, 151 spine surgeon participants received industry payments, totaling USD 48 294 115. The top 10% of orthopedic surgeons receiving payments accounted for 58.7% of total orthopedic general value, while the top 10% of neurosurgeons accounted for 70.1%. There was no significant difference between these groups' general payment amounts. Surgeons with 21-30 years of experience received the most general funding. There was no difference in funding between surgeons in academic or private settings. For all surgeons, royalties accounted for the largest percentage of the general value exchanged, while food/beverage accounted for the largest percentage of transactions. CONCLUSIONS Our study found that only years of experience had a positive association with general payments, and most monetary value belonged to a small handful of surgeons. These participants receiving significant money may promote techniques requiring products of companies providing their compensation. Future conferences may require disclosure policy changes so attendees understand the degree of funding participants receive.
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Affiliation(s)
| | - Emily K Vallee
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Maxwell M Scott
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Seth C Baker
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Ashtah A Das
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Dil V Patel
- Department of Orthopaedics, University at Buffalo, Buffalo, NY, USA
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18
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Graham SS, Sharma N, Karnes MS, Majdik ZP, Barbour JB, Rousseau JF. A Content Analysis of Self-Reported Financial Relationships in Biomedical Research. AJOB Empir Bioeth 2023; 14:91-98. [PMID: 36576202 PMCID: PMC10182247 DOI: 10.1080/23294515.2022.2160509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
INTRODUCTION Financial conflicts of interest (fCOI) present well documented risks to the integrity of biomedical research. However, few studies differentiate among fCOI types in their analyses, and those that do tend to use preexisting taxonomies for fCOI identification. Research on fCOI would benefit from an empirically-derived taxonomy of self-reported fCOI and data on fCOI type and payor prevalence. METHODS We conducted a content analysis of 6,165 individual self-reported relationships from COI statements distributed across 378 articles indexed with PubMed. Two coders used an iterative coding process to identify and classify individual fCOI types and payors. Inter-rater reliability was κ = 0.935 for fCOI type and κ = 0.884 for payor identification. RESULTS Our analysis identified 21 fCOI types, 9 of which occurred at prevalences greater than 1%. These included research funding (24.8%), speaking fees (20.8%), consulting fees (18.8%), advisory relationships (11%), industry employment (7.6%), unspecified fees (4.8%), travel fees (3.2%), stock holdings (3.1%), and patent ownership (1%). Reported fCOI were held with 1,077 unique payors, 22 of which were present in more than 1% of financial relationships. The ten most common payors included Pfizer (4%), Novartis (3.9%), MSD (3.8%), Bristol Myers Squibb (3.2%), AstraZeneca (3.1%), GSK (3%), Boehringer Ingelheim (2.9%), Roche (2.8%), Eli LIlly (2.5%), and AbbVie (2.4%). CONCLUSIONS These results provide novel multi-domain prevalence data on self-reported fCOI and payors in biomedical research. As such, they have the potential to catalyze future research that can assess the differential effects of various types of fCOI. Specifically, the data suggest that comparative analyses of the effects of different fCOI types are needed and that special attention should be paid to the diversity of payor types for research relationships.
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Affiliation(s)
- S Scott Graham
- Department of Rhetoric & Writing, Center for Health Communication, The University of Texas at Austin, Austin, TX, USA
| | - Nandini Sharma
- Moody College of Communication, The University of Texas at Austin, Austin, TX, USA
| | - Martha S Karnes
- Department of English, The University of Texas at Austin, Austin, TX, USA
| | - Zoltan P Majdik
- Department of Communication, North Dakota State University, Fargo, ND, USA
| | - Joshua B Barbour
- Moody College of Communication, The University of Texas at Austin, Austin, TX, USA
| | - Justin F Rousseau
- Departments of Population Health and Neurology, The Dell Medical School at The University of Texas at Austin, Austin, TX, USA
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19
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Shadduck P, Sylla P, Schwarz E, Reinke C, Denk P, Ginsberg S, Asbun H, Pryor A. SAGES perspective: professional medical associations, commercial interests, and conflicts of interest. Surg Endosc 2023. [PMID: 36918413 DOI: 10.1007/s00464-023-09897-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/16/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Professional medical associations (PMAs) have an essential role in advancing medical care and health. PMAs promote skills training, clinical standards, and other important educational activities. Most often, PMAs are not-for-profit entities that rely upon funding from industry to help cover the costs of these valuable activities. Equally important, innovation and progress in surgery require physician collaboration with industry throughout the product development process. SAGES has opined that, with appropriate Conflict of Interest (COI) disclosure and management processes, PMA educational activities can be both scientifically and ethically sound. METHODS SAGES has developed and implemented comprehensive and stringent processes for managing potential COI within the organization, at the annual meeting, and in developing educational offerings. This document reviews the SAGES COI processes and results 2009-2021. RESULTS Implementation of the SAGES COI disclosure and management processes reduced the reported perceived incidence of bias at the annual meeting from 4.4-6.2% (2008-2010) to 1.2-2.2% (2011-2013). Recent comparison of reported disclosures revealed a rise in number of speakers with financial relationships and an increase in reporting of disclosures in presentations without an associated increase in need for conflict resolution by the COI committee. Despite good overall adherence to COI policies, SAGES was recently cited for non-compliance with ACCME standards related to inclusion of faculty with ownership interest. This experience highlighted the potential for discordance in the interpretation of whether disclosures relate to specific CME content. SAGES COI processes have since been updated to reflect the more stringent 2020 ACCME Standards that exclude speakers and planners with ownership interest from any CME activity. CONCLUSIONS The SAGES experience with disclosure and mitigation of financial relationships highlights the challenges of validating the accuracy of physician disclosures and establishing the relevance of financial relationships to the content of accredited educational activities. SAGES will continue to streamline its COI disclosure process with specific focus on aligning all financial disclosures among the various reporting platforms.
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Patay D, Ralston R, Palu A, Jones A, Webster J, Buse K. Fifty shades of partnerships: a governance typology for public private engagement in the nutrition sector. Global Health 2023; 19:11. [PMID: 36804923 PMCID: PMC9942354 DOI: 10.1186/s12992-023-00912-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Multistakeholder collaboration has emerged as a dominant approach for engaging and mobilising non-state actors; notably embedded in the paradigm of the UN Sustainable Development Goals. Yet, considerable ambiguity and contestation surrounds the appropriate terms of public private engagement (PPE) with industry actors. MAIN BODY This paper seeks to conceptualise different forms of engagement with the food industry in tackling diet-related noncommunicable disease, within the context of power asymmetries across engaged stakeholders. It does so by introducing the Governance Typology for Public Private Engagement in the Nutrition Sector, a typology for government-led engagement with food industry actors across three domains: (i) the form of industry and civil society actor engagement (i.e., rules of exercising institutional power), based on the degree of participation in formal decision-making as well as participation at different stages in the policy cycle; (ii) the type of industry actors being engaged (i.e., pre-existing power attributes), based on function, size, and product portfolios for profit; and (iii) the substantive policy focus of engagement. CONCLUSIONS The Governance Typology for Public Private Engagement in the Nutrition Sector seeks to inform national level nutrition policy makers on good engagement practice with food industry actors and complements existing risk assessment tools. This typology has the potential to inform decision-making on public sector engagement with other industries that profit from products detrimental to human and planetary health.
