Infection Control Programme, University of Geneva, Hospitals and Faculty of Medicine, WHO Collaborating Centre on Patient Safety (Infection Control and Improving Practices), Geneva, Switzerland.
Department of Infectious Diseases, Centro Hospitalar Lisboa Norte and Faculdade de Medicine da Universidade de Lisboa, Lisbon, Portugal.
Intensive Care Med. 2018 Oct;44(10):1679-1690. doi: 10.1007/s00134-018-5361-z. Epub 2018 Sep 11.
Conflicts of interest (COIs) do occur in healthcare research, yet their impact on research in the field of infection prevention and control (IPC) is unknown. We conducted a narrative review aiming to identify examples of COIs in IPC research. In addition to well-known instances, we conducted PubMed and Google searches to identify and report case studies of COIs in IPC and antimicrobial resistance (AMR), which were chosen arbitrarily following consensus meetings, to illustrate different types of COIs. We also searched the Retraction Watch database and blog to systematically identify retracted IPC and/or infectious disease-related papers. Our review highlights COIs in academic research linked to ties between industry and physicians, journal editors, peer-reviewed journals' choice for publication, and guideline committees participants and authors. It explores how COIs can affect research and could be managed. We also present several selected case studies that involve (1) the chlorhexidine industry and how it has used marketing trials and key opinion leaders to promote off-label use of its products; (2) the copper industry and how reporting of its trials in IPC have furthered their agenda; (3) the influence of a company developing "closed infusion systems" for catheters and how this affects networks in low- and middle-income countries and guideline development; (4) potential perverse incentives hospitals may have in reporting healthcare-associated infection or AMR rates and how government intervention may restrict AMR research for fear of bad publicity and subsequent negative economic consequences. Finally, the analysis of reasons for the retraction of previously published papers highlights the fact that misconduct in research may have other motivations than financial gain, the most visible form of COIs. COIs occur in the field of research in general, and IPC and AMR are no exceptions. Their effects pervade all aspects of the research and publication processes. We believe that, in addition to improvements in management strategies of COIs, increased public funding should be available to decrease researchers' dependency on industry ties. Further research is needed on COIs and their management.
利益冲突（COI）确实存在于医疗保健研究中，但它们对感染预防和控制（IPC）领域的研究的影响尚不清楚。我们进行了叙述性综述，旨在确定 IPC 研究中 COI 的实例。除了众所周知的情况外，我们还进行了 PubMed 和 Google 搜索，以识别和报告 IPC 和抗菌药物耐药性（AMR）方面的 COI 案例研究，这些研究是根据共识会议随意选择的，以说明不同类型的 COI。我们还搜索了 Retraction Watch 数据库和博客，以系统地识别撤回的 IPC 和/或传染病相关论文。我们的综述重点介绍了与工业界与医师、期刊编辑、同行评议期刊的出版选择以及指南委员会参与者和作者之间的联系相关的学术研究中的 COI。它探讨了 COI 如何影响研究以及可以如何进行管理。我们还介绍了几个选定的案例研究，其中涉及（1）洗必泰工业以及它如何利用营销试验和主要意见领袖来推广其产品的标签外使用；（2）铜工业以及其在 IPC 中的试验报告如何推进其议程；（3）开发用于导管的“密闭输液系统”的公司的影响以及这如何影响中低收入国家和指南制定的网络；（4）医院在报告医疗保健相关感染或 AMR 率方面可能存在的潜在不当激励措施，以及政府干预如何因担心负面宣传和随后的负面经济后果而限制 AMR 研究。最后，对先前发表论文撤回原因的分析强调了这样一个事实，即研究中的不当行为可能有比财务收益更明显的 COI 形式更多的其他动机。COI 存在于一般研究领域，IPC 和 AMR 也不例外。它们的影响渗透到研究和出版过程的各个方面。我们认为，除了改进 COI 的管理策略外，还应提供更多的公共资金，以减少研究人员对行业联系的依赖。需要进一步研究 COI 及其管理。
