Journal of Bioethical Inquiry

, Volume 13, Issue 3, pp 439–448 | Cite as

Association Between Financial Conflicts of Interests and Supportive Opinions for Erectile Dysfunction Treatment

  • Rafael Boscolo-Berto
  • Massimo Montisci
  • Silvia Secco
  • Carolina D’Elia
  • Rosella Snenghi
  • Guido Viel
  • Santo Davide Ferrara
Original Research


A conflict of interest (COI) is a situation in which a person has competing loyalties or interests that make it difficult to fulfil his or her duties impartially. Conflict of interest is not categorically improper in itself but requires proper management. A SCOPUS literature search was performed for publications on the efficacy/safety of Phospho-Di-Esterase Inhibitors (PDEIs) for treating erectile dysfunction. A categorization tool (CoOpCaT) was used to review and classify the publications as supportive/not-supportive for the discussed active ingredient and reporting or not reporting a COI for that specific drug or for the remaining PDEIs (i.e. competitors). Multivariable binary logistic regression was performed. In the 419 selected records the prevalence of supportive opinions was higher when a COI for the index label was declared. The CoOpCaT showed good internal consistency, discriminative validity and intra/inter-rater agreement. The strongest predictor for a supportive opinion was the total number of financial COIs for the index label. A mild protective effect of the total number of financial COIs for any competitor label was noted. Financial COIs have frequently been associated with bias, and the measures currently adopted to restrain it lack effectiveness. Some evidence for monitoring and/or compensating this bias is reported here, but the ultimate solution remains distant.


Sponsor Conflict of interest Bias Ethics Financial disclosure 



The authors wish to thank Thomas Dewis who assisted in the language editing of the manuscript.

Supplementary material

11673_2016_9732_MOESM1_ESM.docx (25 kb)
ESM 1 (DOCX 24 kb)


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Copyright information

© Journal of Bioethical Inquiry Pty Ltd. 2016

Authors and Affiliations

  • Rafael Boscolo-Berto
    • 1
  • Massimo Montisci
    • 1
  • Silvia Secco
    • 2
  • Carolina D’Elia
    • 3
  • Rosella Snenghi
    • 1
  • Guido Viel
    • 1
  • Santo Davide Ferrara
    • 1
  1. 1.Department of Cardiac, Thoracic and Vascular Sciences, Section of Legal MedicineUniversity Hospital of PadovaPadovaItaly
  2. 2.Department of UrologyOspedale Niguarda Cà GrandaMilanoItaly
  3. 3.Department of UrologyUniversity of VeronaVeronaItaly

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