Association between competing interests and authors' conclusions: epidemiological study of randomised clinical trials published in the BMJ

doi:10.1136/bmj.325.7358.249

BMJ 2002;325:249 ( 3 August )

Papers

Association between competing interests and authors' conclusions: epidemiological study of randomised clinical trials published in the BMJ

Lise L Kjaergard, research fellow, Bodil Als-Nielsen, research fellow.

Cochrane Hepatobiliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, Department 7102, H:S Rigshospitalet, DK-2100 Copenhagen, Denmark

Correspondence to: L L Kjaergard Kjaergard{at}ctu.rh.dk

Objective: To assess the association between competinginterests and authors' conclusions in randomised clinicaltrials.
Design: Epidemiological study of randomised clinicaltrials published in the BMJ from January 1997 to June 2001. Financialcompeting interests were defined as funding by for profit organisationsand other competing interests as personal, academic, orpolitical.
Studies: 159 trials from 12 medicalspecialties.
Main outcome measures: Authors' conclusions defined as interpretationof extent to which overall results favoured experimental intervention.Conclusions appraised on 6 point scale; higher scores favour experimentalintervention.
Results: Authors' conclusions were significantly morepositive towards the experimental intervention in trials fundedby for profit organisations alone compared with trials withoutcompeting interests (mean difference 0.48 (SE 0.13), P=0.014),trials funded by both for profit and non-profit organisations(0.30 (SE 0.10), P=0.003), and trials with other competing interests(0.45 (SE 0.13), P=0.006). Other competing interests and fundingfrom both for profit and non-profit organisations were not significantlyassociated with authors' conclusions. The association betweenfinancial competing interests and authors' conclusions was notexplained by methodological quality, statistical power, type ofexperimental intervention (pharmacological or non-pharmacological),type of control intervention (for example, placebo or active drug),or medicalspecialty.
Conclusions: Authors' conclusions in randomised clinicaltrials significantly favoured experimental interventions if financialcompeting interests were declared. Other competing interests werenot significantly associated with authors'conclusions.

What is already known on this topic
Financial competing interests may influence authors' conclusions $---$ for instance, interpretation of whether results favour the experimental or control intervention

Trials of antipsychotic drugs for schizophrenia funded by drug companies were more likely to show a benefit of treatment

It is not known whether other competing interests, such as personal, academic, or political, are associated with authors' conclusions.

What this study adds
In pharmacological and non-pharmacological randomised clinical trials from 12 specialties financial competing interests were significantly associated with authors' conclusions

The association did not reflect inadequate methodological quality, greater statistical power, or use of inactive control interventions

Personal, academic, and political competing interests were not significantly associated with authors' conclusions.

© BMJ 2002

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Articles

Commentary: Risks of doing as the Romans do: Michael Tremblay
BMJ 2009 338: b1107. [Extract] [Full Text]

Relation of study quality, concordance, take home message, funding, and impact in studies of influenza vaccines: systematic review: T Jefferson, C Di Pietrantonj, M G Debalini, A Rivetti, and V Demicheli
BMJ 2009 338: b354. [Abstract] [Full Text] [PDF]

Financial ties and concordance between results and conclusions in meta-analyses: retrospective cohort study: Veronica Yank, Drummond Rennie, and Lisa A Bero
BMJ 2007 335: 1202-1205. [Abstract] [Full Text] [PDF]

How can we regulate medicines better?: Silvio Garattini and Vittorio Bertele'
BMJ 2007 335: 803-805. [Extract] [Full Text] [PDF]

Association between competing interests and conclusions: Benjamin Djulbegovic and Adam Jacobs
BMJ 2002 325: 1420. [Extract] [Full Text]

Trials funded by for profit organisations favour the intervention
BMJ 2002 325: 0. [Full Text]

Western medicine: a confidence trick driven by the drug industry?
BMJ 2002 325: 0. [Full Text] [PDF]

This article has been cited by other articles:

