Milner Lauren C, Cho Mildred K
Center for the Integration of Research on Genetics and Ethics (CIRGE), Stanford Center for Biomedical Ethics, Stanford University, 1215 Welch Road, Modular A, Stanford, CA 94305.
Center for the Integration of Research on Genetics and Ethics (CIRGE), Stanford Center for Biomedical Ethics, Stanford University, 1215 Welch Road, Modular A, Stanford, CA 94305, Tel: (650) 725-7993,
AJOB Prim Res. 2014 Jan 1;5(1):44-55. doi: 10.1080/21507716.2013.811315.
Biomedical research is influenced by many factors, including the involvement of stakeholder groups invested in research outcomes. Stakeholder involvement in research efforts raise questions of justice as their specific interests and motivations play a role in directing research resources that ultimately produce knowledge shaping how different conditions (and affected individuals) are understood and treated by society. This issue is highly relevant to child psychiatry research where diagnostic criteria and treatment strategies are often controversial. Biological similarities and stakeholder differences between attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) provide an opportunity to explore this issue by comparing research foci and stakeholder involvement in these conditions.
A subset of ADHD and ASD research articles published between 1970-2010 were randomly selected from the PubMed database and coded for research focus, funding source(s), and author-reported conflicts of interest (COIs). Chi-square analyses were performed to identify differences between and within ADHD and ASD research across time.
The proportion of ADHD research dedicated to basic, description, and treatment research was roughly similar and remained stable over time, while ASD research showed a significant increase in basic research over the past decade. Government was the primary research funder for both conditions, but for-profit funders were a notable presence in ADHD research, while joint-funding efforts between non-profit and government funders were a notable presence in ASD research. Lastly, COIs were noted more frequently in ADHD than in ASD research.
Our study shows significant differences in research foci and funding sources between the conditions, and identifies the specific involvement of for-profit and non-profit groups in ADHD and ASD, respectively. Our findings highlight the relationship between stakeholders outside the research community and research trajectories and suggest that examinations of these relationships must be included in broader considerations of biomedical research ethics.
生物医学研究受到多种因素的影响，包括对研究成果感兴趣的利益相关者群体的参与。利益相关者参与研究工作引发了公正性问题，因为他们的特定利益和动机在引导研究资源方面发挥着作用，而这些资源最终产生的知识塑造了社会对不同病症（以及受影响个体）的理解和治疗方式。这个问题与儿童精神病学研究高度相关，因为诊断标准和治疗策略往往存在争议。注意缺陷多动障碍（ADHD）和自闭症谱系障碍（ASD）之间的生物学相似性以及利益相关者差异，为通过比较这些病症的研究重点和利益相关者参与情况来探讨这一问题提供了契机。
从PubMed数据库中随机选取1970年至2010年间发表的一部分ADHD和ASD研究文章，并对研究重点、资金来源以及作者报告的利益冲突（COI）进行编码。进行卡方分析以确定ADHD和ASD研究在不同时间之间以及内部的差异。
致力于基础研究、描述性研究和治疗研究的ADHD研究比例大致相似，且随时间保持稳定，而ASD研究在过去十年中基础研究显著增加。政府是这两种病症研究的主要资助者，但营利性资助者在ADHD研究中占显著比例，而非营利性和政府资助者之间的联合资助在ASD研究中占显著比例。最后，ADHD研究中利益冲突的记录比ASD研究更频繁。
我们的研究表明这两种病症在研究重点和资金来源方面存在显著差异，并分别确定了营利性和非营利性团体在ADHD和ASD研究中的具体参与情况。我们的研究结果突出了研究界之外的利益相关者与研究轨迹之间的关系，并表明在更广泛地考虑生物医学研究伦理时必须纳入对这些关系的审视。
