Conflicts of Interest

利益冲突
  • 文章类型: Journal Article
    迷幻药是一组精神活性物质,它们会对意识产生复杂和主观的变化,并具有独特的安全性考虑。随着社会文化和政治接受度的提高,越来越多的工作正在调查使用迷幻药进行心理健康治疗。这种快速发展促使公司资助迷幻临床试验,导致相关研究和出版物中利益冲突的潜在增加。然而,迷幻药辅助心理治疗治疗精神疾病的安全性和有效性的证据尚在早期。人们担心在迷幻临床试验中引入偏见,并在公司参与之外选择性地报告结果。在迷幻药改革的关键时刻,本文探讨了与迷幻药相关的安全问题,财务利益相关者对安全结果报告的潜在影响以及平衡科学交流在维护公共卫生和安全方面的重要性。
    Psychedelics are a group of psychoactive substances which produce complex and subjective changes to consciousness and carry unique safety considerations. There is a growing body of work investigating the use of psychedelics for mental health treatment alongside increasing socio-cultural and political acceptance. This rapid evolution has prompted corporations to fund psychedelic clinical trials, leading to a potential rise in conflicts of interest in relevant studies and publications. However, the body of evidence for the safety and efficacy of psychedelic-assisted psychotherapy for psychiatric illnesses is early. There is concern regarding the introduction of bias in psychedelic clinical trials and the selective reporting of results amidst and beyond corporate involvement. At a crucial time in psychedelic drug reform, this paper explores the safety concerns associated with psychedelics, the potential influences of financial stakeholders on safety outcome reporting and the importance of balanced science communication in maintaining public health and safety.
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  • 文章类型: News
    背景:在线新闻出版物中医学研究报告的完整性对于明智的医疗保健决策和公共卫生话语至关重要。然而,遗漏,缺乏透明度,错误信息在数字和社交媒体平台上的迅速传播可能导致对研究结果的不完整或不准确理解。本研究旨在分析网络新闻在报道医学研究成果时的保真度,关注利益冲突,研究局限性,统计数据,和研究结论。
    方法:对发表在主要医学期刊上的50项随机对照试验及其相应的新闻报道进行了纳入利益冲突的评估,研究局限性,和新闻报道中的推论统计。对结论的一致性进行了评价。使用具有Bonferroni校正的二项检验来评估这些变量相对于90%阈值的包含率。
    结果:在10(20%)的新闻报道中报道了利益冲突,研究限制在14(28%),和19个(38%)的推论统计。这些比率显著低于90%阈值(p<0.001)。43例(86%)研究结论一致,与90%无显著差异(p=0.230)。由于夸大索赔而得出的结论不一致。
    结论:医学新闻文章中重要背景信息的报告存在显著差距。采用结构化的报告格式可以提高医学研究交流的质量和透明度。记者之间的合作,新闻机构,医学研究人员对于建立和推广最佳实践至关重要,促进知情的公共话语,和更好的健康结果。
    BACKGROUND: The integrity of medical research reporting in online news publications is crucial for informed healthcare decisions and public health discourse. However, omissions, lack of transparency, and the rapid spread of misinformation on digital and social media platforms can lead to an incomplete or inaccurate understanding of research findings. This study aims to analyze the fidelity of online news in reporting medical research findings, focusing on conflicts of interest, study limitations, statistical data, and research conclusions.
    METHODS: Fifty randomized controlled trials published in major medical journals and their corresponding news reports were evaluated for the inclusion of conflicts of interest, study limitations, and inferential statistics in the news reports. The alignment of conclusions was evaluated. A binomial test with a Bonferroni correction was used to assess the inclusion rate of these variables against a 90% threshold.
    RESULTS: Conflicts of interest were reported in 10 (20%) of news reports, study limitations in 14 (28%), and inferential statistics in 19 (38%). These rates were significantly lower than the 90% threshold (p<0.001). Research conclusions aligned in 43 (86%) cases, which was not significantly different from 90% (p=0.230). Misaligned conclusions resulted from overstating claims.
    CONCLUSIONS: Significant gaps exist in the reporting of critical contextual information in medical news articles. Adopting a structured reporting format could enhance the quality and transparency of medical research communication. Collaboration among journalists, news organizations, and medical researchers is crucial for establishing and promoting best practices, fostering informed public discourse, and better health outcomes.
