Association between personal financial conflicts of interest and recommendation of medical interventions: systematic review

Article type
Authors
Lundh A1, Jørgensen AW2, Bero L3
1The Nordic Cochrane Centre, Denmark
2Department of Otorhinolaryngology and Head & Neck Surgery, Aarhus University Hospital, Denmark
3Department of Clinical Pharmacy and Institute for Health Policy Studies, University of California, San Francisco, California, USA
Abstract
Background: Financial conflicts of interest may influence scientific data presentation and therefore influence which treatments are recommended in review articles and clinical guidelines.

Objectives: To determine whether authors of scientific opinion pieces or clinical guidelines with personal financial conflicts of interest related to drug, device or medical imaging companies were more likely to recommend the companies’ products.

Methods: We searched The Cochrane Methodology Register, MEDLINE and EMBASE for eligible studies. In addition we searched similar systematic reviews, reference lists of included studies, Web of Science for studies citing the included studies and contacted experts for additional relevant studies. Two assessors independently included studies, extracted data, and assessed studies for risk of bias. We calculated pooled risk ratios (RR) for dichotomous data (with 95% confidence intervals).

Results: Based on a preliminary search we included three studies (303 journal articles about drug treatments). Articles written by authors with any financial conflicts of interest were more likely to recommend a company’s drug than articles by authors without conflicts of interest, risk ratio: 6.31 (95% confidence interval: 1.66–23.92). Despite the inclusion of only three studies the heterogeneity was substantial (I2: 66%). Full data analysis and further exploration of data will be presented at the conference.

Conclusions: Our preliminary findings suggest that recommendations to use a particular drug are associated with financial conflicts of interest of the authors of the recommendation.