Undisclosed Conflicts Of Interest Research Articles

Hepatic Ablation Technology: Assessment of Conflicts of Interest in Recent Literature.

Collaboration between the health care industry and surgeons is critical in modern medicine. Conflict of interest (COI) has the risk of introducing bias into research studies. We investigated the accuracy of self-disclosed COI for studies that researched the use of microwave ablation for liver metastasis. A literature search identified studies that investigated the use of microwave ablation for liver cancer between 2016 and 2022. We utilized the Open Payments Database to query individual authors' financial contributions from the industry. The accuracy of the disclosure statement and financial contribution for each study and author was calculated. We compared the amount of financial contribution authors received based on the accuracy of their COI statement. Twenty-five studies of interest were identified. The mean number of authors was 8.24. A disclosure statement was present in 52% of studies. Of those, 28% had an incongruent disclosure statement. 9/25 (36%) of studies had a conflict of interest based on financial payments provided by industry. Overall, authors received an average of $440,483.41 (SD $1,889,375.34). We did not find a difference in the financial contribution's value based on the disclosure statement's accuracy (P = .55). Over a quarter of studies in our review of microwave ablation literature had discrepancies in the reporting of conflicts of interest, highlighting the need for improved reporting of potential conflicts of interest to protect the integrity of clinical research. Compared to other fields of surgery, we found a lower rate of undisclosed COI, suggesting that the scope of cancer-directed surgery may be more resistant to industry influence.

Conflicts of Interest in Radiology Publishing

Lack of disclosure of Conflicts of Interest (COI) in radiology research can undermine trust in medical recommendations and patient care. A recent study found significant discrepancies between disclosed COIs and those listed in the Open Payments Database (OPD). This commentary discusses the importance of transparency in financial and nonfinancial COIs, the implications of undisclosed COIs on research integrity and clinical decision-making, and the challenges and controversies surrounding current disclosure practices. The field of radiology should discuss and update COI management and ethical standards, for more practical accountability in radiology publishing.

Management of evidence and conflict of interest in guidelines on early childhood allergy prevention and child nutrition: study protocol of a systematic synthesis of guidelines and explorative network analysis.

With the rising prevalence of allergic diseases in children, prevention of childhood allergies becomes an important public health issue. Recently, a paradigm shift is taking place in the approach to preventing allergies, and clinical practice guidelines (CPG) and food-based dietary guidelines (FBDG) play an important role in providing practitioners with the latest evidence and reliable guidance. However, concern about the methodological quality of the development of FBDGs and CPGs, including limitations in the systematic reviews, lack of transparency and unmanaged conflicts of interest (COI), reduce the trust in these guidelines. We aim to synthesize the available guidance on early childhood allergy prevention (ECAP) through a systematic search for national and international CPGs and FBDGs concerning ECAP and child nutrition (CN) and to assess the quality of the guidelines and management of COI. Additionally, we will analyse the content and the evidence base of the recommendation statements. We aim to quantify the COI in guideline panellists and explore possible associations between COI and recommendations. Through a social network analysis, we expect to elucidate ties between panellists, researchers, institutions, industry and other sponsors. Guidelines are an important tool to inform healthcare practitioners with the newest evidence, but quality and reliability have to be high. This study will help identify potential for further improvement in the development of guidelines and the management of COI. If the social network analysis proves feasible and reveals more information on COI in comparison to disclosed COI from the previous analyses, the methodology can be developed further to identify undisclosed COIs in panelists. This research does not require ethical approval because no human subjects are involved. Results will be published in international peer-reviewed open access journals and via presentations at scientific conferences.

Safeguarding scientific integrity: A case study in examining manipulation in the peer review process

ABSTRACT This case study analyzes the expertise, potential conflicts of interest, and objectivity of editors, authors, and peer reviewers involved in a 2022 special journal issue on fertility, pregnancy, and mental health. Data were collected on qualifications, organizational affiliations, and relationships among six papers’ authors, three guest editors, and twelve peer reviewers. Two articles were found to have undisclosed conflicts of interest between authors, an editor, and multiple peer reviewers affiliated with anti-abortion advocacy and lobbying groups, indicating compromised objectivity. This lack of transparency undermines the peer review process and enables biased research and disinformation proliferation.Our study is limited by a few factors including: difficulty collecting peer reviewer data, potentially missing affiliations, and a small sample without comparisons. While this is a case study of one special issue, we do have suggestions for increasing integrity.

