Andreatos Nikolaos, Zacharioudakis Ioannis M, Zervou Fainareti N, Muhammed Maged, Mylonakis Eleftherios
aDivision of Infectious Disease, Rhode Island Hospital bWarren Alpert Medical School of Brown University, Providence, RI, USA.
Medicine (Baltimore). 2017 Jan;96(2):e5711. doi: 10.1097/MD.0000000000005711.
There is a substantial effort to increase the accuracy of conflicts of interest (COI) reporting, and reduce the influence of COI between physicians and industry, especially as it relates to clinical practice guidelines.We used the newly implemented Open Payments dataset to evaluate the accuracy of COI disclosures of authors of clinical practice guidelines that were either newly published or revised within 2014 and were included in the National Guideline Clearinghouse (NGC) website (maintained by the U.S. Department of Health and Human Services). Authors were considered as having inaccurate COI disclosure if they had not reported all companies from which they had received funds >$5000 in the 12 months preceding the guideline's publication.We identified 223 guidelines that were either newly published (109/223; 48.9%) or revised (114/223; 51.1%) within 2014 and were included in the NGC website. Among the 1329 guideline authors with available Open Payments data, 523 received >$5000 from at least 1 healthcare-associated entity. However, only 56 out of the 523 authors (10.7%) were found to have accurate COI disclosure. The percentage of authors with accurate COI disclosure in revised guidelines was significantly lower than in newly published guidelines (6.8% vs 14.3%; P < 0.01) and was also found to differ between specialties. Furthermore, authors were less likely to inaccurately disclose "research payments" (37/49, 75.5%) compared to "general payments" (488/559, 87.3%, P = 0.02) as well as "other/associated research funding" (430/506, 85.0%, P = 0.08). No statistically significant association was detected between funding amount and disclosure accuracy.The majority of guideline authors lacked significant COIs, but among authors that received significant funds from at least 1 healthcare-associated entity the frequency of accurate disclosure was low. These findings indicate that the current process of disclosing COIs may be suboptimal and a proactive approach should be adopted in order to minimize COI reporting discrepancies. Furthermore, every effort should be undertaken to ensure the completeness and accuracy of the data recorded in the Open Payments database.
人们正在付出巨大努力来提高利益冲突（COI）报告的准确性，并减少医生与行业之间利益冲突的影响，尤其是与临床实践指南相关的利益冲突。我们使用新实施的公开支付数据集来评估2014年新发布或修订并被纳入国家指南交换中心（NGC）网站（由美国卫生与公众服务部维护）的临床实践指南作者的利益冲突披露准确性。如果作者在指南发布前12个月内未报告所有他们从其获得超过5000美元资金的公司，则被视为利益冲突披露不准确。我们确定了223份在2014年内新发布（109/223；48.9%）或修订（114/223；51.1%）并被纳入NGC网站的指南。在1329名有公开支付数据的指南作者中，523人从至少1个医疗相关实体获得了超过5000美元。然而，在这523名作者中，只有56人（10.7%）被发现利益冲突披露准确。修订指南中利益冲突披露准确的作者比例显著低于新发布的指南（6.8%对14.3%；P<0.01），并且在不同专业之间也存在差异。此外，与“一般支付”（488/559，87.3%，P=0.02）以及“其他/相关研究资金”（430/506，85.0%，P=0.08）相比，作者不准确披露“研究支付”的可能性较小（37/49，75.5%）。未检测到资金数额与披露准确性之间存在统计学上的显著关联。大多数指南作者没有重大利益冲突，但在从至少1个医疗相关实体获得大量资金的作者中，准确披露的频率较低。这些发现表明，当前的利益冲突披露过程可能并不理想，应采取积极主动的方法以尽量减少利益冲突报告差异。此外，应尽一切努力确保公开支付数据库中记录的数据的完整性和准确性。
