Intensive Care Medicine

, Volume 44, Issue 10, pp 1669–1678 | Cite as

Time trends in the reporting of conflicts of interest, funding and affiliation with industry in intensive care research: a systematic review

  • Michael DarmonEmail author
  • Julie Helms
  • Audrey De Jong
  • Peter Buhl Hjortrup
  • Emmanuel Weiss
  • Anders Granholm
  • Riccardo Pinciroli
  • Charlotte Poussardin
  • Marie Warrer Petersen
  • Stéphanie Sigaut
  • Bruna Brandao Barreto
  • Morten Hylander Moller
  • Elie Azoulay
Systematic Review



Conflict of interest (COI) may compromise, or have the appearance of compromising, a researcher’s judgment or integrity in conducting or reporting research. We sought to assess time trends of COI and funding statement reporting in the critical care literature.


PubMed was searched by using Medical Subject Headings and the appropriate corresponding keywords: “INTENSIVE CARE UNIT” or “ICU” as a major topic. Four years in a 15-year time period (2001–2016) were arbitrarily chosen and one study month was randomly selected for each study period. Studies published during the selected months were included in the analysis.


Three hundred and seventy-four studies were evaluated, including five reviews (1.3%) and ten randomized clinical trials (RCTs) (2.7%). COI statements were available in 65% of the studies and 8% had declared COI. COI statement rate, declared COI and funding statements increased over time, while the number of authors affiliated with industry and the discordance between the lack of COI statement and affiliation with industry decreased. Declared COI were more frequent in 2011–2016 as compared to 2001–2010 (OR 4.06; 95% CI 1.15–25.79) and in the higher quartile of a journal’s impact factor (OR of 16.73; 95% CI 3.28–306.20). Surprisingly, focus of the study, country of the first author and/or endorsement of the study by a trial group were not associated with COI statements.


Our study suggests COI reporting to have been unintuitive to most investigators and unreliable before ICMJE statements, and that strong incentives are needed to implement adequate reporting of COI.


Bibliometrics Conflicts of interest Disclosure/statistics and numerical data Editorial policies Journal impact factor Periodicals as topic/standards Bias 



Confidence interval


Conflict of interest


International Committee of Medical Journal Editors


Intensive care unit


Impact factor


Institute of Medicine


Interquartile range


Randomized clinical trial


Medical subject headings


Odds ratio


Preferred reporting items for systematic reviews and meta-analyses


Receiver operating characteristic


Standard error


Systematic review/meta-analysis


World Association of Medical Editors




Compliance with ethical standards

Conflicts of interest

A De Jong reports personal fees from Baxter and Medtronic-Covidien, and travel reimbursements from Fresenius-Kabi, MSD France, Astellas, Pfizer and Fisher Paykel. J. Helms reports congress and travel reimbursements from Pfizer, Diagnostica Stago, MSD France, Astrazeneca and Gilead Sciences. E. Weiss reports personal fees form Baxter, MSD France and Biomerieux, and travel reimbursements from MSD France and Eumedica. M. Darmon reports having received research support from MSD and from ASTUTE medical, speaker fees from MSD, Astellas and Bristol-Myers-Squibb, support to organize educational meeting from MSD, Astellas, and Jazz Pharma and having participated to an advisory board from SANOFI-AVENTIS. M. Hylander Møller, N. Buhl Hjortrup, A. Granholm and M. Warrer Petersen declare that their department has received research grants from Fresenius Kabi, CSL Bering and Ferring Pharmaceuticals. Elie Azoulay reports having received fees for lectures from Alexion, Gilead, and Baxter. His institution and research group have received support from Fisher & Payckle, Pfizer, Ablkynx, MSD and Jazz Pharma. Other authors declare having no COI to declare.

