A Quantitative and Narrative Evaluation of Goodman and Gilman’s Pharmacological Basis of Therapeutics

Piper, Brian J.; Alinea, Alexandria A.; Wroblewski, John R; Graham, Sara; Chung, Daniel Y. F.; McCutcheon, Livia R.M.; Birkett, Melissa; Kheloussi, Steven; Shah, Vicky; Zalim, Qais K.; Arnott, John A.; McLaughlin, William A.; Lucchessi, Pamela A.; Miller, Kimberly A.; Waite, Gabi N.; Bordonaro, Michael

doi:10.1101/19007385

Cited by 3 publications

(8 citation statements)

References 23 publications

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“…Researchers reviewed authors (n=31) of the online medical resource, Medscape, for potential COIs and found 19 discordant authors (61.3%) who self-reported a nothing to disclose status, but had an OP entry (12). Additionally, this investigation (12) found a strong correlation between the reported payment amounts on OP and DFD, consistent with prior research (3). A small report focused on UpToDate and DynaMed authors and editors, reviewed six articles on each site and found no COIs among DynaMed contributors and “numerous” potential COIs among UpToDate contributors (13).…”

Section: Introductionsupporting

confidence: 90%

“…Additionally, this investigation (12) found a strong correlation between the reported payment amounts on OP and DFD, consistent with prior research (3). A small report focused on UpToDate and DynaMed authors and editors, reviewed six articles on each site and found no COIs among DynaMed contributors and "numerous" potential COIs among UpToDate contributors (13).…”

Section: (Which Was Not Certified By Peer Review)supporting

confidence: 85%

“…The copyright holder for this preprint this version posted October 18, 2021. ; https://doi.org/10.1101/2021.10.12.21264909 doi: medRxiv preprint physicians; or perhaps, the difference was due to the underrepresentation of female physician content contributors, which has been confirmed in prior studies regardless of the source being a printed text or an online website (2,3,12).…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 80%

“…Our gender analysis revealed an interesting difference in disclosure status between males and females. However, there are multiple ways to interpret this—perhaps, male physicians disclose more because they are more often the beneficiaries of industry dollars and in a position requiring disclosure; or they are more ethical than female physicians; or perhaps, the difference was due to the underrepresentation of female physician content contributors, which has been confirmed in prior studies regardless of the source being a printed text or an online website (2, 3, 12).…”

Section: Discussionmentioning

confidence: 95%

“…Prior quantitative bioethical research has found potential COIs among physician authors of biomedical textbooks (2), pharmacology textbooks (3), psychiatry’s Diagnostic and Statistical Manual of Mental Disorders-5 (4), as well as within clinical guidelines (5). However, there is limited research on the potential COIs among authors and editors of online clinical resources, such as UpToDate and DynaMed.…”

Section: Introductionmentioning

confidence: 99%

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Characterizing Potential Conflicts of Interest Among UpToDate and DynaMed Content Contributors

VanDeMark

Woloszyn

Christman

et al. 2021

Preprint

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BACKGROUND: Financial conflicts of interest among physicians have the potential to negatively impact patient care. Physicians contribute content to two popular, evidence-based websites, UpToDate and DynaMed; while other physicians use these websites to influence their clinical decision making. Each website maintains a conflict-of-interest policy, and contributors are required to self-report a disclosure status. This research investigated the occurrence for potential conflicts of interest among the self-reported statuses of UpToDate and DynaMed content contributors. METHODS: An initial list of contributors for each website was compiled using the Centers for Disease Control and Preventions 2017 Leading Causes of Death. The top 50 causes were used to determine a relevant article with clinical implications from each database. All named authors and editors of those articles comprised our list of investigated contributors. Contributor disclosure status was then compared with public records of financial remuneration as reported in the Open Payments database maintained by the Centers for Medicare and Medicaid Services and ProPublicas Dollar for Docs website from 2013 to 2018. Descriptive analysis and Fishers exact tests were performed on the data. RESULTS: Of 76 UpToDate contributors, 57.9% reported nothing to disclose but had a record of receiving a financial payment on Open Payments, which was found to be statistically significant (p = 0.0002). Of DynaMeds 42 contributors who reported nothing to disclose, 83.3% had an entry on Open Payments. However, this was not statistically significant. The sum total of industry payments between 2013-2018 made to UpToDate contributors was $68.1 million. The top ten UpToDate contributors who received the most financial remuneration earned approximately $56.1 million (82.4% of all UpToDate renumeration), were all male, and only one had a nothing-to-disclose status. The sum total of compensation reported for the discordant UpToDate contributors between 2013-2018 was approximately $4.81 million (or 7.07% of the total monies reported to UpToDate contributors.) In that same time frame, DynaMed contributors received a sum total of $9.58 million from industry, while the top ten DynaMed contributors earned $8.88 million (or 92.8%) of that. The top ten DynaMed contributors were 80% male and 20% female, and six individuals reported nothing to disclose, yet had an Open Payments entry. The sum total of money reported for all discordant DynaMed contributors between 2013-2018 was approximately $2.79 million (or 29.2% of the total monies reported to DynaMed contributors). CONCLUSIONS: While this research does not ascertain that a conflict of interest or anything untoward, it does provide evidence that there was a significant difference between having an Open Payment entry among those who did versus those who did not disclose a conflict of interest. Websites such as UpToDate and DynaMed should consider implementing a more stringent conflict of interest policy and employ an unbiased team to verify self-reported disclosure statuses among its content contributors. Similarly, physicians who use such informational websites to inform their clinical decision making should look beyond a contributors self-reported disclosure status and verify relevant financial remuneration from the healthcare industry via Open Payments or Dollars for Docs.