Conflict of interest and funding in health communication on social media: a systematic review

ObjectivesTo synthesise the available evidence on the reporting of conflicts of interest (COI) by individuals posting health messages on social media, and on the reporting of funding sources of studies...

Ethical violations: Shortlisting and interviewing processes in the South African public service

Background: Ethics, integrity and accountability in public service departments have weakened. These departments face ethical violations in recruitment, shortlisting, interviewing and appointment processes despite the presence of human resource management prescripts in place.Aim: This study aimed to probe the level of ethical violations in recruitment, shortlisting and interviewing processes, and describe the challenges faced by human resource practitioners and panel members in South Africa’s public service departments.Setting: Both the national and provincial public service departments of South Africa.Methods: The study adopted the qualitative modernistic research approach. A semi-structured electronic questionnaire was used to gather views from 528 participants, including human resource practitioners and line managers serving as panel members.Results: Ethical violations result in human resource practitioners and panel members being compromised, maltreated, victimised and bullied in the workplace. During recruitment, shortlisting, interviewing and appointment stages, abuses of power, undisclosed conflicts of interest and even patronage by political heads and top-and-middle management are acutely rife. Ethical violations inhibit the human resource functionary from building an ethical, professional and capable public service.Conclusion: Ethical violations during recruitment phases are exacerbated by political heads and top management’s observable disregard of prescripts.Contribution: This study will encourage management to consider human resource practitioners’ role in managing ethical dilemmas and galvanise employees towards maintaining ethics and jointly desisting from unethical practices.

Coaches should not be supervised

This paper examines a coaching myth: the need for supervision. It approaches the issue from the perspectives of language, values and effectiveness. Asking what supervision is, if it is consistent with the values of coaching and if it works.It concludes that coaches should neither seek, nor provide, supervision, that the term does not describe what coaches need for development and quality assurance. The use of the term ‘supervision’ may be holding the domain back by implying a particular interaction which coaches may disagree with, and by discouraging coaches from seeking, developing and exploring methods of development with which they feel comfortable. Finally, it identifies serious, undisclosed conflicts of interest.

Management of evidence and conflict of interest in guidelines on early childhood allergy prevention and child nutrition: study protocol of a systematic synthesis of guidelines and explorative network analysis

Background: With the rising prevalence of allergic diseases in children, prevention of childhood allergies becomes an important public health issue. Recently, a paradigm shift is taking place in the approach to preventing allergies, and clinical practice guidelines (CPG) and food-based dietary guidelines (FBDG) play an important role in providing practitioners with the latest evidence and reliable guidance. However, concern about the methodological quality of the development of FBDGs and CPGs, including limitations in the systematic reviews, lack of transparency and unmanaged conflicts of interest (COI), reduce the trust in these guidelines. Methods: We aim to synthesize the available guidance on early childhood allergy prevention (ECAP) through a systematic search for national and international CPGs and FBDGs concerning ECAP and child nutrition (CN) and to assess the quality of the guidelines and management of COI. Additionally, we will analyse the content and the evidence base of the recommendation statements. We aim to quantify the COI in guideline panellists and explore possible associations between COI and recommendations. Through a social network analysis, we expect to elucidate ties between panellists, researchers, institutions, industry and other sponsors. Guidelines are an important tool to inform healthcare practitioners with the newest evidence, but quality and reliability have to be high. This study will help identify potential for further improvement in the development of guidelines and the management of COI. If the social network analysis proves feasible and reveals more information on COI in comparison to disclosed COI from the previous analyses, the methodology can be developed further to identify undisclosed COIs in panellists. Ethics and dissemination: This research does not require ethical approval because no human subjects are involved. Results will be published in international peer-reviewed open access journals and via presentations at scientific conferences.