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Affiliation(s)
- Dori Patay
- The George Institute for Global Health Australia, Sydney, Australia.
| | - Rob Ralston
- grid.4305.20000 0004 1936 7988Global Heath Policy Unit, Social Policy, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Aliyah Palu
- grid.415508.d0000 0001 1964 6010The George Institute for Global Health Australia, Sydney, Australia
| | - Alexandra Jones
- grid.415508.d0000 0001 1964 6010The George Institute for Global Health Australia, Sydney, Australia
| | - Jacqui Webster
- grid.415508.d0000 0001 1964 6010The George Institute for Global Health Australia, Sydney, Australia
| | - Kent Buse
- grid.7445.20000 0001 2113 8111Healthier Societies Programme, George Institute for Global Health, Imperial College London, London, UK
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Kraus L, Bickl A, Sedlacek L, Schwarzkopf L, Örnberg JC, Loy JK. 'We are not the ones to blame'. Gamblers' and providers' appraisal of self-exclusion in Germany. BMC Public Health 2023; 23:322. [PMID: 36788494 PMCID: PMC9926676 DOI: 10.1186/s12889-023-15117-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 01/17/2023] [Accepted: 01/23/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Given low utilization by individuals experiencing gambling problems the potential of self-exclusion (SE) might be not fully exploited in Germany. This paper aims to gain insight into different actors' perceptions and reflections on the problems and difficulties in the process of self-exclusion to delineate which specific attitudes hamper a successful implementation of SE. METHODS 13 individual and four group interviews with individuals experiencing gambling problems and governmental or commercial gambling providers were examined. A Grounded Theory Approach was used to portray the opinions of these different actors on existing regulations of SE and to delineate potentially diverging interests between the distinct groups. RESULTS The interviewees agreed on the usefulness of SE and consented that it is important to early recognize individuals experiencing gambling problems. They also considered the present practice insufficient but for different reasons. Individuals experiencing gambling problems and providers particularly disagreed on addressing individuals experiencing gambling problems. While individuals experiencing gambling problems stated that they had hardly ever been approached, providers argued that help offers were mostly rejected. Especially commercial providers also regarded insufficient German language skills and rapid fluctuation of guests as strong barriers to approaching individuals experiencing gambling problems. Interviewees from governmental venues furthermore suspected that commercial providers took addressing individuals experiencing gambling problems less seriously. CONCLUSION Our results emphasize the dilemma of conflicting interests in both individuals experiencing gambling problems and providers. Rather than acting against the economic interests of employers, venue staff blame individuals experiencing gambling problems for lack of problem recognition. Conversely, individuals experiencing gambling problems blame the providers for not offering help. To address individuals experiencing gambling problems appropriate staff training is required, and SE regulations need to be controlled by an independent body rather than by the providers themselves.
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Affiliation(s)
- Ludwig Kraus
- IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Leopoldstraße 175, 80804, Munich, Germany. .,Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden. .,Institute of Psychology, ELTE, Eötvös Loránd University, Budapest, Hungary.
| | - Andreas Bickl
- grid.417840.e0000 0001 1017 4547IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Leopoldstraße 175, 80804 Munich, Germany
| | - Lucia Sedlacek
- grid.417840.e0000 0001 1017 4547IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Leopoldstraße 175, 80804 Munich, Germany
| | - Larissa Schwarzkopf
- grid.417840.e0000 0001 1017 4547IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Leopoldstraße 175, 80804 Munich, Germany
| | - Jenny Cisneros Örnberg
- grid.10548.380000 0004 1936 9377Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
| | - Johanna K. Loy
- grid.417840.e0000 0001 1017 4547IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Leopoldstraße 175, 80804 Munich, Germany
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Dugan CD, Lee LM, Jandreau CB. Timing and monitoring of financial disclosures in publications: A cross-institutional assessment of financial conflict of interest reports. Account Res 2023:1-11. [PMID: 36693801 DOI: 10.1080/08989621.2023.2172569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 01/21/2023] [Indexed: 01/26/2023]
Abstract
A consistent mitigation strategy used in sponsored research to manage a financial conflict of interest (FCOI) is disclosure in publications. While federal funding regulations require mitigation strategies to be monitored through the end of the project's term, manuscripts are often published after the project term has ended. We examined whether it would be valuable to extend monitoring of publications for compliance with requirements for disclosure beyond the end date of a project's term and, if so, for how long after the term has ended. Using publicly available databases, we identified FCOI reports from public universities and analyzed disclosure completion in the years before and after the end of the project's term. We found that 80.2% of FCOI reports in our sample had a publication in which a conflicted Investigator served as an author, yet less than half (43.6%) of these publications contained disclosure statements acknowledging the known FCOI. We also found that publication most commonly occurred one year after the end of the project's term. These findings indicate that an effective way to support accountability and accuracy of the scientific record would be to extend monitoring of disclosure in publications through one year following the end of the project's term.
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Affiliation(s)
- Caley D Dugan
- Division of Scholarly Integrity and Research Compliance, Virginia Tech, Blacksburg, Virginia, USA
| | - Lisa M Lee
- Division of Scholarly Integrity and Research Compliance, Virginia Tech, Blacksburg, Virginia, USA
- Population Health Sciences, Virginia Tech, Blacksburg, Virginia, USA
| | - Cristen B Jandreau
- Division of Scholarly Integrity and Research Compliance, Virginia Tech, Blacksburg, Virginia, USA
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Shah P, Olavarria O, Dhanani N, Ciomperlik H, Mohr C, Bernardi K, Neela N, Coelho R, Ali Z, Prabhu A, Liang MK. The Food and Drug Administration's (FDA's) 510(k) Process: A Systematic Review of 1000 Cases. Am J Med 2023; 136:172-178.e14. [PMID: 36170936 DOI: 10.1016/j.amjmed.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND The vast majority of devices cleared by the Food and Drug Administration (FDA) are through the 510(k) process, which allows medical devices to be quickly introduced into the market. The FDA 510(k) process is designed to minimize the burden and expense of bringing new devices to market; however, as a result, the FDA may be limited in its ability to establish the safety of these devices. METHODS The FDA 510(k) online archives were searched for devices cleared from 2013 to 2014. One thousand devices were randomly selected. PubMed was searched for each device to identify publications about the devices. The primary outcome was the percentage of devices cleared through the 510(k) process with no published research. Secondary outcomes included: conflict of interest (COI) of authors and outcomes of published studies on the devices. RESULTS A total of 6152 devices were cleared through the 510(k) process in 2013-2014. Of the 1000 randomly selected devices, 17.8% had published research. There were 375 manuscripts, of which 47 (12.5%) were randomized controlled trials. One-fourth (25.1%) of studies had a clearly identifiable COI, while COI was unclear for half (49.9%). CONCLUSION AND RELEVANCE There is limited evidence examining the safety and effectiveness of devices cleared via the 510(k) process. Thousands of devices are cleared through the FDA's 510(k) process each year with limited or no evidence publicly available. This has led to the market being introduced to potentially costly, nonbeneficial, or harmful devices. Devices, like prescription drugs, should undergo a more rigorous clearance process.
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Affiliation(s)
- Puja Shah
- Department of Surgery, Lyndon B. Johnson General Hospital, McGovern Medical School at UTHealth, Houston, Texas
| | - Oscar Olavarria
- Department of Surgery, Lyndon B. Johnson General Hospital, McGovern Medical School at UTHealth, Houston, Texas; Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School at UTHealth, Houston, Texas
| | - Naila Dhanani
- Department of Surgery, Lyndon B. Johnson General Hospital, McGovern Medical School at UTHealth, Houston, Texas; Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School at UTHealth, Houston, Texas
| | - Hailie Ciomperlik
- Department of Surgery, Lyndon B. Johnson General Hospital, McGovern Medical School at UTHealth, Houston, Texas
| | - Cassandra Mohr
- Department of Surgery, Lyndon B. Johnson General Hospital, McGovern Medical School at UTHealth, Houston, Texas
| | - Karla Bernardi
- Department of Surgery, Lyndon B. Johnson General Hospital, McGovern Medical School at UTHealth, Houston, Texas; Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School at UTHealth, Houston, Texas
| | - Niharika Neela
- Department of Surgery, Lyndon B. Johnson General Hospital, McGovern Medical School at UTHealth, Houston, Texas
| | - Rainna Coelho
- Department of Clinical Sciences, College of Medicine, University of Houston, Texas; Department of Surgery, Graduate Medical Education, HCA Healthcare Kingwood, Kingwood, Texas
| | - Zuhair Ali
- Department of Clinical Sciences, College of Medicine, University of Houston, Texas; Department of Surgery, Graduate Medical Education, HCA Healthcare Kingwood, Kingwood, Texas.
| | | | - Mike K Liang
- Department of Clinical Sciences, College of Medicine, University of Houston, Texas; Department of Surgery, Graduate Medical Education, HCA Healthcare Kingwood, Kingwood, Texas
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Koplovitz A, Freud T, Peleg R. Community physicians' attitudes towards meetings with representatives of pharmaceutical companies: a pilot study. J Pharm Policy Pract 2023; 16:15. [PMID: 36698193 PMCID: PMC9876407 DOI: 10.1186/s40545-023-00521-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 01/14/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Marketing by pharmaceutical companies has become an increasingly controversial issue for the medical community and the public. This controversy stems from the potential influence that pharmaceutical companies can wield through marketing on the medical community. This study assesses community physicians' attitudes towards pharmaceutical companies and their representatives to get a better understanding of how their activities affect daily work in community clinics. METHODS A cross-sectional anonymous questionnaire-based study of 170 community physicians in southern Israel was conducted via convenience sampling. The questionnaire was designed to assess physicians' attitudes about the nature of their relationships with representatives of pharmaceutical companies and possible associations with physicians' demographic and professional profiles. The questionnaire was distributed, at weekly staff meetings in the study clinics, to a convenience sample of physicians, who agreed to participate in the study. RESULTS Most physicians did not have an extreme attitude on interactions with representatives of pharmaceutical companies. Interestingly, while they thought that pharmaceutical companies play an important role in medical progress, they did express concern regarding the risk of misleading information. While they believed that interactions between physicians and representatives of pharmaceutical companies had a negative effect on the clinic workflow, they were not in favor of prohibiting such interactions. Physicians who graduated from medical schools in Israel held a less sympathetic position towards these interactions. CONCLUSION The anticipated heterogeneous attitudes of community-based physicians on interactions with representatives of pharmaceutical companies reflect an inherent complex relationship, with aspects that are specific to the Israeli medical field. Interestingly, physicians trained in other countries than Israel also have divergent attitudes, further affecting the socio-cultural impact on practitioner's attitudes towards this intricate and often politicized topic. Open professional dialogue and targeted educational programs on the physician-pharmaceutical relationship, with more explicit regulation, could potentially ease the discomfort experienced by physicians, especially in the Israeli context and result in a clearer framework of interaction that would leverage the potential advantages while accounting for ethical and regulatory pitfalls.
