Stohl William, Parikh Krishan
University of Southern California Keck School of Medicine, Los Angeles.
University of Southern California, Los Angeles.
ACR Open Rheumatol. 2023 Nov;5(11):609-618. doi: 10.1002/acr2.11609. Epub 2023 Sep 7.
A skewed percentage of industry payments goes to "key opinion leaders" (KOLs) whose prominence and influence has increased with time. Given that KOL is neither precisely defined nor quantifiable, we turned to the level of industry payments as a surrogate quantifiable metric and assessed the associations between industry payments to US rheumatologists and their authorships of publications in high-impact rheumatology journals.
Payments to US rheumatologists during the 2015-2020 interval were obtained from the Centers for Medicare and Medicaid Services Open Payments database, and authorships were tallied for calendar year 2021 publications in the four rheumatology journals (Lancet Rheumatol, Nat Rev Rheumatol, Ann Rheum Dis, Arthritis Rheumatol) with the highest 2021 journal impact factors and journal citation indicators. Differences between groups were determined by chi-squared test, unpaired Student's t-test, one-way analysis of variance (ANOVA), Mann-Whitney rank sum test, and Kruskal-Wallis one-way ANOVA on ranks. Correlations were calculated using Spearman rank order. A P value ≤0.05 was considered significant.
There were 278 individual US rheumatologists who received industry payments and served as authors of publications in the four high-impact rheumatology journals. Non-research-associated payments to these individuals strongly correlated with research-associated payments. Payments to male US rheumatologists were greater than those to their female counterparts, and payments strongly correlated with the number of publications among male authors but only weakly, and often not significantly, among female authors.
A substantial fraction of the authorships in calendar year 2021 publications in four high-impact rheumatology journals arose from a very small percentage of all US rheumatologists who had received industry payments during the 2015-2020 interval. Payments to male US rheumatologist-authors were strikingly different from those to female US rheumatologist-authors, and further investigation is needed to explain the glaring difference in payments.
医药行业支付款项的比例偏向于“关键意见领袖”（KOLs），这些人的知名度和影响力随时间推移而增加。鉴于KOL既没有被精确界定，也无法量化，我们将行业支付水平作为一个可替代的可量化指标，并评估了美国风湿病学家获得的行业支付与其在高影响力风湿病学期刊上发表文章之间的关联。
从医疗保险和医疗补助服务中心公开支付数据库获取2015 - 2020年间美国风湿病学家的收入情况，并统计2021年在四种2021年期刊影响因子和期刊引用指标最高的风湿病学期刊（《柳叶刀·风湿病学》《自然综述·风湿病学》《风湿病学年鉴》《关节炎与风湿病》）上发表文章的作者情况。通过卡方检验、非配对学生t检验、单因素方差分析（ANOVA）、曼 - 惠特尼秩和检验以及克鲁斯卡尔 - 沃利斯单因素秩方差分析来确定组间差异。使用斯皮尔曼等级顺序计算相关性。P值≤0.05被认为具有统计学意义。
有278名美国风湿病学家获得了行业支付，并在这四种高影响力风湿病学期刊上发表文章。这些人获得的与研究无关的支付与研究相关的支付密切相关。美国男性风湿病学家获得的支付高于女性同行，支付与男性作者的发文数量密切相关，但与女性作者的发文数量相关性较弱，且往往不显著。
2021年在四种高影响力风湿病学期刊上发表文章的作者中，很大一部分来自2015 - 2020年间获得行业支付的美国风湿病学家中的一小部分。美国男性风湿病学家作者获得的支付与女性风湿病学家作者获得的支付存在显著差异，需要进一步调查来解释这种明显的支付差异。