Editorial conflicts of interest related to the management of stable ischemic heart disease

ObjectiveOur study examines the association between the favorability of percutaneous coronary intervention (PCI) and/or coronary artery bypass surgery (CABG) and the presence of conflicts of interest (COIs) among authors. MethodsWe used the “Citing Articles” tool on the New England Journal of Medicine website to identify editorials on the use of PCI/CABG for stable ischemic heart disease. Authors were rated as “supportive,” “neutral,” or “critical” of these interventions based on the content of their editorials. COIs for each author were identified using past publications found on Scopus, PubMed, or a general internet search. ResultsA total of 606 articles were identified, and data were extracted from 56 of them. Among the 149 authors, 64 (43.0%) had a COI. Of these 64 authors, 19 (29.7%) disclosed their COI, while 45 (70.3%) did not. Overall, among authors with a COI, there was no association between disclosed and undisclosed COIs and the authors' view of PCI/CABG [χ2 (2, N = 64) = 1.63, p = .44]. If an author was associated with Medtronic, Abbott, or Boston Scientific, they were more likely to favor PCI/CABG if they had an undisclosed COI relative to authors who disclosed COIs [χ2 (1, N = 31) = 5.04, p = .025]. Authors publishing in a cardiology journal were more likely to view PCI/CABG favorably relative to those publishing in a general medicine journal [χ2 (2, N = 62) = 7.17, p = .028]. ConclusionEditors should adopt policies to counteract the unbalancing effects that COIs have on medical opinions and evidence.

Evaluating the relationship between industry sponsorship and conflicts of interest among systematic review authors on treatments for cannabis use disorder

Background: Cannabis is the most commonly used illicit drug worldwide. In addition to potential adverse effects, an estimated 9% consistent cannabis users are likely to become dependent and may develop a cannabis use disorder (CUD). Methods: This cross-sectional study developed a search strategy using Ovid, MEDLINE, and Ovid Embase for systematic reviews and meta-analyses focused on CUD treatment in June 2020. These reviews were evaluated for conflicts of interest (COIs) per previously developed classification scheme. Our primary objectives were to (1) evaluate the presence of disclosed or undisclosed COI of systematic review authors, regarding treatment of CUD; and (2) determine whether overall summary effect estimates, narrative results and conclusions were influenced by the presence of disclosed or undisclosed COIs among systematic review authors. Results: Our systematic search returned 560 articles which 9 systematic reviews were eligible for data extraction. We found 77.8% (7/9) contained at least one author with a COI. From the 51 authors included, 29.4% (15/51) were found to have a COI. Forty-four percent (4/9) were funded, 22.2% (2/9) were not funded, and 33.3% (3/9) had no funding statements. Out of the 7 systematic reviews with one or more authors containing COI, 14.2% (1/7) included results favoring the treatment group and 28.6% (2/7) included conclusions favoring the treatment group. Our results showed no significance between funding source and results (p = 0.429) or conclusions. Additionally, we found no significance between the presence of COIs with the favorability of results (p = 0.56) or conclusions. Conclusion: Multiple studies favored the treatment of cannabis-containing products, even though COIs were found in the majority of the systematic reviews. COIs have the ability to sway results of a study, which can affect clinical decision-making. Stricter guidelines should be enforced among authors displaying COIs in systematic reviews studying CUD treatment.

Evaluation of Industry Relationships Among Authors of Systematic Reviews and Meta-analyses Regarding Ménières Disease.

To quantify the presence of conflicts of interest (COI) in SRs and MAs of Ménières disease treatment and identify any related secondary characteristics of these articles. A search was conducted on May 28, 2020 to search MEDLINE and Embase databases for SRs or MAs pertaining to Ménières disease published between September 1, 2016 and June 2, 2020. A risk of bias assessment was performed using the Cochrane Collaboration risk of bias assessment criteria. A total of 13 systematic reviews conducted by 49 authors met the inclusion criteria. Of the 49 authors, 7 (14.3%) were found to have some form of COI. Of these 7 authors, 1 (14.3%) completely disclosed all COI within the SR, 1 (14.3%) disclosed one or more COI but were found to have an additional undisclosed COI, and 5 (71.4%) were found to have only undisclosed COI. One of 2 industry funded SRs (50%) had a high risk of bias, and 1 (50%) of the non-industry sponsored SRs were found to have a high risk of bias. Overall authors of SRs pertaining to Ménières disease appear to be properly disclosing COI at higher rates than other fields of medicine; however, further room for improvement has been noted.

