Quantification of Conflicts of Interest in an Online Point-of-Care Clinical Support Website
- 19 Downloads
Online medical reference websites are utilized by health care providers to enhance their education and decision making. However, these resources may not adequately reveal pharmaceutical-author interactions and their potential conflicts of interest (CoIs). This investigation: (1) evaluates the correspondence of two well-utilized CoI databases: the Centers for Medicare and Medicaid Services Open Payments (CMSOP) and ProPublica’s Dollars for Docs (PDD) and (2) quantifies CoIs among authors of a publicly available point of care clinical support website which is used to inform evidence-based medicine decisions. Two data sources were used: the hundred most common drugs and the top fifty causes of death. These topics were entered into a freely available database. The authors (N = 139) were then input into CMSOP and PDD and compensation and number of payments were determined for 2013–2015. The subset of highly compensated authors that also reported “Nothing to disclose” were further examined. There was a high degree of similarity between CMSOP and PDD for compensation (R2 ≥ 0.998) and payment number (R2 ≥ 0.992). The amount received was 1.4% higher in CMSOP ($4,059,194) than in PDD ($4,002,891). The articles where the authors had received the greatest compensation were in neurology (Parkinson’s Disease = $1,810,032), oncology (Acute Lymphoblastic Leukemia = $616,727), and endocrinology (Type I Diabetes = $377,388). Two authors reporting “Nothing to disclose” received appreciable and potentially relevant compensation. CMSOP and PDD produced almost identical results. CoIs were common among authors but self-reporting may be an inadequate reporting mechanism. Recommendations are offered for improving the CoI transparency of pharmaceutical-author interactions in point-of-care electronic resources.
Software to complete this research was provided by the National Institute of Environment Health Sciences (NIEHS T32-ES007060-31A1). No specific funding was received for this study. We thank ProPublica for making the Dollars for Docs database publicly available. An earlier version of this paper was completed as part of course requirement for Readings in Basic Sciences with Prof. Darina Lazarova.
No specific support was received for this research.
Compliance with ethical standards
Conflict of interest
ACC has no disclosures. SDN consults with Shire. In the past 3-years, BJP has received research support and travel from the Center for Wellness Leadership, a non-profit organization for a medical marijuana study, travel from the National Institute of Drug Abuse, and is a Fahs-Beck Fellow. He is a co-investigator for a grant under review with Pfizer.
- DeAngelis, C. D., Fontanarosa, P. B. (2009). Conflicts over conflicts of interest. JAMA, E1–E3, published online 3/20/09. https://doi.org/10.1001/jama.2009.480.
- Frishauf, P. (2005). Medscape—The first 5 years. Medscape General Medicine, 7(2), 5.Google Scholar
- International Committee of Medical Journal Editors. ICMJE form for disclosure of potential conflicts of interest. Retrieved July 6, 2019 from http://www.icmje.org/conflicts-of-interest/.
- Jones, R. G., Ornstein, C., Tigas, M. (2016). We’ve updated dollars for docs. Here’s what’s new. ProPublica. 2016. Retrieved December 8, 2018 from https://www.propublica.org/article/updated-dollars-for-docs-heres-whats-new.
- Leo, J., & Lacasse, J. R. (2010). Clinical trials of therapy versus medication: Even in a tie, medication swin. Journal of Critical Psychology, Counselling and Psychotherapy, 10(3), 154–156.Google Scholar
- Melnick, D., & Fugh-Berman, A. (2009). Editing ethics: JAMA’s new conflict of interest policy. The Hastings Center Report, 39, 2.Google Scholar
- Miller, K. D. (2018). ‘No excuse’ for undisclosed conflicts of interest, but perhaps a simple solution. Medscape, 9 October, 2018. Retrieved March 1, 2019 from https://www.medscape.com/viewarticle/903016.
- Stewart, K. F. (2018). Sunshine act expands to advance practice nurses and physician assistants. National Law Rev. Retrieved February 25, 2019 from https://www.natlawreview.com/article/sunshine-act-expands-to-advance-practice-nurses-and-physician-assistants.
- Tigas, M., Jones, R. G., Ornstein, C., Groeger, L. Dollars for Docs. Retrieved December 8, 2018 from https://projects.propublica.org/docdollars/.