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Affiliation(s)
- Amit Koplovitz
- grid.7489.20000 0004 1937 0511Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Tamar Freud
- grid.7489.20000 0004 1937 0511Department of Family Medicine, Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, POB 653, 84105 Beer-Sheva, Israel
| | - Roni Peleg
- grid.7489.20000 0004 1937 0511Department of Family Medicine, Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, POB 653, 84105 Beer-Sheva, Israel ,grid.414553.20000 0004 0575 3597Family Medicine and Primary Care Clinic, Clalit Health Services, Southern District, Beer-Sheva, Israel
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Reade MC. Whose side are you on? Complexities arising from the non-combatant status of military medical personnel. New Bioeth 2023:10.1007/s40592-022-00168-2. [PMID: 36630051 DOI: 10.1007/s40592-022-00168-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Since the mid-1800s, clergy, doctors, other clinicians, and military personnel who specifically facilitate their work have been designated "non-combatants", protected from being targeted in return for providing care on the basis of clinical need alone. While permitted to use weapons to protect themselves and their patients, they may not attempt to gain military advantage over an adversary. The rationale for these regulations is based on sound arguments aimed both at reducing human suffering, but also the ultimate advantage of the nation-state fielding non-combatant staff. However, this is sometimes not immediately apparent to combatant colleagues. Clinicians in the armed force are also military officers, owing a "dual loyalty" that can create conflict if their non-combatant status is not well understood. Historical examples of doctors breaching their responsibilities include prioritisation of combat capability over the rights of individual soldiers (as occurred when scarce medical resources were allocated to soldiers more likely to return to battle in preference to those most likely to die without them), use of physicians to facilitate prisoner interrogation, medical research or treatment to enhance physical performance at the expense of health, application of Medical Rules of Eligibility according to factors other than clinical need, provision of treatment contingent upon support for military objectives, and use of medical knowledge to enhance weapons. However, not being a combatant party to a conflict does not imply that the non-combatant clinician cannot act in the national interest. Indeed, by adhering to the same universal ethics as their civilian colleagues, military clinicians provide optimal care to their own troops, facilitate freedom of action in host nations, and build positive international relationships during the conflict and in the post-conflict state.
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Affiliation(s)
- Michael C Reade
- Medical School, University of Queensland, Brisbane, QLD, Australia.
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Abstract
While experience often affords important knowledge and insight that is difficult to garner through observation or testimony alone, it also has the potential to generate conflicts of interest and unrepresentative perspectives. We call this tension the paradox of experience. In this paper, we first outline appeals to experience made in debates about access to unproven medical products and disability bioethics, as examples of how experience claims arise in bioethics and some of the challenges raised by these claims. We then motivate the idea that experience can be an asset by appealing to themes in feminist and moral epistemology, distinguishing between epistemic and justice-based appeals. Next, we explain the concern that experience may be a liability by appealing to empirical work on cognitive biases and theoretical work about the problem of partial representation. We conclude with preliminary recommendations for addressing the paradox and offer several questions for future discussion.
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Affiliation(s)
- Ryan H Nelson
- Baylor College of Medicine, Center for Medical Ethics and Health Policy
| | - Bryanna Moore
- University of Texas Medical Branch, Institute for Bioethics and Health Humanities
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Murayama A, Hoshi M, Saito H, Kamamoto S, Tanaka M, Kawashima M, Mamada H, Kusumi E, Sapkota B, Shrestha S, Shrestha R, Bhandari D, Sawano T, Yamashita E, Tanimoto T, Ozaki A. Nature and Trends in Personal Payments Made to the Respiratory Physicians by Pharmaceutical Companies in Japan between 2016 and 2019. Respiration 2022; 101:1088-1098. [PMID: 36353778 PMCID: PMC9811425 DOI: 10.1159/000526576] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/14/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Financial relationships between healthcare professionals and pharmaceutical companies have historically caused conflicts of interest and unduly influenced patient care. However, little was known about such relationship and its effect in clinical practice among specialists in respiratory medicine. METHODS Based on the retrospective analysis of payment data made available by all 92 pharmaceutical companies in Japan, this study evaluated the magnitude and trend of financial relationships between all board-certified Japanese respiratory specialists and pharmaceutical companies between 2016 and 2019. Magnitude and prevalence of payments for specialists were analyzed descriptively. The payment trends were assessed using the generalized estimating equations for the payment per specialist and the number of specialists with payments. RESULTS Among all 7,114 respiratory specialists certified as of August 2021, 4,413 (62.0%) received a total of USD 53,547,391 and 74,195 counts from 72 (78.3%) pharmaceutical companies between 2016 and 2019. The median (interquartile range) 4-year combined payment values per specialist were USD 2,210 (USD 715-8,178). At maximum, one specialist received USD 495,332 personal payments over the 4 years. Both payments per specialist and number of specialists with payments significantly increased during the 4-year period, with 7.8% (95% CI: 5.5-9.8; p < 0.001) in payments and 1.5% (95% CI: 0.61-2.4; p = 0.001) in number of specialists with payments, respectively. CONCLUSION The majority of respiratory specialists had increasingly received more personal payments from pharmaceutical companies for the reimbursement of lecturing, consulting, and writing between 2016 and 2019. These increasing financial relationships with pharmaceutical companies might cause conflicts of interest among respiratory physicians.
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Affiliation(s)
- Anju Murayama
- Medical Governance Research Institute, Tokyo, Japan,Tohoku University School of Medicine, Sendai, Japan,*Anju Murayama,
| | - Momoko Hoshi
- Medical Governance Research Institute, Tokyo, Japan,Department of Public Health Nursing, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Saito
- Department of Gastroenterology, Sendai Kosei Hospital, Sendai, Japan
| | - Sae Kamamoto
- Medical Governance Research Institute, Tokyo, Japan
| | | | - Moe Kawashima
- Medical Governance Research Institute, Tokyo, Japan,School of Medicine, Fukushima Medical University, Fukushima, Japan
| | | | - Eiji Kusumi
- Department of Internal Medicine, Navitas Clinic Shinjuku, Tokyo, Japan
| | - Binaya Sapkota
- Nobel College Faculty of Health Sciences, Affiliated to Pokhara University, Kathmandu, Nepal
| | - Sunil Shrestha
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Malaysia
| | - Rajeev Shrestha
- Department of Pharmacy, District Hospital Lamjung, Besisahar, Nepal
| | | | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
| | | | - Tetsuya Tanimoto
- Department of Internal Medicine, Navitas Clinic, Tachikawa, Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute, Tokyo, Japan,Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan
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Fabbri A, Mulinari S, Johansson M, Ghaur W, Khalil AM, Lundh A. Content and strength of conflict of interest policies at Scandinavian medical schools: a cross sectional study. BMC Med Educ 2022; 22:812. [PMID: 36435782 PMCID: PMC9701355 DOI: 10.1186/s12909-022-03881-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 11/09/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Concerns around staffs' and students' interactions with commercial entities, for example drug companies, have led several North American medical schools to implement conflict of interest (COI) policies. However, little is known about COI policies at European medical schools. We analysed the content and strength of COI policies at Scandinavian medical schools. METHODS We searched the websites of medical schools in Denmark, Norway, and Sweden and emailed the Deans for additional information. Using comparable methodology to previous studies, the strength of the COI policies was rated on a scale from 0 to 2 across 11 items (higher score more restrictive); we also assessed the presence of oversight mechanisms and sanctions. RESULTS We identified 77 unique policies for 15 medical schools (range 2-8 per school). Most of the policies (n = 72; 94%) were University wide and only five (6%) were specific for the medical schools. For six of eleven items one or more schools had a restrictive policy (score of two). None of the schools had a restrictive policy for the five additional items (speaking relationships, sales representatives, on-site education activities, medical school curriculum, and drug samples). Honoraria was the item with the highest score, with eight of the 15 schools having a score of two. Thirteen of the 15 schools had policies that identified a party responsible for policy oversight and mentioned sanctions for non-compliance. CONCLUSION Our study provides the first evaluation of all Scandinavian medical schools' COI policies. We found that the content of COI policies varies widely and still has shortcomings. We encourage Scandinavian medical schools to develop more stringent COI policies to regulate industry interactions with both faculty and students.