Association between industry sponsorship and author conflicts of interest with outcomes of systematic reviews and meta-analyses of interventions for opioid use disorder

IntroductionAuthor conflicts of interest (COI) and industry sponsorship may lead to biased research results and conclusions. Considering the direct influence that systematic reviews have on patient care, including the management of patients being treated for opioid use disorders (OUD), these studies should be free of industry bias. Thus, we sought to determine whether a relationship exists between COI and the favorability of systematic review outcomes using a sample of systematic reviews regarding OUD interventions. MethodsWe searched MEDLINE and Embase for systematic reviews and meta-analysis related to OUD treatment. The study team performed all data extraction in a masked duplicate fashion. We searched for undisclosed COI for each systematic review author in 3 databases––the CMS Open Payments database, Dollars for Profs, and the United States Patent and Trademark Office (USPTO). The research team quantified results using descriptive statistics. We evaluated associations between review characteristics using Fisher's exact tests, when possible. ResultsThis article includes seventeen systematic reviews and meta-analyses with 81 authors. We found that 25 authors (30.9%) had some form of COI, and 22 (of 25, 88.0%) authors had an undisclosed COI. However, no significant association existed between COI and favorability of results and conclusions. Notably, two systematic reviews (of 17; 11.76%) were industry-sponsored. Similarly, we found no association between the study sponsor source and the favorability of systematic review results and conclusions. ConclusionsOur results suggest the favorability of systematic review results and conclusions are not influenced by author COI or industry sponsorship. However, nearly one-fourth of authors had an undisclosed COI, further emphasizing the need for standardization and adherence to COI disclosure policies within addiction medicine literature.

Association between author conflicts of interest and industry‐sponsorship with the favorability of outcomes of systematic reviews focusing on treatments of erectile dysfunction

Authors' conflicts of interest and industry sponsorship have been shown to influence study outcomes. We aimed to determine whether author conflicts of interest and industry sponsorship influenced the nature of results and conclusions of systematic reviews focusing on treatment interventions for erectile dysfunction. We searched PubMed and Embase for systematic reviews and meta-analyses focusing on erectile dysfunction treatments published between September 1, 2016, and June 2, 2020. Authors' conflicts of interest were collected from the systematic reviews' disclosure statements. These disclosures were verified using the information provided by the Open Payments, Dollars for Profs, Google Patents, and US Patent and Trademark Office databases and from previously published disclosure statements. Our study included 24 systematic reviews authored by 138 authors. Nineteen authors (13.8%) were found to have conflicts of interest (disclosed, undisclosed, or both). No authors completely disclosed all conflicts. Nine reviews (37.5%) contained at least one author with conflicts of interest; of which eight reported narrative results favoring the treatment group, and seven reported conclusions favoring the treatment group. Of the 15 (62.5%) reviews without a conflicted author, 11 reported results favoring the treatment group, and 12 reported conclusions favoring the treatment group. The results and conclusions of systematic reviews for erectile dysfunction treatments did not appear to be influenced by authors who reported conflicts of interest. However, our search algorithm relied on the US-based Open Payments database and a large percentage of reviews in our study were produced by authors with international affiliations. Our study results underscore the difficulties in conducting such analyses. Although we found that undisclosed conflicts of interest (COI) were problematic among systematic reviews of erectile dysfunction treatment, only 14% of authors in our sample possessed them and these COI did not appear to influence the favorability of systematic review outcomes.