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  • 文章类型: Journal Article
    背景:行业资金固有的利益冲突可能会使医学研究方法产生偏差,结果,报告和临床应用。这项研究探索了提供给美国医师研究人员的资金范围,这些研究人员研究了用于治疗子宫脱垂或压力性尿失禁的外科网状物,以及这笔资金是由研究人员宣布的,还是影响了同行评审期刊上产生的出版物的道德完整性。
    方法:通过Pubmed搜索(2014-2021)确定的术语网格和盆腔器官脱垂或压力性尿失禁,并与至少一位美国医师作者进行了审查。使用前一年这些MD收到的CMS开放支付数据库行业资金,在记录出版后,每个研究的资金申报和14项质量措施也是如此。
    结果:所审查的56项研究中有53项至少有一名美国医学博士作者在今年获得了行业资助,或出版前或出版后一年。对于47篇文章,没有宣布这笔资金。在247位医师作者中,60%收到>$100,而13%收到$100,000-$1,000,000,其中约60%未申报。虽然57%的研究明确得出结论,网格是安全的,只有39%的结果支持这一点。随访持续时间的质量指标或有关网状物安全性的总体陈述均未随声明状态而变化。
    结论:《期刊编辑》指南重新声明利益冲突没有得到遵循。行业在网格研究中的财务参与是广泛的,往往没有申报,并可能塑造的质量,得出的结论,导致临床实践中过度使用骨盆网状物和过度获益。
    BACKGROUND: Conflicts of interest inherent in industry funding can bias medical research methods, outcomes, reporting and clinical applications. This study explored the extent of funding provided to American physician researchers studying surgical mesh used to treat uterine prolapse or stress urinary incontinence, and whether that funding was declared by researchers or influenced the ethical integrity of resulting publications in peer reviewed journals.
    METHODS: Publications identified via a Pubmed search (2014-2021) of the terms mesh and pelvic organ prolapse or stress urinary incontinence and with at least one US physician author were reviewed. Using the CMS Open Payments database industry funding received by those MDs in the year before, of and after publication was recorded, as were each study\'s declarations of funding and 14 quality measures.
    RESULTS: Fifty-three of the 56 studies reviewed had at least one American MD author who received industry funding in the year of, or one year before or after publication. For 47 articles this funding was not declared. Of 247 physician authors, 60% received > $100 while 13% received $100,000-$1,000,000 of which approximately 60% was undeclared. While 57% of the studies reviewed explicitly concluded that mesh was safe, only 39% of outcomes supported this. Neither the quality indicator of follow-up duration nor overall statements as to mesh safety varied with declaration status.
    CONCLUSIONS: Journal editors\' guidelines re declaring conflicts of interest are not being followed. Financial involvement of industry in mesh research is extensive, often undeclared, and may shape the quality of, and conclusions drawn, resulting in overstated benefit and overuse of pelvic mesh in clinical practice.
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  • 文章类型: Journal Article
    背景:酒精行业组织在英国酒精政策中占据重要地位,但是公共卫生机构对他们的参与提出了质疑,理由是他们的经济目标与公共卫生目标之间存在利益冲突(COI)。在研究文献中,关于如何在健康研究和实践中概念化COI并减轻这种情况的争论正在进行。然而,特别是与酒精行业有关的这些问题受到的关注较少。本文探讨了酒精政策参与者之间关于COI的信念的异同,以及在英国公共卫生政策背景下与酒精行业接触的含义。
    方法:对包括医疗专业人员在内的一系列政策参与者(n=26)进行半结构化访谈,议员,公务员,学术研究人员,健康运动家,和酒精行业代表。对酒精行业代表的采访补充了对行业对公众咨询的反应的分析。使用NVivo软件对所有数据进行主题编码。
    结果:确定了两个相互竞争的“联盟”,表达对与酒精行业参与有关的COI的信念。这两个联盟都表达了与行业参与者类型有关的分歧和趋同的信念,参与形式,正在讨论的政策问题和政策过程的阶段。
    结论:酒精政策是一个复杂而有争议的空间,在这个空间中,政策参与者有不同的,对COI的细微差别和偶然理解,并确定与酒精行业参与相关的各种风险。在确定在酒精特定环境中理解和评估COI的收敛和转移领域时,这些发现将有助于决策者和非政府行为者制定政策和准则,以管理未来的潜在COI。
    BACKGROUND: Alcohol industry organisations occupy a prominent position in UK alcohol policy, but their involvement has been contested by public health bodies on the basis that a conflict of interest (COI) exists between their economic objectives and those of public health. There are ongoing debates in the research literature about how to conceptualise COI and mitigate this in health research and practise. However, less attention has been paid to these issues in relation to the alcohol industry specifically. This article explores similarities and differences in beliefs among alcohol policy actors regarding COI and the implications of engagement with the alcohol industry in the context of UK public health policy.