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Affiliation(s)
- Alice Fabbri
- Department for Health, University of Bath, Claverton Down, BA2 7AY Bath, UK
- Centre for Evidence-Based Medicine Odense (CEBMO), University of Southern Denmark and Odense University Hospital, Odense, Denmark
| | - Shai Mulinari
- Department of Sociology, Lund University, Lund, Sweden
| | - Martin Johansson
- Department of Clinical Sciences Lund, Clinical Physiology, Lund University, Skåne University Hospital, Lund, Sweden
- Department of Paediatric Anaesthesia and Intensive Care, Children’s Hospital, Skane University Hospital, Lund University, Lund, Sweden
| | | | | | - Andreas Lundh
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
- Department of Respiratory Medicine and Infectious Diseases, Bispebjerg Hospital, Copenhagen, Denmark
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Via GG, Brueggeman DA, Lyons JG, Ely IC, Froehle AW, Krishnamurthy AB. Funding has no effect on clinical outcomes of total joint arthroplasty emerging technologies: a systematic review of bibliometrics and conflicts of interest. Arthroplasty 2022; 4:45. [PMID: 36316729 PMCID: PMC9623935 DOI: 10.1186/s42836-022-00146-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/14/2022] [Indexed: 11/06/2022]
Abstract
Background The use of new total joint arthroplasty technologies, including patient-specific implants/instrumentation (PSI), computer-assisted (CA), and robotic-assisted (RA) techniques, is increasing. There is an ongoing debate regarding the value provided and potential concerns about conflicts of interest (COI). Methods PRISMA guidelines were followed. PubMed, MEDLINE, and Web of Science databases were searched for total hip and knee arthroplasties, unicompartmental knee arthroplasties (UKA), PSI, CA, and RA. Bibliometric data, financial COI, clinical/functional scores, and patient-reported outcomes were assessed. Results Eighty-seven studies were evaluated, with 35 (40.2%) including at least one author reporting COI, and 13 (14.9%) disclosing industry funding. COI and industry funding had no significant effects on outcomes (P = 0.682, P = 0.447), and there were no significant effects of conflicts or funding on level of evidence (P = 0.508, P = 0.826). Studies in which author(s) disclosed COI had significantly higher relative citation ratio (RCR) and impact factor (IF) than those without (P < 0.001, P = 0.032). Subanalysis demonstrated RA and PSI studies were more likely to report COI or industry funding (P = 0.045). RA (OR = 6.31, 95% CI: 1.61–24.68) and UKA (OR = 9.14, 95% CI: 1.43–58.53) had higher odds of reporting favorable outcomes than PSI. Conclusions Author COIs (about 40%) may be lower than previously reported in orthopedic technologies/techniques reviews. Studies utilizing RA and PSI were more likely to report COI, while RA and UKA studies were more likely to report favorable outcomes than PSI. No statistically significant association between the presence of COIs and/or industry funding and the frequency of favorable outcomes or study level of evidence was found. Level of evidence Level V Systematic Review Supplementary Information The online version contains supplementary material available at 10.1186/s42836-022-00146-3.
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Affiliation(s)
- Garrhett G. Via
- grid.268333.f0000 0004 1936 7937Department of Orthopedic Surgery, Wright State University, 30 E. Apple St., Ste 2200, Dayton, OH 45409 USA
| | - David A. Brueggeman
- grid.268333.f0000 0004 1936 7937Department of Orthopedic Surgery, Wright State University, 30 E. Apple St., Ste 2200, Dayton, OH 45409 USA
| | - Joseph G. Lyons
- grid.268333.f0000 0004 1936 7937Department of Orthopedic Surgery, Wright State University, 30 E. Apple St., Ste 2200, Dayton, OH 45409 USA
| | - Isabelle C. Ely
- grid.268333.f0000 0004 1936 7937Department of Orthopedic Surgery, Wright State University, 30 E. Apple St., Ste 2200, Dayton, OH 45409 USA
| | - Andrew W. Froehle
- grid.268333.f0000 0004 1936 7937Department of Orthopedic Surgery, Wright State University, 30 E. Apple St., Ste 2200, Dayton, OH 45409 USA
| | - Anil B. Krishnamurthy
- grid.268333.f0000 0004 1936 7937Department of Orthopedic Surgery, Wright State University, 30 E. Apple St., Ste 2200, Dayton, OH 45409 USA
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Bombak AE, Adams L, Thille P. Drivers of medicalization in the Canadian Adult Obesity Clinical Practice Guidelines. Can J Public Health 2022; 113:743-748. [PMID: 35838981 PMCID: PMC9481752 DOI: 10.17269/s41997-022-00662-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
The new Canadian Adult Obesity Clinical Practice Guidelines frame higher body weight as a chronic, relapsing disease requiring comprehensive medical treatment pathways. In this commentary, we will demonstrate how a process called pharmaceuticalization is informing the new guidelines. We join those questioning the normalization of industry and medical collaboration and interrogate whether the new guidelines meaningfully address stigma.
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Affiliation(s)
- Andrea E Bombak
- Department of Sociology, University of New Brunswick, 3 Bailey Drive, P.O. Box 4400, Fredericton, New Brunswick, E3B 5A3, Canada.
| | - Louise Adams
- Flourish Kirribilli, 13/1 Broughton St, Kirribilli, NSW, 2061, Australia
| | - Patricia Thille
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Room R131 - 771 McDermot Ave., Winnipeg, MB, R3E 0T6, Canada
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Storino A, Vigna C, Polanco-Santana JC, Park E, Crowell K, Fabrizio A, Cataldo TE, Messaris E. Disparities in industry funding among Colorectal Surgeons: a cross-sectional study. Surg Endosc 2022; 36:6592-6600. [PMID: 35103858 DOI: 10.1007/s00464-022-09062-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 01/17/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Health Industry and physician collaboration generates innovation. Colorectal Surgeon (CRS) selection to collaborate might not be random. We aim to identify CRS personal and professional characteristics that facilitate collaboration with the Industry. METHOD Cross-sectional study of Industry payments to CRS (2014-2018) using Open Payments Database from Centers for Medicare & Medicaid Services. Multivariable regression compared variables predicting payment amount including gender, years in practice, leadership positions, H-index, Twitter presence and geographic location. RESULTS Surgeons who were male received 3.1 times the amount in Industry payments as compared to females (p = 0.014). Chairs and Division Chiefs received 2.7 times the amount in payments as compared to those without these leadership positions (p = 0.003). Surgeons with an H-index ≥ 8 received 2.2 times the amount in payments as compared to those with H-index < 8 (p = 0.001). Surgeons in practice for 12-19 and 20-30 years received 3 times and 4.4 times the amount in payments as compared to surgeons in practice for 1-11 years (p = 0.036 and p = 0.017, respectively). Surgeons in the South received 3.2 times and 2 times the amount in payments as compared to surgeons in the Northeast (p < 0.0005) and in the Midwest (p = 0.006). Surgeons with Twitter accounts received 1.7 times the amount in payments as compared to surgeons without Twitter (p = 0.036). Among Twitter users, those with 321-17,200 followers received 4.7 times and 9.5 times the amount in payments as compared to those with 0-15 and 16-79 followers, respectively (p = 0.008 and p = 0.009). CONCLUSION Industry payments are more commonly addressed to male, senior surgeons in leadership tracks with strong social media outreach. With the increasing gender and racial variety in the CRS field, it is expected that collaborations between industry and surgeons will become more diverse and inclusive.
