Blog | Thursday, February 7, 2013

QD: News Every Day--Study finds financial bias does not impact outcomes of largest cardiovascular trials

Research authors' self-declared financial conflicts of interest do not seem to impact outcomes of the largest cardiovascular trials that are published in three high-impact medical journals, a study found.

Cardiologists were twice as likely as family practitioners to receive industry payments, the authors began, because cardiologists are viewed by industry as opinion leaders and as being more likely to be involved in research.

So, the authors reviewed the results of major, potentially practice-altering cardiovascular trials published from January 2000 through April 200 in The New England Journal of Medicine, Lancet, and JAMA. Results appeared in the Journal of the American College of Cardiology.

Of the 550 articles that met eligibility criteria, 51.1% satisfied financial conflict of interest criteria, including stock ownership, employment, and being on a speaker’s bureau or a consultant. (Research funding was not deemed a conflict.)

Prevalence of financial conflicts of interest significantly increased with level of industry funding: 21.5% (none), 50.0% (shared), 75.0% (industry solely, n=281, P less than 0.0001). However, no differences in reporting of favorable results were detected when articles were analyzed by self-declared financial conflicts (60.5% in those studies with conflicts compared to 59.5% in those without, unadjusted odds ratio [OR], 1.04; P=0.81).

In an editorial, Robert M. Califf, MD, FACP, noted that the lack of influence of industry finding would surprise many observers.

But, he added, the study was limited to three high-impact journals that may not be representative of the rest of the medical literature, and that less prestigious journals might be more susceptible to either positive publication bias or to inaccurate reporting of financial conflicts.

Dr. Califf continued that a centralized format for reporting financial conflicts, as well as a way of reporting non-financial conflicts such as work on competing projects, would further bolster reporting in the medical literature.

He wrote, "The comprehensive availability of journal contents, combined with the increasingly granular data available via the registry, could enable both the clinical community and patient advocates to monitor bias--including bias arising from less obvious sources than financial conflicts."