    METHODS: Semi-structured interviews with a range of policy actors (n=26) including medical professionals, parliamentarians, civil servants, academic researchers, health campaigners, and alcohol industry representatives. Interviews with alcohol industry representatives were supplemented with an analysis of industry responses to a public consultation. All data was thematically coded using NVivo software.
    RESULTS: Two competing \"coalitions\" were identified, expressing beliefs about COI linked to alcohol industry engagement. Both divergent and convergent beliefs were expressed by the two coalitions in relation to the type of industry actor, form of engagement, the policy issue under discussion and the stage of policy process.
    CONCLUSIONS: Alcohol policy is a complex and contested space in which policy actors have differing, nuanced and contingent understandings of COI and identify varying risks associated with alcohol industry engagement. In identifying the areas of convergence and diversion in both understanding and evaluation of COI in alcohol-specific settings, these findings will assist both decision-makers and non-governmental actors in developing policies and guidelines to manage potential COI in future.
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  • 文章类型: Editorial
    在不断发展的生物医学研究和出版领域,国际医学杂志编辑委员会的建议是维持道德标准的重要框架.通过提供一个适应技术进步的框架,国际医学杂志编辑委员会的建议积极塑造负责任和透明的做法,确保科学调查的完整性,并在不断变化的医学出版格局中促进全球合作。这篇社论深入探讨了国际医学期刊编辑委员会建议的最新变化的关键方面,专注于作者身份,利益冲突披露,数据共享和可重复性,医疗出版和碳排放,人工智能的使用,以及开放获取领域内掠夺性期刊带来的挑战。它强调了新建议的重要性,它代表了生物医学研究和出版领域不断发展的伦理指导的灯塔。
    In the ever-evolving landscape of biomedical research and publishing, the International Committee of Medical Journal Editors recommendations serve as a critical framework for maintaining ethical standards. By providing a framework that adapts to technological advancements, the International Committee of Medical Journal Editors recommendations actively shape responsible and transparent practices, ensuring the integrity of scientific inquiry and fostering global collaboration in the ever-evolving landscape of medical publishing. This editorial delves into key aspects of the latest changes in the International Committee of Medical Journal Editors recommendations, focusing on authorship, conflict of interest disclosure, data sharing and reproducibility, medical publishing and carbon emissions, the use of artificial intelligence, and the challenges posed by predatory journals within the realm of open access. It emphasizes the importance of new recommendations, which represent a beacon of ethical guidance in the ever-evolving domain of biomedical research and publishing.
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  • 文章类型: Journal Article
    本范围审查的目的是系统地审查有关非财务利益冲突(nfCOI)如何定义和评估的文献,以及在健康相关和生物医学期刊中提出的管理策略。PubMed,Embase,搜索了Scopus和WebofScience在1970年至2023年12月之间以英语发表的同行评审研究,这些研究至少解决了以下问题之一:定义,评估,或非财务利益冲突的管理。从658项研究中,190项研究纳入审查。nfCOI在经验中最常见的讨论(22%;42/190),理论(15%;29/190)和“其他”研究(18%;34/190)-包括评论,透视,和意见文章。nfCOI在研究领域得到了频繁的解决(36%;68/190),出版领域(29%;55/190)和临床实践领域(17%;32/190)。对nfCOI及其管理的态度分为两个不同的组。第一个更大的团体声称nfCOI有问题,需要某种形式的管理,而第二组认为nfCOI没有问题,因此,不需要管理。尽管关于自然的争论仍在继续,定义,和nfCOI的管理,这篇综述中包含的许多文章都同意需要认真考虑患病率,非金融COI的影响和最佳缓解。
    The objective of this scoping review was to systematically review the literature on how non-financial conflicts of interest (nfCOI) are defined and evaluated, and the strategies suggested for their management in health-related and biomedical journals. PubMed, Embase, Scopus and Web of Science were searched for peer reviewed studies published in English between 1970 and December 2023 that addressed at least one of the following: the definition, evaluation, or management of non-financial conflicts of interest. From 658 studies, 190 studies were included in the review. nfCOI were discussed most commonly in empirical (22%; 42/190), theoretical (15%; 29/190) and \"other\" studies (18%; 34/190) - including commentary, perspective, and opinion articles. nfCOI were addressed frequently in the research domain (36%; 68/190), publication domain (29%; 55/190) and clinical practice domain (17%; 32/190). Attitudes toward nfCOI and their management were divided into two distinct groups. The first larger group claimed that nfCOI were problematic and required some form of management, whereas the second group argued that nfCOI were not problematic, and therefore, did not require management. Despite ongoing debates about the nature, definition, and management of nfCOI, many articles included in this review agreed that serious consideration needs to be given to the prevalence, impact and optimal mitigation of non-financial COI.