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Affiliation(s)
- Alessandra Storino
- Division of Colorectal Surgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215-5400, USA
| | - Carolina Vigna
- Division of Colorectal Surgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215-5400, USA
| | - John C Polanco-Santana
- Division of Colorectal Surgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215-5400, USA
| | - Ernest Park
- Division of Colorectal Surgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215-5400, USA
| | - Kristen Crowell
- Division of Colorectal Surgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215-5400, USA
| | - Anne Fabrizio
- Division of Colorectal Surgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215-5400, USA
| | - Thomas E Cataldo
- Division of Colorectal Surgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215-5400, USA
| | - Evangelos Messaris
- Division of Colorectal Surgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215-5400, USA.
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Vidaña-Perez D, Reynales-Shigematsu LM, Antonio-Ochoa E, Ávila-Valdez SL, Barrientos-Gutiérrez I. The fallacy of science is science: the impact of conflict of interest in vaping articles. Rev Panam Salud Publica 2022; 46:e81. [PMID: 35702716 PMCID: PMC9186096 DOI: 10.26633/rpsp.2022.81] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 04/14/2022] [Indexed: 11/24/2022] Open
Abstract
Objective. To explore the association between reporting conflict of interest (COI) and having a positive outcome toward vaping in scientific articles. Methods. A cross-sectional study that analyzed a sample of 697 articles published between 2017 and 2020 regarding vaping. Information on the reporting of COI, type of COI (no conflict, conflict with the tobacco industry, pharmaceutical industry, or other), and country of publication were collected. To explore the association between reporting COI and having a positive result for vaping, two logistic regression models were fitted, both adjusted by country of publication. Results. From 88 articles that reported COI, 23 reported COI with the tobacco industry, 44 with the pharmaceutical industry, and 21 reported another type of conflict. We found that reporting any type of COI increased by 4.7 times the odds (OR 4.70; 95% CI [2.89, 7.65]) of having a positive result for vaping. Additionally, compared to other countries, manuscripts published in England had 2 times higher odds (OR 2.40; 95% CI [1.16, 4.98]) of reporting a positive result for vaping. Reporting COI with the tobacco and pharmaceutical industries increased the odds of favorable results by 29 times (OR 29.95; 95% CI [9.84, 90.98]) and 2 times (OR 2.87; 95% CI [1.45, 5.69]), respectively. Conclusions. In scientific articles, reporting COI and having positive results for vaping are highly associated. COI should be considered and caution should be exercised when using data for policy-making.
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Affiliation(s)
- Dèsirée Vidaña-Perez
- National Institute of Public Health Cuernavaca Mexico National Institute of Public Health, Cuernavaca, Mexico
| | | | | | - Sandra L Ávila-Valdez
- National Institute of Public Health Cuernavaca Mexico National Institute of Public Health, Cuernavaca, Mexico
| | - Inti Barrientos-Gutiérrez
- National Institute of Public Health Cuernavaca Mexico National Institute of Public Health, Cuernavaca, Mexico
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Akl EA, Hakoum M, Khamis A, Khabsa J, Vassar M, Guyatt G. A framework is proposed for defining, categorizing, and assessing conflicts of interest in health research. J Clin Epidemiol 2022; 149:236-243. [PMID: 35697333 DOI: 10.1016/j.jclinepi.2022.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 04/08/2022] [Accepted: 06/06/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE We propose an operational definition of conflicts of interest (COI), a framework for categorizing interests, and an approach to assessing whether an interest qualifies as a COI. STUDY DESIGN AND SETTING We reviewed the literature and conducted methodological studies to inform the development of a draft framework for classifying interests. RESULTS We developed the following operational definition: "a conflict of interest exists when a past, current, or expected interest creates a significant risk of inappropriately influencing an individual's judgment, decision, or action when carrying out a specific duty". Interest refers to a benefit (e.g., money received from industry) or to an attribute of the individual (e.g., having specific religious beliefs). The proposed framework includes seven types of interests relating to individuals (direct financial benefit, benefit through professional status, intellectual, and personal) or their institution (direct financial benefit to the institution, benefit through increasing services provided by the institution, and nonfinancial). When assessing whether an interest qualifies as a COI, one could consider its relevance, nature (e.g., cash vs. educational support), magnitude, and recency. CONCLUSION The proposed operational definition and categorization framework may help journals, guideline organizations, professional societies, and healthcare institutions enhance transparency in health research.
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Affiliation(s)
- Elie A Akl
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
| | | | - Assem Khamis
- Hull York Medical School, University of Hull, Hull, UK
| | - Joanne Khabsa
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Matt Vassar
- Department of Biomedical Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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Abstract
While most medical journals require disclosures of industry payments to authors and editors, there is no requirement for textbooks. In this study we evaluated nine well-known psychopharmacology textbooks to identify payments to their writers and editors. Two-thirds of the textbooks had at least one editor or author who received personal payments from one or more pharmaceutical companies, for a total of 11,021,409 USD paid to 11 of 21 editors/authors over a seven-year period. Much of this money was paid to a single author but 24% of the writers received over 75,000 USD each over this time period. There are several psychopharmacology textbooks authored by writers without apparent financial conflicts of interest. Just as with medical journals, medical textbooks should be transparent about payments made to their authors and editors.
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Affiliation(s)
- Lisa Cosgrove
- Counseling Psychology Department, Applied Ethics Center, University of Massachusetts-Boston, 100 William T Morrissey Blvd, Boston, USA.
| | - Farahdeba Herrawi
- Counseling Psychology Department, Applied Ethics Center, University of Massachusetts-Boston, 100 William T Morrissey Blvd, Boston, USA
| | - Allen F Shaughnessy
- Department of Family Medicine, Tufts University School of Medicine, 195 Canal Street, Malden, MA, 02148, USA
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Graham JD, Gunderman RB. The Importance of an Exam Post-Mortem: Step 2 CS. Acad Radiol 2022; 29:627-629. [PMID: 34991943 DOI: 10.1016/j.acra.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 11/25/2022]
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Grundy Q, Parker L, Wong A, Fusire T, Dimancesco D, Tisocki K, Walkowiak H, Vian T, Kohler J. Disclosure, transparency, and accountability: a qualitative survey of public sector pharmaceutical committee conflict of interest policies in the World Health Organization South-East Asia Region. Global Health 2022; 18:33. [PMID: 35303902 PMCID: PMC8931570 DOI: 10.1186/s12992-022-00822-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Weak governance over public sector pharmaceutical policy and practice limits access to essential medicines, inflates pharmaceutical prices, and wastes scarce health system resources. Pharmaceutical systems are technically complex and involve extensive interactions between the private and public sectors. For members of public sector pharmaceutical committees, relationships with the private sector can result in conflicts of interest, which may introduce commercial biases into decision-making, potentially compromising public health objectives and health system sustainability. We conducted a descriptive, qualitative study of conflict of interest policies and practices in the public pharmaceutical sector in ten countries in the World Health Organization (WHO) South-East Asia Region (SEAR) (Bangladesh, Bhutan, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, and Timor-Leste) between September 2020 and March 2021. RESULTS We identified 45 policy and regulatory documents and triangulated documentary data with 21 expert interviews. Key informants articulated very different governance priorities and conflict of interest concerns depending on the features of their country's pharmaceutical industry, market size, and national economic objectives related to the domestic pharmaceutical industry. Public sector pharmaceutical policies and regulations consistently contained provisions for pharmaceutical committee members to disclose relevant interests, but contained little detail about what should be declared, when, and how often, nor whether disclosures are evaluated and by whom. Processes for preventing or managing conflicts of interest were less well developed than those for disclosure except for a few key procurement processes. Where processes for managing conflicts of interest were specified, the dominant strategy was to recuse committee members with a conflict of interest from relevant work. Policies rarely specified that committee members should divest or otherwise be free from conflicts of interest. CONCLUSIONS Robust processes for conflict of interest prevention and management could ensure the integrity of decision-making and build public trust in pharmaceutical processes to achieve public health objectives. Upstream approaches including supportive legislative frameworks, the creation of oversight bodies, and strengthening regulatory institutions can also contribute to building cultures of transparency, accountability, and trust.
