The impact of disclosing financial ties in research and clinical care: a systematic review.

BACKGROUND Despite increased demand for disclosure of physician and researcher financial ties (FTs) to industry, little is known about patients', research participants', or journal readers' attitudes toward FTs. METHODS We systematically reviewed original, quantitative studies of patients', research participants', or journal readers' views about FTs to pharmaceutical and medical device companies. The MEDLINE, Scopus, and Web of Knowledge databases were searched for English-language studies containing original, quantitative data on attitudes toward FTs. We screened 6561 citations and retrieved 244 potentially eligible abstracts. Of these, 20 met inclusion criteria. RESULTS Eleven studies assessed FTs and perceptions of quality. In clinical care, patients believed FTs decreased the quality and increased the cost of care. In research, FTs affected perceptions of study quality. In 2 studies, readers' perceptions of journal article quality decreased after disclosure of FTs. Eight studies assessed the acceptability of FTs. Patients were more likely to view personal gifts to physicians as unacceptable, compared with professional gifts. In 6 of the 10 studies that assessed the importance of disclosure, most patients and research participants believed FTs should be disclosed; in the other 4, approximately one-quarter believed FTs should be disclosed. Among the 7 studies assessing willingness to participate in research, approximately one-quarter of participants reported less willingness after disclosure of FTs. CONCLUSIONS Patients believe that FTs influence professional behavior and should be disclosed. Patients, physicians, and research participants believe FTs decrease the quality of research evidence, and, for some, knowledge of FTs would affect willingness to participate in research.

[1]  Ana Marusic,et al.  Uniform format for disclosure of competing interests in ICMJE journals. , 2010, JAMA.

[2]  R. Steinbrook.  A higher bar--Vermont's new law on marketing prescribed products. , 2009, The New England journal of medicine.

[3]  R. Cooper,et al.  Requirements and definitions in conflict of interest policies of medical journals. , 2009, JAMA.

[4]  R. Horton,et al.  Uniform format for disclosure of competing interests in ICMJE journals , 2009, The Lancet.

[5]  Marilyn J. Field,et al.  Conflict of Interest in Medical Research, Education, and Practice , 2009 .

[6]  B. Mullan,et al.  Trust not in money: The effect of financial conflict of interest disclosure on dietary behavioural intention , 2009 .

[7]  B. Kahn,et al.  Effect of exposure to small pharmaceutical promotional items on treatment preferences. , 2009, Archives of internal medicine.

[8]  J. Jastifer,et al.  Patients' Awareness of and Attitudes toward Gifts from Pharmaceutical Companies to Physicians , 2009, International journal of health services : planning, administration, evaluation.

[9]  M. Tattersall,et al.  Patients expect transparency in doctors’ relationships with the pharmaceutical industry , 2009, The Medical journal of Australia.

[10]  K. Weinfurt,et al.  Effects of disclosing financial interests on participation in medical research: a randomized vignette trial. , 2008, American heart journal.

[11]  A. Hutchinson,et al.  Financial disclosure and clinical research: what is important to participants? , 2008, The Medical journal of Australia.

[12]  R. Califf,et al.  Consistency of Financial Interest Disclosures in the Biomedical Literature: The Case of Coronary Stents , 2008, PloS one.

[13]  K. Weinfurt,et al.  Effects of Disclosing Financial Interests on Attitudes Toward Clinical Research , 2008, Journal of General Internal Medicine.

[14]  Veronica Yank,et al.  Financial ties and concordance between results and conclusions in meta-analyses: retrospective cohort study , 2007, BMJ : British Medical Journal.

[15]  Moe R. Lim,et al.  The Surgeon as a Consultant for Medical Device Manufacturers: What Do Our Patients Think? , 2007, Spine.

[16]  M. Ratain,et al.  Attitudes toward research participation and investigator conflicts of interest among advanced cancer patients participating in early phase clinical trials. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[17]  Lisa Bero,et al.  Factors Associated with Findings of Published Trials of Drug–Drug Comparisons: Why Some Statins Appear More Efficacious than Others , 2007, PLoS medicine.

[18]  K. Weinfurt,et al.  Use and Perceptions of Clinical Practice Guidelines by Internal Medicine Physicians , 2007, American journal of medical quality : the official journal of the American College of Medical Quality.

[19]  David Blumenthal,et al.  A national survey of physician-industry relationships. , 2007, The New England journal of medicine.