Authorial Conflicts of Interest and Sponsorship in Systematic Reviews and Meta-Analyses on Psoriasis

Background: Because industry influence – in the form of study sponsorship and authorial conflicts of interest (COI) – can bias the results and conclusions of systematic reviews, there is a need to understand their role in systematic reviews, particularly for common conditions like psoriasis. Objectives: This study identifies conflicts of interest and industry-author relationships in systematic reviews on psoriasis treatment. Methods: Consistent with our cross-sectional design, we searched MEDLINE and Embase for systematic reviews and meta-analyses focused on psoriasis treatment. We then performed a subgroup analysis to determine further industry ties within the systemic reviews funded by industry. Results: Our study consisted of 27 systematic reviews and meta-analyses by 146 researchers. We found that 22 (81.5%) of the included systematic reviews contained at least 1 conflicted author. Six authors (of 47; 4.1%) disclosed all COI within the systematic review, 23 (of 47; 15.7%) partially disclosed COI but were also found to have undisclosed COI, and 18 (of 47; 12.3%) did not disclose any COI. Thirteen (of 22; 59.1%) contained narratives that favored the treatment group and 19 (of 22; 86.4%) reported conclusions favoring the treatment group. Importantly, 3 systematic reviews were industry-sponsored. In terms of our subgroup analysis, we found several additional industry ties within the primary studies. Conclusion: Our study calls attention to conflicts of interest, industry sponsorship, and their influence on research outcomes in systematic reviews and meta-analyses. Further, we provide examples of how specific industry ties can influence systematic reviews and recommendations for reporting.

Management of bias and conflict of interest among occupational exposure limit expert groups

Our aim was to evaluate policies and procedures for management of conflict of interest (CoI) and other sources of bias, implemented in Occupational Exposure Limit (OEL) expert groups. First, we compiled procedural criteria applicable to OEL-setting, based on literature on CoI and systematic reviews. Second, we identified 58 global OEL-sources and sought the underlying expert groups and operating procedures. We identified eleven active groups, of which five have documented CoI policies. In all five, CoI management is based on declarations of interests (DoIs) and removal of experts from decisions in which they have an interest. Notable differences include publication of DoIs (three of five groups), limitation of DoI to current interests (two groups), quantitative limits for financial interests (none specified to ≥€10,000 per interest), control procedures for undisclosed CoI (one group), and procedures in case of discovery of undisclosed CoI (three groups). Methods to evaluate study quality are described by three groups, while reproducible and comprehensive strategies to identify and select data receive less attention. We conclude that procedures to manage CoI and bias are not broadly implemented, or at least not openly and transparently communicated. This lack of visible procedures is remarkable, considering OEL's impact on health and economy.

Discrepancies in self-reported financial conflicts of interest disclosures by physicians: a systematic review

BackgroundThere is a high prevalence of financial conflicts of interest (COI) between physicians and industry.ObjectivesTo conduct a systematic review with meta-analysis examining the completeness of self-reported financial COI disclosures by...

Do Author Conflicts of Interest and Industry Sponsorship Influence Outcomes of Systematic Reviews and Meta-Analyses Regarding Glaucoma Interventions? A Cross-sectional Analysis.

In our sample of systematic reviews focusing on treatments for glaucoma, reviews conducted by authors with a conflict of interest were more likely to reach favorable conclusions compared with reviews without conflicted authors. Previous studies have demonstrated that authors' conflict of interest can influence outcomes of systematic reviews. Therefore, we aimed to determine whether the presence of 1 of more conflicts was associated with more favorable results and conclusions in systematic reviews of glaucoma interventions. MEDLINE and Embase were searched for systematic reviews of glaucoma treatments published between September 1, 2016 and June 2, 2020. Author conflicts of interest were located using multiple databases (eg, CMS Open Payments Database, Dollars for Profs, Google Patents, the United States Patent and Trademark Office USPTO) and previously published disclosure statements. Study sponsorship was determined using each review's funding disclosure statement. Our study included 26 systematic reviews conducted by 108 authors. Of these reviews, 9 (35%) were conducted by at least 1 author with an undisclosed conflict of interest. Of those 9, 3 (33%) reported results favoring the treatment group, and 5 (56%) reported conclusions favoring the treatment group. Of the 17 systematic reviews with no conflicted authors, 1 (6%) reported results favoring the treatment group, and 2 (12%) reported conclusions favoring the treatment group. The Fisher exact tests demonstrated that these differences held a statistically significant association between author conflicts and the favorability of the reviews' conclusions toward the treatment group (P=0.04). We found that systematic reviews conducted by 1 or more authors with conflicts of interest were more likely than those with no conflicted authors to draw favorable conclusions about the investigated intervention.

Assessment of Conflicts of Interest in Studies of Breast Implants and Breast Implant Mesh.