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  • 文章类型: Journal Article
    轻推,一种以可预测的方式改变人们行为的有争议的技术,声称在保护选择自由的同时影响它。轻推在很大程度上仅限于促进健康饮食选择等情况,但在2019年冠状病毒病(COVID-19)危机中被采用,转向涉及显著减少选择的措施,比如推挤和行为刺激。共享决策(SDM)直接参与和自治的方法,是一种沟通风险的替代方法。主要来自PubMed等标准文献数据库的同行评审科学出版物,PsycInfo,和Psyndex在叙述性审查中进行了评估。所谓的恐惧轻推,以及传播强烈的情绪化或道德化信息可能导致强烈的心理-生理压力。在COVID-19大流行期间,专业单位使用这些推动产生了一种恐惧的社会氛围,导致人口的身心健康恶化。德国COVID-19快照监测(COSMO)研究的主要建议,基于轻推和强制措施的要素,不遵守道德原则,基本的心理学原则,或基于证据的数据。SDM在COVID-19危机中被滥用,这有助于实现政府的片面目标。批评强调功利主义思想,并通过使用道德脱离接触的概念和应对策略的成熟度来解释决策者的不道德行为。应该回到一个开放式的,民主,和不使用轻推的多元化科学辩论。因此,有必要回到SDM的起源。
    Nudging, a controversial technique for modifying people\'s behavior in a predictable way, is claimed to preserve freedom of choice while simultaneously influencing it. Nudging had been largely confined to situations such as promoting healthy eating choices but has been employed in the coronavirus disease 2019 (COVID-19) crisis in a shift towards measures that involve significantly less choice, such as shoves and behavioral prods. Shared decision making (SDM), a method for direct involvement and autonomy, is an alternative approach to communicate risk. Predominantly peer-reviewed scientific publications from standard literature databases like PubMed, PsycInfo, and Psyndex were evaluated in a narrative review. The so-called fear nudges, as well as the dissemination of strongly emotionalizing or moralizing messages can lead to intense psycho-physical stress. The use of these nudges by specialized units during the COVID-19 pandemic generated a societal atmosphere of fear that precipitated a deterioration of the mental and physical health of the population. Major recommendations of the German COVID-19 Snapshot Monitoring (COSMO) study, which are based on elements of nudging and coercive measures, do not comply with ethical principles, basic psychological principles, or evidence-based data. SDM was misused in the COVID-19 crisis, which helped to achieve one-sided goals of governments. The emphasis on utilitarian thinking is criticized and the unethical behavior of decision makers is explained by both using the concept of moral disengagement and the maturity level of coping strategies. There should be a return to an open-ended, democratic, and pluralistic scientific debate without using nudges. It is therefore necessary to return to the origins of SDM.