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Affiliation(s)
- Quinn Grundy
- University of Toronto, Suite 130, 155 College Street, Toronto, M5T 1P8, Canada.
| | | | - Anna Wong
- University of Toronto, Suite 130, 155 College Street, Toronto, M5T 1P8, Canada
| | - Terence Fusire
- World Health Organization, South East Asia Region Office, New Delhi, India
| | | | | | - Helena Walkowiak
- USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Arlington, USA
| | - Taryn Vian
- University of San Francisco, San Francisco, USA
| | - Jillian Kohler
- University of Toronto, Suite 130, 155 College Street, Toronto, M5T 1P8, Canada
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Baram L, Dai Z, McDonald S, Bero LA. Disclosure of funding sources and conflicts of interest in evidence underpinning vitamin D and calcium recommendations in bone health guidelines. Public Health Nutr 2022; 25:1-8. [PMID: 35067274 PMCID: PMC9991793 DOI: 10.1017/s1368980022000246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/16/2021] [Accepted: 01/13/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The present study aims to examine the relationship between study funding sources, author conflicts of interest (COI) and conclusions in studies supporting vitamin D and Ca intake cited in bone health guideline recommendations. DESIGN Cross-sectional. SETTING Forty-seven global bone health guidelines with vitamin D and/or Ca recommendations for adults aged 40 years and above. PARTICIPANTS The evidence cited to support the recommendations was extracted by two independent reviewers and classified by type of recommendation, article characteristics, study design, types of funding sources and conflict of interest (COI) disclosure and direction of study conclusions. RESULTS Of 156 articles cited to support the bone health recommendations, 120 (77 %) disclosed a funding source, and 43 (28 %) declared that at least one author had a COI. Compared with articles with non-commercial or no funding source, those funded by commercial sponsors tended to have a study conclusion favourable towards vitamin D/Ca (relative risk (95 % CI): 1·32 (0·94, 1·87), P = 0·16), but the association was not statistically significant (Fisher's exact test). Compared to those with a COI disclosure statement, articles with missing or unclear COI disclosure were more likely to have favourable conclusions (1·56 (1·05, 2·31), P = 0·017) (Fisher's exact test). CONCLUSION In the evidence underpinning a sample of global bone health guidelines, COI disclosure was low and studies with missing or unclear COI disclosures were more likely to have favourable study conclusions than those with disclosures, suggesting a need for greater transparency of COI in bone health guidelines.
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Affiliation(s)
- Liora Baram
- Charles Perkins Centre, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, D17, The Hub, Camperdown, NSW2006, Australia
| | - Zhaoli Dai
- Charles Perkins Centre, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, D17, The Hub, Camperdown, NSW2006, Australia
| | - Sally McDonald
- Charles Perkins Centre, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, D17, The Hub, Camperdown, NSW2006, Australia
| | - Lisa A Bero
- Charles Perkins Centre, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, D17, The Hub, Camperdown, NSW2006, Australia
- School of Medicine and Colorado School of Public Health, Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus, Mail Stop B137, 13080 E. 19th Ave, Aurora, CO80045, USA
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Nakada H. [Clinical research and conflict of interest]. Rinsho Ketsueki 2022; 63:1344-1347. [PMID: 36198561 DOI: 10.11406/rinketsu.63.1344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
In clinical research, the term "conflict of interest" appears quiet frequently. Conflict of interest does not always result in research misconduct, nor is it always an issue. Conflict of interest rules differ depending on the type and stage of research, and researchers are expected to choose and follow them appropriately. In this paper, we review the fundamental concept of conflict of interest management in clinical research and the importance of conflict of interest management, and then organize the various rules based on the type and stage of research. Furthermore, the key points for effective conflict of interest management that researchers should be aware of are summarized.
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Affiliation(s)
- Haruka Nakada
- COI management section, Bioethics Division, Center for Research Administration and Support, National Cancer Center
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McCambridge J, Mitchell G. The Views of Researchers on the Alcohol Industry's Involvement in Science: Findings from an Interview Study. Eur Addict Res 2022; 28:267-274. [PMID: 35316806 PMCID: PMC9501792 DOI: 10.1159/000522603] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 02/11/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Debates in the peer-reviewed literature on alcohol industry involvement in science have been polarized, with the activities of the International Center on Alcohol Policies and industry provision of research funding being particularly contentious. We aimed to explore researchers' views on the nature of the debates and the issues raised. METHODS Qualitative interview study with experienced researchers working on alcohol policy-relevant topics across ten countries (n = 37). Thematic analysis of views articulated, supported where appropriate by accounts of how experiences informed particular perspectives. RESULTS The main finding is how much common ground there now is among participants, regardless of whether they had previously worked with industry organizations or received alcohol industry funding. Norms have changed and participants agree that the earlier debates were dysfunctional. Participants on all sides of these earlier debates experienced significant psychological burdens as a result of industry-related activity in alcohol research. These include reputational harms from working with industry organizations and/or receiving research funding, and harassment by industry for producing findings contrary to commercial interests. Key ongoing contentious issues include the extent to which conflicts of interest can or should be managed by individual researchers, and how distinct the alcohol industry is from other funders and other industries. Participant views on ways forward include improving the evidence-base underpinning the debates, and having collegiate discussions among researchers, including all strands of opinion and experience. CONCLUSIONS This group of alcohol researchers shares more nuanced contemporary positions on issues relating to industry involvement in science than are reflected in the existing material in peer-reviewed journals. Almost all regard the alcohol industry's involvement in research as having been damaging.
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Affiliation(s)
| | - Gemma Mitchell
- Department of Health Sciences, University of York, York, UK
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Rao S. Ethics on the Learning Curve. J Indian Assoc Pediatr Surg 2022; 27:191-195. [PMID: 35937115 PMCID: PMC9350650 DOI: 10.4103/jiaps.jiaps_364_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 03/08/2021] [Indexed: 11/18/2022] Open
Abstract
Advances in surgical techniques and technologies require surgeons to constantly retrain and adopt these into their practices. Until the surgeon gains proficiency in the new technique, he is said to be on the learning curve. During this time, the patient is at higher risk of adverse outcomes. This poses significant ethical challenges. Several factors impact the surgeon's decision-making and ability to obtain a truly informed consent. These factors include personal bias - both the surgeons and the patients, absence of high-quality evidence, and market forces. This paper describes the ethical dilemmas faced by surgeons as they adopt newer technologies into their practice. It suggests measures that can ensure that surgical progress does not happen at the cost of patient safety.
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Affiliation(s)
- Sanjay Rao
- Department of Pediatric Surgery, Narayana Health Hospitals, Bengaluru, Karnataka, India,Address for correspondence: Dr. Sanjay Rao, Department of Pediatric Surgery, Narayana Health Hospitals, 258/A, Bommasandra Industrial Area, Bengaluru - 560 099, Karnataka, India. E-mail:
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41
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Hashimoto T, Murayama A, Mamada H, Saito H, Tanimoto T, Ozaki A. Evaluation of Financial Conflicts of Interest and Drug Statements in the Coronavirus Disease 2019 Clinical Practice Guideline in Japan. Clin Microbiol Infect 2021; 28:460-462. [PMID: 34826620 PMCID: PMC8610564 DOI: 10.1016/j.cmi.2021.11.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/14/2021] [Accepted: 11/14/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Takanao Hashimoto
- Medical Governance Research Institute, Minato City, Tokyo, Japan; Department of Pharmacy, Sendai City Medical Center, Sendai City, Miyagi, Japan
| | - Anju Murayama
- Medical Governance Research Institute, Minato City, Tokyo, Japan; Tohoku University School of Medicine, Sendai City, Miyagi, Japan.
| | - Hanano Mamada
- Medical Governance Research Institute, Minato City, Tokyo, Japan
| | - Hiroaki Saito
- Department of Gastroenterology, Sendai Kosei Hospital, Sendai City, Miyagi, Japan
| | - Tetsuya Tanimoto
- Department of Internal Medicine, Navitas Clinic, Tachikawa City, Tokyo, Japan
| | - Akihiko Ozaki
- Medical Governance Research Institute, Minato City, Tokyo, Japan; Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Fukushima, Japan
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Al Sulais E, Alsahafi M, AlAmeel T. Undisclosed payments by pharmaceutical manufacturers to authors of inflammatory bowel disease guidelines in the United States. Saudi J Gastroenterol 2021; 27:342-347. [PMID: 34755712 PMCID: PMC8656332 DOI: 10.4103/sjg.sjg_426_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Payments from pharmaceutical drug manufacturers to authors of clinical practice guidelines (CPGs) may have an impact on their recommendations. In this study, we aimed to evaluate the accuracy of financial conflict of interest (FCOI) declarations among authors of Inflammatory Bowel Disease (IBD) guidelines. METHODS We collected data on industry payments to authors of IBD guidelines published by the American Gastroenterology Association (AGA), American College of Gastroenterology (ACG) and American Society of Gastrointestinal Endoscopy (ASGE). We reported the accuracy of the authors' declarations by comparing their statements in the FCOI section of the guidelines with the data reported on the Centers for Medicare and Medicaid Services website (CMS-OP). We also investigated the adherence of IBD guidelines to the National Academy of Medicine (NAM) criteria for trustworthy guidelines. RESULTS A total of eight clinical practice guidelines and 35 individual authors were included. Four authors had no profile identified at CMS-OP. The total payment to all included authors was $10,575,843.06, with a mean payment of $314,242.38 per author. A total of 28/35 authors (80%) received payment from pharmaceutical companies, 23/35 (65.7%) received $10,000 or more, 15/35 (42.8%) received $100,000 or more and 3/35 (8.57%) received $1,000,000 or more. Total discrepancies identified while comparing the authors' declaration of their FCOI and CMS-OP were 28: ACG had 12/14 (85.7%), AGA had 7/12 (53.8%) and ASGE had 9/10 (90%) discrepancies. None of the guidelines met all NAM criteria and 4/8 (50%) guidelines met none. CONCLUSIONS Discrepancies exist between authors' declarations in the FOCI section and data on CMS-OP. Poor compliance with the NAM criteria was prevalent among authors of IBD guidelines. More transparency in reporting and monitoring is needed.
