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March 9, 2011

Reporting of Conflicts of Interest in Meta-analyses of Trials of Pharmacological Treatments

Author Affiliations

Author Affiliations: Departments of Psychiatry (Mss Roseman and Milette and Dr Thombs), Epidemiology, Biostatistics, and Occupational Health (Dr Thombs), and Medicine (Dr Thombs), McGill University, Montréal, Québec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada (Mss Roseman and Milette and Dr Thombs); Department of Clinical Pharmacy, School of Pharmacy and Institute for Health Policy Studies, School of Medicine, University of California, San Francisco (Dr Bero); Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, and Health Psychology Section, Department of Health Sciences, University Medical Center Groningen, University of Groningen, the Netherlands (Dr Coyne); School of Health Policy and Management, York University; Emergency Department, University Health Network; and Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada (Dr Lexchin); and Department of Psychiatry, Oregon Health and Science University, and Portland Veterans Affairs Medical Center, Portland (Dr Turner).

JAMA. 2011;305(10):1008-1017. doi:10.1001/jama.2011.257

Context Disclosure of conflicts of interest (COIs) from pharmaceutical industry study funding and author-industry financial relationships is sometimes recommended for randomized controlled trials (RCTs) published in biomedical journals. Authors of meta-analyses, however, are not required to report COIs disclosed in original reports of included RCTs.

Objective To investigate whether meta-analyses of pharmacological treatments published in high-impact biomedical journals report COIs disclosed in included RCTs.

Data Sources and Study Selection We selected the 3 most recent meta-analyses of patented pharmacological treatments published January 2009 through October 2009 in each general medicine journal with an impact factor of at least 10; in high-impact journals in each of the 5 specialty medicine areas with the greatest 2008 global therapeutic sales (oncology, cardiology, respiratory medicine, endocrinology, and gastroenterology); and in the Cochrane Database of Systematic Reviews.

Data Extraction Two investigators independently extracted data on disclosed study funding, author-industry financial ties, and author employment from each meta-analysis, from RCTs included in each meta-analysis, and on whether meta-analyses reported disclosed COIs of included RCTs.

Results Of 29 meta-analyses reviewed, which included 509 RCTs, only 2 meta-analyses (7%) reported RCT funding sources; and 0 reported RCT author-industry ties or employment by the pharmaceutical industry. Of 318 meta-analyzed RCTs that reported funding sources, 219 (69%) were industry funded; and 91 of 132 (69%) that reported author financial disclosures had 1 or more authors with pharmaceutical industry financial ties. In 7 of the 29 meta-analyses reviewed, 100% of included RCTs had at least 1 form of disclosed COI (pharmaceutical industry funding, author-industry financial ties, or employment), yet only 1 of these 7 meta-analyses reported RCT funding sources, and 0 reported RCT author-industry ties or employment.

Conclusion Among a group of meta-analyses of pharmacological treatments published in high-impact biomedical journals, information concerning primary study funding and author COIs for the included RCTs were only rarely reported.