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  • 文章类型: Journal Article
    目的:我们之前描述了欧洲药品管理局(EMA)和美国食品和药物管理局的指南,每个都有一个特定的精神病适应症,关于如何设计用于新药应用的关键药物试验。这里,我们报告了我们3年来从EMA检索利益冲突声明的努力。我们希望评估潜在的内部行业影响力,该影响力被判断为具有行业利益冲突的指南委员会成员的比例。
    方法:我们于2020年2月提交了信息自由请求,以访问EMA的委员会成员名单(及其宣布的利益冲突),该名单涉及起草13个“临床疗效和安全性”有关精神病适应症的指南。在我们的请求中,我们没有指定确切的EMA委员会。这里,我们描述收到的文件,并报告具有行业利益(即定义为任何金融行业关系)的成员比例。这是我们第一份报告(http://doi.org/10.1017/S2045796021000147)的后续文件。
    结果:经过2年零9个月(2022年11月),EMA向我们发送了2012年,2013年和2017年人用医药产品委员会(CHMP)的成员名单和相应的利益冲突声明.这些成员名单与13项要求的指南中的3项(精神分裂症,抑郁症和自闭症谱系障碍)。剩下的10个指南在2011年之前发布,EMA表示他们需要获得专家成员的许可(检索率未知),并预见工作量过多和漫长的等待。因此,我们撤回了我们的请求。2012年,2013年和2017年的CHMP拥有34至36名成员;39%-44%的人宣布了任何利益,我们认为14%-18%的人具有行业利益。对于精神分裂症指南,我们向提交了对该指南的反馈意见的公司确定了两名具有行业兴趣的成员。我们没有收到中枢神经系统(CNS)工作组的声明,CHMP任命了专家组,负责起草并将反馈纳入指南。
    结论:经过近3年,我们收到了消息,仅部分满足了我们的要求。我们建议EMA通过直接在“临床疗效和安全性”指南中发布作者姓名及其相应的利益冲突声明来提高透明度,并且在1年后不要从其网站上删除利益冲突声明,以降低在制定这些有影响力的指南期间隐身企业影响力的风险。
    OBJECTIVE: We have previously described the European Medicines Agency\'s (EMA) and the US Food and Drug Administration\'s guidelines, each for a specific psychiatric indication, on how to design pivotal drug trials used in new drug applications. Here, we report on our efforts over 3 years to retrieve conflicts of interest declarations from EMA. We wanted to assess potential internal industry influence judged as the proportion of guideline committee members with industry conflicts of interest.
    METHODS: We submitted Freedom of Information requests in February 2020 to access EMA\'s lists of committee members (and their declared conflicts of interest) involved in drafting the 13 \'Clinical efficacy and safety\' guidelines available on EMA\'s website pertaining to psychiatric indications. In our request, we did not specify the exact EMA committees. Here, we describe the received documents and report the proportion of members with industry interests (i.e. defined as any financial industry relationship). It is a follow-up paper to our first report (http://doi.org/10.1017/S2045796021000147).
    RESULTS: After 2 years and 9 months (November 2022), the EMA sent us member lists and corresponding conflicts of interest declarations from the Committee for Medicinal Products for Human use (CHMP) from 2012, 2013 and 2017. These member lists pertained to 3 of the 13 requested guidelines (schizophrenia, depression and autism spectrum disorder). The 10 remaining guidelines were published before 2011 and EMA stated that they needed to require permission from their expert members (with unknown retrieval rate) and foresaw excessive workload and long wait. Therefore, we withdrew our request. The CHMPs from 2012, 2013 and 2017 had from 34 to 36 members; 39%-44% declared any interests and we judged 14%-18% as having industry interests. For the schizophrenia guideline, we identified two members with industry interests to companies who submitted feedback on the guideline. We did not receive declarations from the Central Nervous System (CNS) Working Party, the CHMP appointed expert group responsible for drafting and incorporating feedback into the guidelines.
    CONCLUSIONS: After almost 3 years, we received information, which only partly addressed our request. We recommend EMA to improve transparency by publishing the author names and their corresponding conflicts of interest declarations directly in the \'Clinical efficacy and safety\' guidelines and to not remove conflicts of interest declarations after 1 year from their website to reduce the risk of stealth corporate influence during the development of these influential guidelines.
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  • 文章类型: Journal Article
    机器人全膝关节置换术(R-TKA)的使用率和营销继续上升。我们检查了外科医生网站上关于R-TKA益处的营销,并试图确定这些索赔是否得到现有文献的支持。
    谷歌搜索确定了10个医生网站,这些网站来自美国5个最大的市场,每个市场的人口都有“机器人全膝关节置换术城市”,状态。“对网站上有关R-TKA的声明进行了分类。对2012-2022年的文献进行了“针对”或“针对”每个索赔的数据审查。收集每个出版物的证据水平。
    捕获了50个网站,其中包括59名外科医生。68%的网站提到了特定的R-TKA平台。关于机器人技术的网站声明被分为8个主要类别。文献综述支持更精确/准确的主张,减少对组织的伤害,与“反对”索赔相比,更多的文献“为”的痛苦更少。
    在医生网站上提出的关于R-TKA益处的声明是可变的,并且没有得到现有文献的明确支持。大多数可用的数据可以分为证据级别III,IV,和V.缺乏支持各种营销声明的一级证据。医师应了解其网站上提出的主张以及可用于支持或反驳这些特定主张的文献。
    UNASSIGNED: Robotic total knee arthroplasty (R-TKA) utilization and marketing continue to rise. We examined the marketing on surgeon websites regarding R-TKA benefits and sought to determine if the claims were supported by existing literature.