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Affiliation(s)
- Eman Al Sulais
- Department of Medicine, Division of Gastroenterology, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK,Address for correspondence: Dr. Eman Al Sulais, Addenbrooke's Hospital, University of Cambridge, Cambridge - CB20QQ, UK. E-mail:
| | - Majid Alsahafi
- Department of Medicine, Division of Gastroenterology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Turki AlAmeel
- Department of Medicine, King Fahad Specialist Hospital, Dammam, Saudi Arabia
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Golder S, McCambridge J. Alcohol, cardiovascular disease and industry funding: A co-authorship network analysis of systematic reviews. Soc Sci Med 2021; 289:114450. [PMID: 34607052 PMCID: PMC8586735 DOI: 10.1016/j.socscimed.2021.114450] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/14/2021] [Accepted: 09/29/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Alcohol's effects on heart health is the site of a major scientific controversy. We conducted a co-authorship network analysis of systematic reviews on the impacts on alcohol on cardiovascular disease (CVD) in order to investigate patterns of co-authorship in the literature, with particular attention given to industry funding. METHODS We used Epistemonikos to identify systematic reviews. Review characteristics, influential authors, co-authorship subnetworks, prior histories of alcohol industry funding, study outcomes and citations were investigated. RESULTS 60 systematic reviews with 231 unique authors met our inclusion criteria. 14 systematic reviews were undertaken by authors with histories of alcohol industry funding, including 5 that were funded directly by the alcohol industry itself. All 14 such reviews identified a cardioprotective effect of alcohol. These formed distinct co-authorship subnetworks within the literature. Of reviews by authors with no prior histories of alcohol industry funding, the findings were mixed, with 54% (25/46) concluding there was evidence of health protective effects. These two groups of reviews differed in other respects. Those with industry funding were more likely to study broader outcomes such as 'cardiovascular disease' or 'coronary heart disease' as opposed to specific CVD issues such as hypertension or stroke (93% [13/14] versus 41% [19/46]) (chi-squared 12.4, p < 0.001) and have more included studies (mean of 29 versus 20). They were also more widely cited by others. Over time the proportions of systematic reviews on CVD and alcohol undertaken by authors with no prior histories of alcohol industry funding has increased. CONCLUSIONS Systematic reviews undertaken by authors with histories of alcohol industry funding were more likely to study broader outcomes, and be cited more widely, and exclusively reported favorable conclusions.
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Affiliation(s)
- Su Golder
- Department of Health Sciences, University of York, York, United Kingdom.
| | - Jim McCambridge
- Department of Health Sciences, University of York, York, United Kingdom
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44
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Spiroux de Vendômois J, Bourdineaud JP, Apoteker A, Defarge N, Gaillard E, Lepage C, Testart J, Vélot C. Trans-disciplinary diagnosis for an in-depth reform of regulatory expertise in the field of environmental toxicology and security. Toxicol Res 2021; 37:405-419. [PMID: 34631497 DOI: 10.1007/s43188-020-00075-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/18/2020] [Accepted: 11/04/2020] [Indexed: 02/07/2023] Open
Abstract
Repeated health and environmental scandals, the loss of biodiversity and the recent burst of chronic diseases constantly remind us the inability of public authorities and risk assessment agencies to protect health and the environment. After reviewing the main shortcomings of our evaluation system of chemicals and new technologies, supported by some concrete examples, we develop a number of proposals to reform both the risk assessment agencies and the evaluation processes. We especially propose the establishment of an independent structure, a High Authority of Expertise, supervising, either at European level or at national level, all the evaluation agencies, and ensuring the transparency, the methodology and the deontology of the expertise. In addition to modifying the evaluation protocols, both in their nature and in their content, especially in order to adapt them to current pollutants such as endocrine disruptors, we propose a reform of the expertise processes based on transparency, contradiction, and greater democracy, including close collaboration between the institutional and scientific parties on the one hand and the whole civil society on the other. All the proposals we make are inspired by the desire to prevent, through appropriate mechanisms, the human, health, ecological, but also economic consequences of contemporary technological choices.
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Affiliation(s)
- Joël Spiroux de Vendômois
- Committee for Independent Research and Information on Genetic Engineering (CRIIGEN), 42 rue de Lisbonne, 75008 Paris, France
| | - Jean-Paul Bourdineaud
- CNRS, UMR 5234, Laboratory of Fundamental Microbiology and Pathogenicity, European Institute of Chemistry and Biology, University of Bordeaux, Bordeaux, France
| | - Arnaud Apoteker
- Committee for Independent Research and Information on Genetic Engineering (CRIIGEN), 42 rue de Lisbonne, 75008 Paris, France
| | - Nicolas Defarge
- Committee for Independent Research and Information on Genetic Engineering (CRIIGEN), 42 rue de Lisbonne, 75008 Paris, France.,Institute of Integrative Biology IBZ, Swiss Federal Institute of Technology, Universitätstrasse 16, 8092 Zurich, Switzerland
| | - Emilie Gaillard
- Committee for Independent Research and Information on Genetic Engineering (CRIIGEN), 42 rue de Lisbonne, 75008 Paris, France.,Université de Caen-Basse Normandie, Esplanade de la Paix, 14000 Caen, France
| | - Corinne Lepage
- Committee for Independent Research and Information on Genetic Engineering (CRIIGEN), 42 rue de Lisbonne, 75008 Paris, France
| | - Jacques Testart
- Committee for Independent Research and Information on Genetic Engineering (CRIIGEN), 42 rue de Lisbonne, 75008 Paris, France.,Sciences Citoyennes, 38 rue Saint Sabin, 75011 Paris, France
| | - Christian Vélot
- Committee for Independent Research and Information on Genetic Engineering (CRIIGEN), 42 rue de Lisbonne, 75008 Paris, France.,Sciences Citoyennes, 38 rue Saint Sabin, 75011 Paris, France.,Laboratory VEAC, University Paris-Saclay, Faculty of Sciences, Bât. 350-RdC, Avenue Jean Perrin, 91405 Orsay, France.,Risk Pole MRSH-CNRS, EA2608, University of Caen, Esplanade de la Paix, 14032 Caen, France
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Horstman AA, Niziol LM, Shedden K, Chimonas S, Lichter PR. Physician-Industry Financial Relationships, Key Opinion Leader Status, and Program Visibility. Ophthalmology 2021; 129:463-465. [PMID: 34637855 DOI: 10.1016/j.ophtha.2021.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/02/2021] [Accepted: 10/05/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Alyssa A Horstman
- W.K. Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan; New England School of Optometry, Boston, Massachusetts
| | - Leslie M Niziol
- W.K. Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | - Kerby Shedden
- Department of Statistics, Department of Biostatistics, School of Literature, Science, and the Arts, University of Michigan, Ann Arbor, Michigan
| | - Susan Chimonas
- Center for Health Policy & Outcomes, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Paul R Lichter
- W.K. Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan.