Supplementary material

134_2018_5350_MOESM1_ESM.docx (174 kb)
Supplementary material 1 (DOCX 133 kb)


  1. 1.
    Ferris LE, Fletcher RH (2010) Conflict of interest in peer-reviewed medical journals: the World Association of Medical Editors (WAME) position on a challenging problem. Neurosurgery 66:629–630. CrossRefPubMedGoogle Scholar
  2. 2.
    Lemmens T (2004) Confronting the conflict of interest crisis in medical research. Monash Bioeth Rev 23:19–40CrossRefPubMedGoogle Scholar
  3. 3.
    Friedman PJ (2002) The impact of conflict of interest on trust in science. Sci Eng Ethics 8:413–420CrossRefPubMedGoogle Scholar
  4. 4.
    Bekelman JE, Li Y, Gross CP (2003) Scope and impact of financial conflicts of interest in biomedical research: a systematic review. JAMA 289:454–465CrossRefPubMedGoogle Scholar
  5. 5.
    Elliott KC (2008) Scientific judgment and the limits of conflict-of-interest policies. Acc Res 15:1–29. CrossRefGoogle Scholar
  6. 6.
    McCrary SV, Anderson CB, Jakovljevic J et al (2000) A national survey of policies on disclosure of conflicts of interest in biomedical research. N Engl J Med 343:1621–1626. CrossRefPubMedGoogle Scholar
  7. 7.
    Marušić A, Hren D, Mansi B et al (2014) Five-step authorship framework to improve transparency in disclosing contributors to industry-sponsored clinical trial publications. BMC Med 12:197. CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Santhakumar S, Adashi EY (2015) The physician payment sunshine act: testing the value of transparency. JAMA 313:23–24. CrossRefPubMedGoogle Scholar
  9. 9.
    World Association of Medical Editors (2009) Conflict of interest in peer-reviewed medical journals: a policy statement of the World Association of Medical Editors (WAME). J Child Neurol 24:1321–1323. CrossRefGoogle Scholar
  10. 10.
    Cohen JJ (2002) Managing financial conflicts of interest in clinical research. Sci Eng Ethics 8:401–406CrossRefPubMedGoogle Scholar
  11. 11.
    Rothman DJ, McDonald WJ, Berkowitz CD et al (2009) Professional medical associations and their relationships with industry: a proposal for controlling conflict of interest. JAMA 301:1367–1372. CrossRefPubMedGoogle Scholar
  12. 12.
    Steinbrook R (2009) Controlling conflict of interest–proposals from the Institute of Medicine. N Engl J Med 360:2160–2163. CrossRefPubMedGoogle Scholar
  13. 13.
    Managing conflict of interest in NIH peer review of grants and contracts. Accessed 6 Aug 2018
  14. 14.
    Krimsky S, Rothenberg LS (1998) Financial interest and its disclosure in scientific publications. JAMA 280:225–226CrossRefPubMedGoogle Scholar
  15. 15.
    Institute of Medicine (US) Committee on Potential Conflicts of Interest in Patient Outcomes Research Teams (1991) Patient outcomes research teams: managing conflict of interest. National Academies Press, WashingtonGoogle Scholar
  16. 16.
    Drazen JM, de Leeuw PW, Laine C et al (2010) Toward more uniform conflict disclosures—the updated ICMJE conflict of interest reporting form. N Engl J Med 363:188–189. CrossRefPubMedGoogle Scholar
  17. 17.
    Liberati A, Altman DG, Tetzlaff J et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339:b2700CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Qureshi J, Sud A, Vakil N (2012) Funding source and conflict of interest disclosures by authors and editors in gastroenterology specialty journals revisited. Aliment Pharmacol Ther 35:690–695. CrossRefPubMedGoogle Scholar
  19. 19.
    Hakoum MB, Jouni N, Abou-Jaoude EA et al (2017) Authors of clinical trials reported individual and financial conflicts of interest more frequently than institutional and nonfinancial ones: a methodological survey. J Clin Epidemiol 87:78–86. CrossRefPubMedGoogle Scholar
  20. 20.
    Bindslev JBB, Schroll J, Gøtzsche PC, Lundh A (2013) Underreporting of conflicts of interest in clinical practice guidelines: cross sectional study. BMC Med Ethics 14:19. CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Rodwin MA (2018) Attempts to redefine conflicts of interest. Acc Res 25:67–78. CrossRefGoogle Scholar
  22. 22.
    Bhargava N, Qureshi J, Vakil N (2007) Funding source and conflict of interest disclosures by authors and editors in gastroenterology specialty journals. Am J Gastroenterol 102:1146–1150. CrossRefPubMedGoogle Scholar
  23. 23.
    Beyari MM, Strain D, Li CS, Lamfon HA (2014) Conflict of interest reporting in dentistry meta-analyses: a systematic review. J Clin Exp Dent 6:e280–e285. CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Lo B, Wolf LE, Berkeley A (2000) Conflict-of-interest policies for investigators in clinical trials. N Engl J Med 343:1616–1620. CrossRefPubMedGoogle Scholar
  25. 25.
    Neuman J, Korenstein D, Ross JS, Keyhani S (2011) Prevalence of financial conflicts of interest among panel members producing clinical practice guidelines in Canada and United States: cross sectional study. BMJ 343:d5621CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Choudhry NK, Stelfox HT, Detsky AS (2002) Relationships between authors of clinical practice guidelines and the pharmaceutical industry. JAMA 287:612–617CrossRefPubMedGoogle Scholar
  27. 27.
    Campsall P, Colizza K, Straus S, Stelfox HT (2016) Financial relationships between organizations that produce clinical practice guidelines and the biomedical industry: a cross-sectional study. PLoS Med 13:e1002029. CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Rose SL, Krzyzanowska MK, Joffe S (2010) Relationships between authorship contributions and authors’ industry financial ties among oncology clinical trials. J Clin Oncol 28:1316–1321. CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

