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Intensive Care Medicine

, Volume 44, Issue 10, pp 1638–1656 | Cite as

Association of conflicts of interest with the results and conclusions of goal-directed hemodynamic therapy research: a systematic review with meta-analysis

  • Lina Zhang
  • Feng Dai
  • Alexandria Brackett
  • Yuhang Ai
  • Lingzhong Meng
Systematic Review

Abstract

Purpose

The association between conflicts of interest (COI) and study results or article conclusions in goal-directed hemodynamic therapy (GDHT) research is unknown.

Methods

Randomized controlled trials comparing GDHT with usual care were identified. COI were classified as industry sponsorship, author conflict, device loaner, none, or not reported. The association between COI and study results (complications and mortality) was assessed using both stratified meta-analysis and mixed effects meta-regression. The association between COI and an article’s conclusion (graded as GDHT-favorable, neutral, or unfavorable) was investigated using logistic regression.

Results

Of the 82 eligible articles, 43 (53%) had self-reported COI, and 50 (61%) favored GDHT. GDHT significantly reduced complications on the basis of the meta-analysis of studies with any type of COI, studies declaring no COI, industry-sponsored studies, and studies with author conflict but not on studies with a device loaner. However, no significant relationship between COI and the relative risk (GDHT vs. usual care) of developing complications was found on the basis of meta-regression (p = 0.25). No significant effect of GDHT was found on mortality. COI had a significant overall effect (p = 0.016) on the odds of having a GDHT-favorable vs. neutral conclusion based on 81 studies. Eighty-four percent of the industry-sponsored studies had a GDHT-favorable conclusion, while only 27% of the studies with a device loaner had the same conclusion grade.

Conclusions

The available evidence does not suggest a close relationship between COI and study results in GDHT research. However, a potential association may exist between COI and an article’s conclusion in GDHT research.

Keywords

Conflicts of interest Goal-directed hemodynamic therapy Study results Article conclusions Association 

Notes

Acknowledgements

We thank Dr. Cary P. Gross from the Center for Outcomes Research & Evaluation, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut for his help with manuscript preparation.

Funding

Support was provided from institutional and/or departmental sources at Yale University and Central South University, China.

Compliance of ethical standards

Conflicts of interest

L. Meng is a consultant for CAS Medical Systems, Inc. The other authors declare no competing interests.

Supplementary material

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature and ESICM 2018

Authors and Affiliations

  1. 1.Department of Critical Care Medicine, Central South UniversityXiangya HospitalChangshaChina
  2. 2.Department of BiostatisticsYale University School of Public HealthNew HavenUSA
  3. 3.Cushing/Whitney Medical LibraryYale UniversityNew HavenUSA
  4. 4.Department of AnesthesiologyYale University School of MedicineNew HavenUSA

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