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纤维肌痛药物治疗随机对照试验中的利益冲突及其与结果和质量的关联。

Financial conflicts of interest and their association with outcome and quality of fibromyalgia drug therapy randomized controlled trials.

作者信息

Pang Winnie K, Yeter Karen C, Torralba Karina D, Spencer Horace J, Khan Nasim A

机构信息

University of Southern California-Los Angeles County Medical Center, Los Angeles, CA, USA.

Loma Linda University, Loma Linda, CA, USA.

出版信息

Int J Rheum Dis. 2015 Jul;18(6):606-15. doi: 10.1111/1756-185X.12607. Epub 2015 May 27.

Abstract

AIMS

To evaluate the association of financial conflicts of interest (FCOI) with the characteristics, outcome and reported methodological quality of fibromyalgia drug therapy randomized controlled trials (FM-RCTs).

METHODS

A cross-sectional study of original, parallel-group, drug therapy FM-RCTs published between 1997 and 2011 from Medline and Cochrane Central Register of Controlled Trials was conducted. Two reviewers independently assessed each RCT for funding source, authors' FCOI(s), study characteristics, reporting of methodological measures important for internal validity and outcome (positive [statistically significant result favoring experimental drug for the primary outcome] or non-positive).

RESULTS

Forty-seven RCTs were eligible with funding source as: 26 (55.3%) industry; eight (17%) non-profit source(s); five (10.6%) mixed; and eight (17%) unspecified. Industry-funded RCTs were more likely to be multicenter and enroll greater number of patients. Reporting of key methodological measures was suboptimal; however, industry and non-profit funded RCTs did not differ in their reporting. Thirty (63.8%) RCTs had ≥ one author who disclosed an FCOI (receipt of research grant [21, 44.7%], industry sponsor employee [20, 42.6%], receipt of consultancy fee/honorarium [16, 34%] and stock ownership [11, 23.4%]). Although industry funding and certain authors' FCOIs (employment and receipt of consultancy fee/honorarium) were univariately associated with positive outcome, such association was not observed after adjusting for study sample size.

CONCLUSIONS

The majority of FM-RCTs were industry-sponsored, and had at least one author with an FCOI. Reporting of key methodological measures was suboptimal. After adjusting for study sample size, no association of industry funding or author's FCOI with study outcome was seen.

摘要

目的

评估财务利益冲突(FCOI)与纤维肌痛药物治疗随机对照试验(FM-RCTs)的特征、结果及报告的方法学质量之间的关联。

方法

对1997年至2011年间发表于Medline和Cochrane对照试验中央注册库的原始、平行组、药物治疗FM-RCTs进行横断面研究。两名评审员独立评估每项随机对照试验的资金来源、作者的财务利益冲突、研究特征、对内部有效性和结果重要的方法学措施报告(阳性[主要结局有利于试验药物的统计学显著结果]或非阳性)。

结果

47项随机对照试验符合条件,资金来源如下:26项(55.3%)由行业资助;8项(17%)由非营利来源资助;5项(10.6%)混合资助;8项(17%)未明确说明。行业资助的随机对照试验更有可能是多中心的,且纳入的患者数量更多。关键方法学措施的报告并不理想;然而,行业资助和非营利资助的随机对照试验在报告方面没有差异。30项(63.8%)随机对照试验有≥1名作者披露了财务利益冲突(获得研究资助[21项,44.7%]、行业赞助商员工[20项,42.6%]、获得咨询费/酬金[16项,34%]和持股[11项,23.4%])。尽管行业资助和某些作者的财务利益冲突(受雇及获得咨询费/酬金)单因素分析与阳性结果相关,但在调整研究样本量后未观察到这种关联。

结论

大多数FM-RCTs由行业资助,且至少有一名作者存在财务利益冲突。关键方法学措施的报告并不理想。在调整研究样本量后,未发现行业资助或作者的财务利益冲突与研究结果之间存在关联。

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