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

Authors and Affiliations

  • Michael Darmon
    • 1
    • 2
    • 3
    Email author
  • Julie Helms
    • 4
    • 5
  • Audrey De Jong
    • 1
    • 6
  • Peter Buhl Hjortrup
    • 7
    • 8
  • Emmanuel Weiss
    • 9
    • 2
  • Anders Granholm
    • 7
  • Riccardo Pinciroli
    • 10
  • Charlotte Poussardin
    • 4
  • Marie Warrer Petersen
    • 7
  • Stéphanie Sigaut
    • 8
  • Bruna Brandao Barreto
    • 1
    • 11
  • Morten Hylander Moller
    • 7
  • Elie Azoulay
    • 1
    • 2
    • 3
  1. 1.Medical ICUSaint-Louis University Hospital, AP-HPParisFrance
  2. 2.Faculté de MédecineUniversité Paris-Diderot, Sorbonne-Paris-CitéParisFrance
  3. 3.ECSTRA team, Biostatistics and clinical epidemiologyUMR 1153 (center of epidemiology and biostatistic Sorbonne Paris Cité, CRESS), INSERMParisFrance
  4. 4.Faculté de Médecine, Hôpitaux universitaires de Strasbourg, Service de réanimationNouvel Hôpital Civil, Université de Strasbourg (UNISTRA)StrasbourgFrance
  5. 5.ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d’Immunologie et d’Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS)Université de StrasbourgStrasbourgFrance
  6. 6.PhyMedExp, INSERM, CNRS, CHU de Montpellier, Département d’anesthésie-réanimation Saint-EloiUniversité de MontpellierMontpellier CedexFrance
  7. 7.Department of Intensive CareCopenhagen University Hospital-RigshospitaletCopenhagenDenmark
  8. 8.Department of Anaesthesiology and Intensive CareZealand University HospitalKøgeDenmark
  9. 9.Department of Anesthesia and Critical CareBeaujon University Hospital, AP-HPParisFrance
  10. 10.Department of Anesthesia and Critical CareNiguarda Hospital, University of Milan-BicoccaMilanItaly
  11. 11.Intensive Care UnitHospital da MulherSalvadorBrazil

Personalised recommendations