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

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Abbreviations

CI:

Confidence interval

COI:

Conflict of interest

ICMJE:

International Committee of Medical Journal Editors

ICU:

Intensive care unit

IF:

Impact factor

IOM:

Institute of Medicine

IQR:

Interquartile range

RCT:

Randomized clinical trial

MESH:

Medical subject headings

OR:

Odds ratio

PRISMA:

Preferred reporting items for systematic reviews and meta-analyses

ROC:

Receiver operating characteristic

SE:

Standard error

SR/MA:

Systematic review/meta-analysis

WAME:

World Association of Medical Editors

References

  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. https://doi.org/10.1227/01.neu.0000369904.38343.e4

    Article  PubMed  Google Scholar 

  2. 2.

    Lemmens T (2004) Confronting the conflict of interest crisis in medical research. Monash Bioeth Rev 23:19–40

    Article  PubMed  Google Scholar 

  3. 3.

    Friedman PJ (2002) The impact of conflict of interest on trust in science. Sci Eng Ethics 8:413–420

    Article  PubMed  Google 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 289:454–465

    Article  PubMed  Google Scholar 

  5. 5.

    Elliott KC (2008) Scientific judgment and the limits of conflict-of-interest policies. Acc Res 15:1–29. https://doi.org/10.1080/08989620701783725

    Article  Google 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. https://doi.org/10.1056/NEJM200011303432207

    CAS  Article  PubMed  Google 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. https://doi.org/10.1186/s12916-014-0197-z

    Article  PubMed  PubMed Central  Google Scholar 

  8. 8.

    Santhakumar S, Adashi EY (2015) The physician payment sunshine act: testing the value of transparency. JAMA 313:23–24. https://doi.org/10.1001/jama.2014.15472

    CAS  Article  PubMed  Google 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. https://doi.org/10.1177/0883073809345928

    Article  Google Scholar 

  10. 10.

    Cohen JJ (2002) Managing financial conflicts of interest in clinical research. Sci Eng Ethics 8:401–406

    Article  PubMed  Google 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. https://doi.org/10.1001/jama.2009.407

    CAS  Article  PubMed  Google Scholar 

  12. 12.

    Steinbrook R (2009) Controlling conflict of interest–proposals from the Institute of Medicine. N Engl J Med 360:2160–2163. https://doi.org/10.1056/NEJMp0810200

    CAS  Article  PubMed  Google Scholar 

  13. 13.

    Managing conflict of interest in NIH peer review of grants and contracts. https://grants.nih.gov/grants/peer/peer_coi.htm. Accessed 6 Aug 2018

  14. 14.

    Krimsky S, Rothenberg LS (1998) Financial interest and its disclosure in scientific publications. JAMA 280:225–226

    CAS  Article  PubMed  Google 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, Washington

    Google 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. https://doi.org/10.1056/NEJMe1006030

    CAS  Article  PubMed  Google 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:b2700

    Article  PubMed  PubMed Central  Google 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. https://doi.org/10.1111/j.1365-2036.2011.04989.x

    CAS  Article  PubMed  Google 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. https://doi.org/10.1016/j.jclinepi.2017.04.002

    Article  PubMed  Google 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. https://doi.org/10.1186/1472-6939-14-19

    Article  PubMed  PubMed Central  Google Scholar 

  21. 21.

    Rodwin MA (2018) Attempts to redefine conflicts of interest. Acc Res 25:67–78. https://doi.org/10.1080/08989621.2017.1405728

    Article  Google 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. https://doi.org/10.1111/j.1572-0241.2007.01268.x

    Article  PubMed  Google 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. https://doi.org/10.4317/jced.51225

    Article  PubMed  PubMed Central  Google 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. https://doi.org/10.1056/NEJM200011303432206

    CAS  Article  PubMed  Google 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:d5621

    Article  PubMed  PubMed Central  Google Scholar 

  26. 26.

    Choudhry NK, Stelfox HT, Detsky AS (2002) Relationships between authors of clinical practice guidelines and the pharmaceutical industry. JAMA 287:612–617

    Article  PubMed  Google 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. https://doi.org/10.1371/journal.pmed.1002029

    Article  PubMed  PubMed Central  Google 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. https://doi.org/10.1200/JCO.2008.21.6606

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

None.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Michael Darmon.

Ethics declarations

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.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 133 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Darmon, M., Helms, J., De Jong, A. et al. Time trends in the reporting of conflicts of interest, funding and affiliation with industry in intensive care research: a systematic review. Intensive Care Med 44, 1669–1678 (2018). https://doi.org/10.1007/s00134-018-5350-2

Download citation

Keywords

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