Okike, K., Kocher, M. S., Wei, E. X., Mehlman, C. T., Bhandari, M. (2009). Accuracy of Conflict-of-Interest Disclosures Reported by Physicians. NEJM 361: 1466-1474 [Abstract] [Full text]
Hirsch, L. J. (2009). Conflicts of Interest, Authorship, and Disclosures in Industry-Related Scientific Publications: The Tort Bar and Editorial Oversight of Medical Journals. Mayo Clin Proc. 84: 811-821 [Full text]
Irwin, R. S. (2009). The Role of Conflict of Interest in Reporting of Scientific Information. Chest 136: 253-259 [Abstract] [Full text]
Scott, P. J., Briggs, J. S. (2009). A Pragmatist Argument for Mixed Methodology in Medical Informatics. Journal of Mixed Methods Research 3: 223-241 [Abstract]
Tremblay, M. (2009). Commentary: Risks of doing as the Romans do. BMJ 338: b1107-b1107 [Full text]
Jefferson, T, Di Pietrantonj, C, Debalini, M G, Rivetti, A, Demicheli, V (2009). Relation of study quality, concordance, take home message, funding, and impact in studies of influenza vaccines: systematic review. BMJ 338: b354-b354 [Abstract] [Full text]
Booth, C. M., Cescon, D. W., Wang, L., Tannock, I. F., Krzyzanowska, M. K. (2008). Evolution of the Randomized Controlled Trial in Oncology Over Three Decades. JCO 26: 5458-5464 [Abstract] [Full text]
Hochman, M., Hochman, S., Bor, D., McCormick, D. (2008). News Media Coverage of Medication Research: Reporting Pharmaceutical Company Funding and Use of Generic Medication Names. JAMA 300: 1544-1550 [Abstract] [Full text]
Civaner, M., Sarikaya, O., Alici, S. U., Bozkurt, G. (2008). Exposing Nursing Students To the Marketing Methods of Pharmaceutical Companies. Nurs Ethics 15: 396-410 [Abstract]
Walsh, K., Sandars, J. (2008). Competing interests and research in medical education. Postgrad. Med. J. 84: 113-114 [Full text]
Yank, V., Rennie, D., Bero, L. A (2007). Financial ties and concordance between results and conclusions in meta-analyses: retrospective cohort study. BMJ 335: 1202-1205 [Abstract] [Full text]
Nieto, A., Mazon, A., Pamies, R., Linana, J. J., Lanuza, A., Jimenez, F. O., Medina-Hernandez, A., Nieto, F. J. (2007). Adverse Effects of Inhaled Corticosteroids in Funded and Nonfunded Studies. Arch Intern Med 167: 2047-2053 [Abstract] [Full text]
Garattini, S., Bertele', V. (2007). How can we regulate medicines better?. BMJ 335: 803-805 [Full text]
Riechelmann, R. P., Wang, L., O'Carroll, A., Krzyzanowska, M. K. (2007). Disclosure of Conflicts of Interest by Authors of Clinical Trials and Editorials in Oncology. JCO 25: 4642-4647 [Abstract] [Full text]
Lynch, J. R., Cunningham, M. R.A., Warme, W. J., Schaad, D. C., Wolf, F. M., Leopold, S. S. (2007). Commercially Funded and United States-Based Research Is More Likely to Be Published; Good-Quality Studies with Negative Outcomes Are Not. JBJS 89: 1010-1018 [Abstract] [Full text]
Okike, K., Kocher, M. S. (2007). The Legal and Ethical Issues Surrounding Financial Conflict of Interest in Orthopaedic Research. JBJS 89: 910-913 [Full text]
Okike, K., Kocher, M. S., Mehlman, C. T., Bhandari, M. (2007). Conflict of Interest in Orthopaedic Research. An Association Between Findings and Funding in Scientific Presentations. JBJS 89: 608-613 [Abstract] [Full text]
Coyne, D. W. (2007). Influence of Industry on Renal Guideline Development. CJASN 2: 3-7 [Full text]
Psaty, B. M., Rennie, D. (2006). Clinical Trial Investigators and Their Prescribing Patterns: Another Dimension to the Relationship Between Physician Investigators and the Pharmaceutical Industry. JAMA 295: 2787-2790 [Full text]
MONTGOMERY, J. H. (2006). Industry Funding and Author-Industry Affiliation in Clinical Trials in Psychiatry. Am. J. Psychiatry 163: 1110-1111 [Full text]
Ridker, P. M, Torres, J. (2006). Reported outcomes in major cardiovascular clinical trials funded by for-profit and not-for-profit organizations: 2000-2005.. JAMA 295: 2270-2274 [Abstract] [Full text]
Busfield, J. (2006). Pills, Power, People: Sociological Understandings of the Pharmaceutical Industry. Sociology 40: 297-314 [Abstract]
Gluud, L. L. (2006). Bias in Clinical Intervention Research. Am J Epidemiol 163: 493-501 [Abstract] [Full text]
Perlis, R. H., Perlis, C. S., Wu, Y., Hwang, C., Joseph, M., Nierenberg, A. A. (2005). Industry Sponsorship and Financial Conflict of Interest in the Reporting of Clinical Trials in Psychiatry. Am. J. Psychiatry 162: 1957-1960 [Abstract] [Full text]