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Section: Introductionsupporting

confidence: 90%

Section: (Which Was Not Certified By Peer Review)supporting

confidence: 85%

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 80%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Characterizing Potential Conflicts of Interest Among UpToDate and DynaMed Content Contributors

VanDeMark

Woloszyn

Christman

et al. 2021

Preprint

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A Cross-Sectional Examination of Conflict-of-Interest Disclosures of Physician-Authors Publishing in High-Impact US Medical Journals

Baraldi

Picozzo

Arnold

et al. 2021

Preprint

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Objective: To assess the accuracy of self-reported financial conflict-of-interest (COI) disclosures in the New England Journal of Medicine (NEJM) and Journal of the American Medical Association (JAMA) within the requisite disclosure period prior to article submission. Design: Cross-sectional investigation. Data Sources: Original clinical-trial research articles published in NEJM (n = 206) or JAMA (n = 188) from January 1 to December 31, 2017; self-reported COI disclosure forms submitted to NEJM or JAMA with the authors published articles; Open Payments website (from database inception; latest search: August 2019). Main outcome measures: Financial data reported to Open Payments from 2014 to 2016 (time period that included all subjects requisite disclosure windows) were compared to self-reported disclosure forms submitted to the journals. Payments were defined as those not associated with a research study or formal research funding. Payment types were categorized as disclosed, undisclosed, indeterminate, or unrelated. Results: Thirty-one articles from NEJM and 31 articles from JAMA met inclusion criteria. The physician-authors (n = 118) received a combined total of $7.48 million. Of the 106 authors (89.8%) who received payments, 86 (81.1%) received undisclosed payments. The top 23 most highly compensated received $6.32 million, of which $3.00 million (47.6%) was undisclosed. Disclosure rates were the equivalent between the top 23 and the entire sample. Conclusions: High payment amounts, as well as high proportions of undisclosed financial compensation, regardless of amount received, comprised potential COIs for two influential US medical journals. Further research is needed to explain why such high proportions of general payments were undisclosed and whether journals that rely on self-reported COI disclosure need to reconsider their policies.

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The treatment of Qibai Pingfei Capsule on chronic obstructive pulmonary disease may be mediated by Th17 / Treg balance and gut-lung axis microbiota

Jia

et al. 2022

Preprint

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Background: Chronic obstructive pulmonary disease (COPD), a prevalent, progressive respiratory disease, has become the third leading cause of death globally. Increasing evidence suggests that intestinal and pulmonary microbiota dysbiosis is associated with COPD. Researchers have shown that T helper (Th) 17/regulatory T (Treg) imbalance is involved in COPD. Qibai Pingfei Capsule (QBPF) is a traditional Chinese medicine used to treat COPD clinically in China. However, the effects of QBPF intervention on the Th17/Treg balance and microbiota in the gut and lung are still poorly understood. Methods: This study divided the rats into three groups (n=8): control, model, and QBPF group. After establishing the model of COPD for four weeks and administration of QBPF for two weeks, Th17 cells, Treg cells, their associated cytokines, transcription factors, and intestinal and pulmonary microbiota of rats were analyzed. Furthermore, the correlations between intestinal and pulmonary microbiota and between bacterial genera and pulmonary function and immune function were measured. Results: The results revealed that QBPF could improve pulmonary function and contribute to the new balance of Th17/Treg in COPD rats. Meanwhile, QBPF treatment could regulate the composition of intestinal and pulmonary microbiota and improve community structure in COPD rats, suppressing the relative abundance of Coprococcus_2 , Prevotella_9 , and Blautia in the gut and Mycoplasma in the lung, but accumulating the relative abundance of Prevotellaceae_UCG_003 in the gut and Rikenellaceae_RC9_gut_group in the lung. Additionally, gut–lung axis was confirmed by the significant correlations between the intestinal and pulmonary microbiota. Functional analysis of microbiota showed amino acid metabolism was altered in COPD rats in the gut and lung. Spearman correlation analysis further enriched the relationship between the microbiota in the gut and lung and pulmonary function and immune function in COPD model rats. Conclusions: Our study indicated that the therapeutic effects of QBPF may be achieved by maintaining the immune cell balance and regulating the gut-lung axis microbiota, providing references to explore the potential biomarkers of COPD and the possible mechanism of QBPF to treat COPD.

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A Quantitative and Narrative Evaluation of Goodman and Gilman’s Pharmacological Basis of Therapeutics

Cited by 3 publications

References 23 publications

Characterizing Potential Conflicts of Interest Among UpToDate and DynaMed Content Contributors

Characterizing Potential Conflicts of Interest Among UpToDate and DynaMed Content Contributors

A Cross-Sectional Examination of Conflict-of-Interest Disclosures of Physician-Authors Publishing in High-Impact US Medical Journals

The treatment of Qibai Pingfei Capsule on chronic obstructive pulmonary disease may be mediated by Th17 / Treg balance and gut-lung axis microbiota

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