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Barbaroux A, Lardy G. [Observational study of links of interest disclosure at the Congress of General Medicine France and links of interest of French physicians attending]. Therapie 2021; 77:309-317. [PMID: 34688470 DOI: 10.1016/j.therap.2021.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/13/2021] [Accepted: 09/17/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Medical opinion leaders represent a marketing tool whose effectiveness is well documented in France and worldwide. They are less distrusted than pharmaceutical representatives, but this trust declines when they declare their ties. In France, the public database "Transparence-Santé" presents the financial ties of each professional with the health industries since 2012. These ties must be declared at the beginning of any public intervention since 2002 to improve the transparency of healthcare stakeholders. OBJECTIVES This study assessed the compliance with the obligation to disclose conflicts of interests at the Congress of General Medicine France 2020. Its secondary objective was to assess the financial ties of French physicians attending the congress using the data listed in "Transparence-Santé" through the Eurosfordocs project. METHOD Prospective cross-sectional observational study of all the interventions available on the congress' internet platform. All speakers, making either an oral or a written and commented presentation, who must declare their conflicts of interest, were included. A descriptive analysis of "Transparence-Santé" data was carried out for the doctors attending the congress. RESULTS Among 253 interventions, 34% complied with the disclosure requirement. The doctors participating in symposiums links of interests represented 92% of the global amount of congress' links of interests, with an average of 11,2k€/year, significantly higher than the 126€/year of other physicians. CONCLUSION The legal obligation to declare one's conflict of interest at congresses is little respected in France. Involvement of the organizers and using pre-established disclosure formats would improve transparency. It is necessary to develop the independence of speakers to improve research and medical expertise.
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Affiliation(s)
- Adriaan Barbaroux
- Département d'enseignement et de recherche en médecine générale, RETINES, LAPCOS, HEALTHY, université Côte-d'Azur, 06107 Nice, France.
| | - Guillaume Lardy
- Département d'enseignement et de recherche en médecine générale, RETINES, HEALTHY, université Côte-d'Azur, 06107 Nice, France
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Mitchell AP, Mishra A, Dey P, Curry MA, Trivedi NU, Haddadin M, Rahman MW, Winn AN, Dusetzina SB, Bach PB. Personal Payments from Pharmaceutical Companies to Authors of Oncology Clinical Practice Guidelines. Oncologist 2021; 26:771-778. [PMID: 33982829 PMCID: PMC8417859 DOI: 10.1002/onco.13823] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/30/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Oncologists who author clinical practice guidelines frequently have financial relationships with the pharmaceutical industry. It is unknown whether participation on clinical practice guideline committees is associated with differences in the amounts of industry money received. MATERIALS AND METHODS We conducted a nested case-control study from August 2013 to December 2018. We manually abstracted membership records of National Comprehensive Cancer Network (NCCN) Guidelines committees for the 20 most common cancers and linked to Open Payments. The study sample included medical oncologists selected to join an NCCN Guidelines committee ("joiners") during the study period. Joiners were matched 1:2 to medical oncologists who had no participation on NCCN committees (controls) by gender, NCCN institution, and medical school graduation year. We performed difference-in-differences (DiD) estimation to assess whether selection to an NCCN committee was associated with the dollar value of payments received from industry, using generalized estimating equations to address correlation between matched pairs and between repeated observations of the same pair. RESULTS During the study period, 54 physicians joined an NCCN Guidelines committee. These physicians received more payments than matched controls in the year prior to joining ($11,259 vs. $3,427; p = .02); this difference did not increase in the year after joining (DiD = $731; p = .45). CONCLUSION Medical oncologists selected to NCCN Guidelines committees had greater financial ties to industry than their peers. The potential influence of industry in oncology clinical practice guidelines may be reduced through the selection of committee members with fewer ties to industry. IMPLICATIONS FOR PRACTICE Oncologists who author clinical practice guidelines frequently have financial conflicts of interest with the pharmaceutical industry. This creates concern about the potential for industry influence on guidelines. However, it is unknown whether oncologists who author guidelines have greater industry relationships than their peers. This study compared medical oncologists who were newly selected to join a National Comprehensive Cancer Network (NCCN) Guidelines panel with medical oncologists at the same institutions and at similar career stages. At the time they joined, oncologists joining NCCN Guidelines panels had received more than three times the dollar value of industry payments than their peers. The potential for industry influence may be reduced by the selection of less-conflicted panel members.
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Affiliation(s)
- Aaron P. Mitchell
- Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Akriti Mishra
- Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Pranam Dey
- Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
- Yale University School of MedicineNew HavenConnecticutUSA
| | - Michael A. Curry
- Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Niti U. Trivedi
- Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Michael Haddadin
- Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
- University of Massachusetts Memorial Medical CenterWorcesterMassachusettsUSA
| | - Mohammed W. Rahman
- Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
- Hunter College, State University of New YorkNew YorkNew YorkUSA
| | - Aaron N. Winn
- Department of Clinical Sciences, School of Pharmacy, Medical College of WisconsinMilwaukeeWisconsinUSA
| | - Stacie B. Dusetzina
- Department of Health Policy, School of Medicine, Vanderbilt UniversityNashvilleTennesseeUSA
| | - Peter B. Bach
- Health Outcomes Research Group, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
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Huntoon K, Stacy J, Cioffi S, Profitt C, Mazzola C. Sales Representatives in the Operating Room: Conflict of Interest or Clinical Support? World Neurosurg 2021; 155:e480-3. [PMID: 34455095 DOI: 10.1016/j.wneu.2021.08.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/19/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The Physician Payment Sunshine Act, which became federal law in January 2012, mandated that medical device manufacturers must disclose any financial support provided to individual physicians on a publicly available Web site. The law reflects increasing concern about physician-industry relationships. METHODS The connection between surgeon and sales representative creates possibilities for both financial and non-financial conflicts of interest (COIs). Indeed, COIs may be inherent when a sales representative is motivated by profit while also serving a critical role in many surgeries. RESULTS The potential benefits and risks for patients, who may not even be aware of the sales representative's presence in the operating room, must be considered. CONCLUSIONS This paper adds to the national discussion about neurosurgical physician-industry conflicts of interests and the issues relative to sales representatives in the operating room.
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Moriarty F, Larkin J, Fahey T. Payments reported by the pharmaceutical industry in Ireland from 2015 to 2019: An observational study. Health Policy 2021; 125:1297-1304. [PMID: 34429238 DOI: 10.1016/j.healthpol.2021.07.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/25/2021] [Accepted: 07/30/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND The pharmaceutical industry makes large numbers of payments to healthcare organisations (HCOs) and healthcare professionals (HCPs). Ireland has a large pharmaceutical industry presence and national debate on legislating for greater industry payment transparency. This study characterises payments in Ireland to HCPs and HCOs during 2015-2019, and the content, consistency and methodology of the data source. METHODS An observational study of TransfersOfValue.ie, the disclosure website for the Irish Pharmaceutical Health Association pharmaceutical companies. We conducted a quantitative analysis, summarising payments to HCOs, HCPs and for research and development (R&D). We quantified disclosure rates of names for HCP and HCO payment recipients. We also conducted a content analysis of the methodology notes and website content. RESULTS Payments totalling €163 million were reported by 47 companies during 2015-2019, €84.6 million for R&D, with non-R&D payments of €45.1 million to HCOs and €33.6 million to HCPs. HCOs were named for 91.2% of payments, and HCPs for 55.1-62.8% across study years. For 2019, ten companies disclosed >€1 million in payments, and three disclosed >€1 million in HCO and HCP payments. Content analysis of 132 data reports and 46 methodology notes indicated substantial variation in methodologies for reporting between companies. CONCLUSIONS There are substantial payments in Ireland, often the recipient is undisclosed, and companies differ in their reporting. A mandatory disclosure system could enhance transparency.
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Affiliation(s)
- Frank Moriarty
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, 123 St Stephen's Green 2, Dublin, Ireland; Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
| | - James Larkin
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Tom Fahey
- Department of General Practice, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Abstract
Two tendencies have emerged in environmental epidemiology that hamper the translation of research findings into prevention of environmental hazards. One is the increased focus on highlighting weaknesses of epidemiology research that is clearly meant to explain away the research conclusions and weaken their possible implications for interventions to control environmental hazards. Another is the voluminous amount of information sharing that involves a substantial amount of misinformation, as part of the ongoing infodemic. In this light, the appearance of the catalogue of doubt-raising strategies, indeed the worst practices of scientific inference, is good news. Collected under the auspices of the International Network for Epidemiology in Policy, it serves to illustrate the range of possible (and impossible) forms of critique that may be raised on behalf of vested interests or other groups who for some reason disagree with the epidemiological conclusions. We believe that this systematic list will be useful in our field and help to identify critiques of policy options that are hidden and sometimes suppressed in weighing the epidemiological evidence.
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Affiliation(s)
- Ruth A. Etzel
- Milken Institute School of Public Health, The George Washington University, D. C, Washington, 20052 USA
| | - Philippe Grandjean
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA 02115 USA
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - David M. Ozonoff
- Department of Environmental Health, Boston University School of Public Health, Boston, USA
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