Neale, A. V., Schwartz, K. L., Bowman, M. A. (2005). Conflict of Interest: Can We Minimize Its Influence in the Biomedical Literature?. J Am Board Fam Med 18: 411-413 [Full text]
Mirowski, P., Van Horn, R. (2005). The Contract Research Organization and the Commercialization of Scientific Research. Social Studies of Science 35: 503-548 [Abstract]
Ahmer, S., Arya, P., Anderson, D., Faruqui, R. (2005). Conflict of interest in psychiatry. Psychiatr. Bull. 29: 302-304 [Abstract] [Full text]
Cooper, R. J., Schriger, D. L. (2005). The availability of references and the sponsorship of original research cited in pharmaceutical advertisements. CMAJ 172: 487-491 [Abstract] [Full text]
Bhandari, M., Bajammal, S., Guyatt, G. H., Griffith, L., Busse, J. W., Schunemann, H., Einhorn, T. A. (2005). Effect of Bisphosphonates on Periprosthetic Bone Mineral Density After Total Joint Arthroplasty. A Meta-Analysis. JBJS 87: 293-301 [Abstract] [Full text]
Lexchin, J. R (2005). Implications of Pharmaceutical Industry Funding on Clinical Research. The Annals of Pharmacotherapy 39: 194-197 [Abstract] [Full text]
Steurer-Stey, C., Bachmann, L. M., Steurer, J., Tramer, M. R. (2004). Oral Purified Bacterial Extracts in Chronic Bronchitis and COPD: Systematic Review. Chest 126: 1645-1655 [Abstract] [Full text]
Ahmer, S. (2004). Analysing the efficacy of clozapine. Br. J. Psychiatry 185: 264-264 [Full text]
Bhandari, M., Busse, J. W., Jackowski, D., Montori, V. M., Schunemann, H., Sprague, S., Mears, D., Schemitsch, E. H., Heels-Ansdell, D., Devereaux, P.J. (2004). Association between industry funding and statistically significant pro-industry findings in medical and surgical randomized trials. CMAJ 170: 477-480 [Abstract] [Full text]
Hirsch, L. (2004). Randomized clinical trials: What gets published, and when?. CMAJ 170: 481-483 [Full text]
Zuckerman, J. D., Prasarn, M., Kubiak, E. N., Koval, K. J. (2004). Conflict of Interest in Orthopaedic Research. JBJS 86: 423-428 [Abstract] [Full text]
Citrome, L. L, Jaffe, A. B (2003). Relationship of Atypical Antipsychotics with Development of Diabetes Mellitus. The Annals of Pharmacotherapy 37: 1849-1857 [Abstract] [Full text]
Zuess, J. (2003). Complementary and Alternative Medicine and Mental Health Care: Shared Challenges. Complementary Health Practice Review 8: 193-197
Als-Nielsen, B., Chen, W., Gluud, C., Kjaergard, L. L. (2003). Association of Funding and Conclusions in Randomized Drug Trials: A Reflection of Treatment Effect or Adverse Events?. JAMA 290: 921-928 [Abstract] [Full text]
Heinig, M. J. (2003). The "Price" of Information. J Hum Lact 19: 133-135
Tobin, M. J. (2003). Conflicts of Interest and AJRCCM: Restating Policy and a New Form to Upload. Am. J. Respir. Crit. Care Med. 167: 1161-1164 [Full text]
Healy, D., Thase, M. E. (2003). Is academic psychiatry for sale?. Br. J. Psychiatry 182: 388-390 [Full text]
Bekelman, J. E., Li, Y., Gross, C. P. (2003). Scope and Impact of Financial Conflicts of Interest in Biomedical Research: A Systematic Review. JAMA 289: 454-465 [Abstract] [Full text]
Djulbegovic, B., Jacobs, A. (2002). Association between competing interests and conclusions. BMJ 325: 1420-1420 [Full text]
(2002). Financial Competing Interests Are Associated with Authors' Conclusions. JWatch Gastroenterology 2002: 9-9 [Full text]
(2002). Financial Competing Interests Are Associated with Authors' Conclusions. JWatch Psychiatry 2002: 16-16 [Full text]
(2002). Financial Competing Interests Are Associated with Authors' Conclusions. Journal Watch Cardiology 2002: 5-5 [Full text]
(2002). Financial Competing Interests Are Associated with Authors' Conclusions. JWatch General 2002: 5-5 [Full text]

Rapid Responses:

Read all Rapid Responses

Working with transformed data.: William P Plummer
bmj.com, 6 Aug 2002 [Full text]
Two types of correlation.: William P Plummer
bmj.com, 6 Aug 2002 [Full text]
The use of masking procedures.: Wwilliam P Plummer
bmj.com, 6 Aug 2002 [Full text]
Separating results and conclusions: Adam Jacobs
bmj.com, 9 Aug 2002 [Full text]
An opportunity for BMJ editors: tackling the "denominator problem": Benjamin Djulbegovic
bmj.com, 13 Aug 2002 [Full text]
Be aware of publication bias: Ron Law
bmj.com, 17 Aug 2002 [Full text]
Funding-related bias in clinical trials: Paul S THOMAS, et al.
bmj.com, 22 Aug 2002 [Full text]
Authors' response: Lise L Kjaergard, et al.
bmj.com, 9 Sep 2002 [Full text]
Industry sponsored trials: an alternative view: Nawab Qizilbash, et al.
bmj.com, 2 Jun 2003 [Full text]