With increased collaboration between surgeons and industry, there has been a push towards improving transparency of conflicts of interest (COI). A literature search identified all articles published between 2016 - 2018 involving breast implants/implantable mesh from three major United States plastic surgery journals. Industry payment data from 8 breast implant/implantable mesh companies was collected using the CMS Open Payments database. COI discrepancies were identified by comparing author declaration statements with payments >$100.00 found for the year of publication and year prior. Risk factors for discrepancy were determined at study and author levels. A total of 162 studies (548 authors) were identified. 126 (78%) studies had at least one author receive undisclosed payments. 295 (54%) authors received undisclosed payments. Comparative studies were significantly more likely to have COI discrepancy than non- comparative studies (83% vs 69%, p < 0.05). Multivariate analysis showed no association between COI discrepancy and final product recommendation. Authors who accurately disclosed payments received higher payments compared to authors who did not accurately disclose payments (median $40,349 IQR 7278-190,413 vs median $1300 IQR 429-11,1544, p <0.001). The majority of breast implant-based studies had undisclosed COIs. Comparative studies were more likely to have COI discrepancy. Authors who accurately disclosed COIs received higher payments than authors with discrepancies. This study highlights the need for increased efforts to improve the transparency of industry sponsorship for breast implant-based studies.

Financial Conflicts of Interest Among Systematic Review Authors Investigating Interventions for Achilles Tendon Ruptures.

Background:The primary aim of our study was to evaluate the effects of undisclosed financial conflicts of interest in Achilles tendon rupture repair–focused systematic reviews.Methods:Following a cross-sectional study design, we searched MEDLINE and Embase for Achilles tendon rupture repair systematic reviews. We performed screening and data extraction in a blind, triplicate fashion. Each systematic review was evaluated on the individual characteristics of the study, presence of undisclosed and disclosed conflicts of interest, favorability of results and conclusions, and the relationship between conflicts of interest and the favorability of results and conclusions.Results:Our search produced 172 total systematic reviews pertaining to Achilles tendon rupture repair; of those, only 12 were included in our study. Undisclosed conflicts of interest were found in half (6/12) of the included reviews. However, no significant association was found between conflict of interest and the favorability of results and conclusions.Conclusion:Undisclosed conflicts of interests were discovered in a large percentage of our sample. This lack of disclosure did not appear to increase the likelihood of the systematic review results or conclusions reporting favorability of the intervention being investigated.Level of Evidence:Level II.

Undisclosed Conflict of Interest Is Prevalent in Spine Literature.

Cohort study. The aim of this study was to determine the rate of accurate conflict of interest (COI) disclosure within three prominent subspecialty Spine journals during a 4-year period. Industry-physician relationships are crucial for technological advancement in spine surgery but serve as a source of bias in biomedical research. The Open Payments Database (OPD) was established after 2010 to increase financial transparency. All research articles published from 2014 to 2017 in Spine, The Spine Journal (TSJ), and the Journal of Neurosurgery: Spine (JNS) were reviewed in this study. In these articles, all author's COI statements were recorded. The OPD was queried for all author entries within the disclose period of the journal. Discrepancies between the author's self-reported COIs and the documented COIs from OPD were recorded. A total of 6816 articles meeting inclusion criteria between 2014 and 2017 in Spine, TSJ, and JNS with 39,869 contributing authors. Overall, 15.8% of all authors were found to have an OPD financial relationship. Of 2633 authors in Spine with financial disclosures, 77.1% had accurate financial disclosures; 42.5% and 41.0% of authors with financial relationships in the OPD had accurate financial disclosures in TSJ and JNS, respectively. The total value of undisclosed conflicts of interest between 2014 and 2017 was $421 million with $1.48 billion in accurate disclosures. Of undisclosed payments, 68.7% were <$1000 and only 7.2% were >$10,000. Undisclosed payments included $180 million in research funding and $188 million in royalties. This study demonstrates that undisclosed COI is highly prevalent for authors in major Spine journals. This study indicates that there remains a need to standardize definitions and financial thresholds for significant COI as well as to shift the reporting burden for COI to journals who actively review potential COIs instead of relying on self-reporting. 3.