资金对评估膝关节骨关节炎粘弹性补充疗法的研究没有影响：一项文献计量学和利益冲突的系统评价
Funding has no effect on studies evaluating viscosupplementation for knee osteoarthritis: A systematic review of bibliometrics and conflicts of interest.
作者信息
Via Garrhett Glenn, Brueggeman David Anthony, Lyons Joseph Gabriel, Frommeyer Timothy Charles, Froehle Andrew William, Krishnamurthy Anil Bangalore
机构信息
Wright State University Department of Orthopaedic Surgery, 30 E. Apple St., Ste 2200, Dayton, OH, 45409, USA.
出版信息
J Orthop. 2023 Apr 4;39:18-29. doi: 10.1016/j.jor.2023.03.015. eCollection 2023 May.
BACKGROUND
Viscosupplementation for knee osteoarthritis (OA) may raise concerns regarding conflicts of interest (COI). Evidence of inconclusive study results and publication bias in previous studies has led to concern that financial COI have influenced viscosupplementation outcomes. It is critical to ensure that clinical practice is guided by informed decision making and evidence-based medicine.
METHODS
A systematic review was conducted following PRISMA guidelines. PubMed, MEDLINE, and Web of Science databases were searched for articles pertaining to hyaluronic acid (or similarly derived) injections to native knees with primary OA only. Bibliometric data, financial COI, and study outcomes were assessed.
RESULTS
67 studies met inclusion criteria for analysis, 53 of which (79.1%) presented Level I evidence, and 21 of which (31.3%) reported at least one author with COI. All studies reporting COI also disclosed industry funding. There were no relationships between reported COI and study outcomes ( = 0.31, = 0.577), levels of evidence ( = 3.48, = 0.176), or relative citation ratio (RCR) (S = 743, = 0.591). Studies reporting COIs/industry funding tended to be published in journals with significantly higher impact factors (IF) (reporting COI: IF = 3.5 ± 2.0; no COI: IF = 1.8 ± 1.1; S = 950, < 0.001). Study outcomes were not related to the probability of being published in an open access journal ( = 0.01, = 0.960), nor to level of evidence ( = 2.67, = 0.263), RCR (S = 618, = 0.835), or IF (S = 563, = 0.655).
CONCLUSIONS
Investigator COIs (and commercial funding of studies) have not significantly influenced the frequency of favorable outcomes or study level of evidence regarding contemporary viscosupplementation for the treatment of knee OA. Studies reporting COIs/industry funding tended to be published in journals with significantly higher impact factors. Results overwhelmingly supported using viscosupplementation to treat knee OA.
LEVEL OF EVIDENCE
Level V Systematic Review.
背景
膝关节骨关节炎（OA）的粘弹性补充治疗可能引发对利益冲突（COI）的担忧。既往研究中不确定的研究结果及发表偏倚的证据引发了人们对经济利益冲突是否影响粘弹性补充治疗效果的担忧。确保临床实践以明智的决策和循证医学为指导至关重要。
方法
按照PRISMA指南进行系统评价。检索PubMed、MEDLINE和Web of Science数据库，查找仅针对原发性OA天然膝关节注射透明质酸（或类似衍生物）的相关文章。评估文献计量数据、经济利益冲突和研究结果。
结果
67项研究符合纳入分析标准，其中53项（79.1%）提供了I级证据，21项（31.3%）报告至少有一位作者存在利益冲突。所有报告利益冲突的研究也披露了行业资助情况。报告的利益冲突与研究结果（χ² = 0.31，P = 0.577）、证据水平（χ² = 3.48，P = 0.176）或相对引用率（RCR）（S = 743，P = 0.591）之间均无关联。报告存在利益冲突/行业资助的研究往往发表在影响因子显著更高的期刊上（报告利益冲突：影响因子 = 3.5 ± 2.0；无利益冲突：影响因子 = 1.8 ± 1.1；S = 950，P < 0.001）。研究结果与在开放获取期刊上发表的可能性（χ² = 0.01，P = 0.960）、证据水平（χ² = 2.67，P = 0.263）、RCR（S = 618，P = 0.835）或影响因子（S = 563，P = 0.655）均无关联。
结论
研究者的利益冲突（以及研究的商业资助）并未显著影响当代膝关节OA粘弹性补充治疗的良好结局频率或研究证据水平。报告存在利益冲突/行业资助的研究往往发表在影响因子显著更高的期刊上。结果压倒性地支持使用粘弹性补充治疗膝关节OA。
证据水平
V级系统评价
Zotero 插件