Association Between Conflict of Interest and Published Position on Hypoglossal Nerve Stimulation for Sleep Apnea

Abstract

Objective To determine if there is an association between authors’ financial conflict of interest and published position on clinical use of hypoglossal nerve stimulation for obstructive sleep apnea. Study Design Retrospective cross-sectional analysis. Setting International roster of authors and articles analyzed. Methods A Google Scholar search was performed for editorials and reviews citing the 2014 New England Journal of Medicine article on hypoglossal nerve stimulation for obstructive sleep apnea. Included articles were coded as favorable or neutral. Conflict of interest was recorded as declared by the authors in these articles and as independently searched in the Open Payments registry. Results Sixteen articles from 45 independent authors were analyzed. Nine articles by authors were coded as favorable. Among authors of articles with favorable views, 16 (59%) had a financial conflict of interest with the manufacturer of the hypoglossal nerve stimulator device, as opposed to only 1 of 21 (5%) authors of neutral/unfavorable articles. When we included only authors to whom payments could be identified or excluded on Open Payments, 16 of 20 (80%; 95% CI, 62%-98%) authors of favorable articles had a financial conflict, while 1 of 10 (10%; 95% CI, 0%-29.6%) of neutral/unfavorable articles did ( P = .004). Conclusion Our study demonstrates an association between published position on hypoglossal nerve stimulator use and financial conflict with the device manufacturer. Several undeclared conflicts were also found, suggesting a role for independent search for conflicts during the review process.

Tip of the Iceberg? Country- and Company-Level Analysis of Drug Company Payments for Research and Development in Europe

“…For instance, receiving general payments by authors was associated with positions favourable to the funding companies expressed in editorials, guidelines and review articles. 50 While some studies have documented an association between general payments, 51 including consultancies, 52 and positive clinical trial outcomes, others have established no such relationship. 53 Further, undisclosed general payments, detected by comparing Open Payments with researchers’ self-reporting, are widespread in articles presenting findings from research studies, 54 - 56 including reports of clinical trials.…”

Patient-reported outcomes with hypoglossal nerve stimulation for treatment of obstructive sleep apnea: a systematic review and meta-analysis

“…Of note, a recent study by Crossley et al reported a potential bias in HNS studies, since research has been sponsored by manufacturers of the stimulation devices [ 85 ]. Though this imposes a conflict of interest, it is common for early clinical research in absence of sufficient funding for these activities.…”