[20]  Samuel S. Lee,et al.  Impact of pharmaceutical industry versus university sponsorship on survey response: a randomized trial among Canadian hepatitis C care providers. , 2007, Canadian journal of gastroenterology = Journal canadien de gastroenterologie.

[21]  A. Zaslavsky,et al.  Physician incentives and disclosure of payment methods to patients , 2001, Journal of General Internal Medicine.

[22]  K. Kroenke,et al.  A comparison of physicians’ and patients’ attitudes toward pharmaceutical industry gifts , 1998, Journal of General Internal Medicine.

[23]  G. Guagnano,et al.  Investigator financial disclosures and its effect on research subjects. , 2007, Food and drug law journal.

[24]  E. Emanuel,et al.  Patients' views on financial conflicts of interest in cancer research trials. , 2006, The New England journal of medicine.

[25]  D. Güldal,et al.  What patients think about promotional activities of pharmaceutical companies in Turkey , 2006, Pharmacy World and Science.

[26]  K. Weinfurt,et al.  Views of potential research participants on financial conflicts of interest: barriers and opportunities for effective disclosure. , 2006 .

[27]  C. Grady,et al.  The Limits of Disclosure: What Research Subjects Want to Know about Investigator Financial Interests , 2006, Journal of Law, Medicine & Ethics.

[28]  Ken Kleinman,et al.  A trial of disclosing physicians' financial incentives to patients. , 2006, Archives of internal medicine.

[29]  Ermenegyldo Munhoz Junior.  Requisitos uniformes para manuscritos submetidos a periódicos biomédicos: escrevendo e editando para publicações biomédicas , 2006 .

[30]  K. Weinfurt,et al.  Policies of Academic Medical Centers for Disclosing Financial Conflicts of Interest to Potential Research Participants , 2006, Academic medicine : journal of the Association of American Medical Colleges.

[31]  Lisa A Bero,et al.  Attitudes of academic and clinical researchers toward financial ties in research: A systematic review , 2005, Science and engineering ethics.

[32]  W. Levinson,et al.  The effect of physician disclosure of financial incentives on trust. , 2005, Archives of internal medicine.

[33]  Carlos Alberto Guimarães,et al.  Uniform requirements for manuscripts submitted to biomedical journals: Writing and editing for biomedical publication , 2008, Revista espanola de cardiologia.

[34]  Sara Schroter,et al.  Does the type of competing interest statement affect readers' perceptions of the credibility of research? Randomised trial , 2004, BMJ : British Medical Journal.

[35]  E. Caine,et al.  Potential research participants’ views regarding researcher and institutional financial conflicts of interest , 2004, Journal of Medical Ethics.

[36]  C. Gross,et al.  Scope and impact of financial conflicts of interest in biomedical research: a systematic review. , 2003, JAMA.

[37]  Sara Schroter,et al.  Does declaration of competing interests affect readers' perceptions? A randomised trial , 2002, BMJ : British Medical Journal.

[38]  Rajesh Balkrishnan,et al.  How disclosing HMO physician incentives affects trust. , 2002, Health affairs.

[39]  M. Spillman,et al.  Managing conflicts of interest in the conduct of clinical trials. , 2002, JAMA.

[40]  T. Bodenheimer,et al.  Uneasy alliance--clinical investigators and the pharmaceutical industry. , 2000, The New England journal of medicine.

[41]  A. Wazana,et al.  Physicians and the pharmaceutical industry: is a gift ever just a gift? , 2000, JAMA.

[42]  G. Loewenstein,et al.  The role of decision analysis in informed consent: choosing between intuition and systematicity. , 1997, Social science & medicine.

[43]  R. Blake,et al.  Patients' Attitudes About Gifts To Physicians From Pharmaceutical Companies , 1995, The Journal of the American Board of Family Medicine.

[44]  C. Stocking,et al.  An Ethical Debate: Financial ties as part of informed consent to postmarketing research Attitudes of American doctors and patient , 1995 .

[45]  Mainous Ag rd,et al.  Patient perceptions of physician acceptance of gifts from the pharmaceutical industry. , 1995, Archives of family medicine.

[46]  D F Thompson,et al.  Understanding financial conflicts of interest. , 1993, The New England journal of medicine.

[47]  K J Rothman,et al.  Conflict of interest. The new McCarthyism in science. , 1993, JAMA.

[48]  B. Gandevia,et al.  DECLARATION OF HELSINKI , 1964, Definitions.