    UNASSIGNED: A Google search identified 10 physician websites from each of the 5 largest U.S. markets by population with the term \"robotic total knee arthroplasty city, state.\" Claims on websites about R-TKA were categorized. Literature from 2012-2022 was reviewed for data \"for\" or \"against\" each claim. Level of evidence for each publication was collected.
    UNASSIGNED: Fifty websites were captured that included 59 surgeons. A specific R-TKA platform was mentioned on 68% of websites. Website claims about robotics were placed into 8 major categories. Literature review supported the claims of more precise/accurate, reduced injury to tissue, and less pain with more literature \"for\" than \"against\" the claims.
    UNASSIGNED: Claims made on physician websites regarding the benefits of R-TKA are variable and not definitively supported by existing literature. Most available data can be categorized into levels of evidence III, IV, and V. There is a paucity of level I evidence to support the various marketing statements. Physicians should be cognizant of both the claims made on their websites and the literature that could be used to support or refute those specific claims.
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  • 文章类型: Journal Article
    背景:制药公司和医生之间的财务互动导致利益冲突。这项研究调查了2016年至2020年间日本制药公司向董事会认证的过敏症患者支付的非研究费用的程度和趋势。
    方法:对日本药品制造商协会下属制药公司披露的支付数据进行了回顾性分析。这项研究的重点是讲座的非研究费用,咨询,以及2016年至2020年向董事会认证的变态反应学家起草的手稿。我们对付款数据进行了描述性分析。使用广义估计方程模型对趋势进行了分析。
    结果:在3,943名经董事会认证的过敏症专科医生中,2,398(60.8%)在五年内获得了总计4,340万美元的非研究付款。演讲费占付款总额的85.7%(3720万美元)。对于至少收到一笔付款的过敏症患者,每位过敏症患者的中位数为3,106美元(四分位数范围:966-12,124美元),相比之下,五年期间的平均值为18092美元(标准偏差:49233美元)。这些过敏症患者中排名前1%和10%的患者占所有非研究费用的20.8%和68.8%,分别。年度付款金额大幅增加7.2%(95%CI:4.4-10.0%,p<0.001),直到2019年,但在COVID-19大流行期间,2020年出现显著下降。
    结论:大多数过敏症患者获得了非研究费用,在一小群人中有明显的浓度。在大流行爆发之前,付款每年都在增加,这与大幅下降相吻合。需要进一步的研究来探索这些财务互动对日本临床实践和患者护理的影响。
    Financial interactions between pharmaceutical companies and physicians lead to conflicts of interest. This study examines the extent and trends of non-research payments made by pharmaceutical companies to board-certified allergists in Japan between 2016 and 2020.
    A retrospective analysis of disclosed payment data from pharmaceutical companies affiliated with the Japanese Pharmaceutical Manufacturers Association was conducted. The study focused on non-research payments for lecturing, consulting, and manuscript drafting made to board-certified allergists from 2016 to 2020. We performed descriptive analyses on payment data. Trends were analyzed using generalized estimating equation models.
    Of the 3,943 board-certified allergists, 2,398 (60.8%) received non-research payments totaling $43.4 million over five years. Lecturing fees comprised 85.7% ($37.2 million) of the total payment amounts. For allergists who received at least one payment, the median amount per allergist was $3,106 (interquartile range: $966 - $12,124), in contrast to a mean of $18,092 (standard deviation: $49,233) over the five-year span. The top 1% and 10% of these allergists accounted for 20.8% and 68.8% of all non-research payments, respectively. The annual payment amounts significantly increased by 7.2% annual increase (95% CI: 4.4 - 10.0%, p < 0.001) each year until 2019, but saw a significant decrease in 2020 amid the COVID-19 pandemic.
    The majority of allergists received non-research payments, with a notable concentration among a small group. Payments increased annually until the pandemic\'s onset, which coincided with a substantial decrease. Further research is needed to explore the implications of these financial interactions on clinical practice and patient care in Japan.
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