Author Financial Conflicts of Interest, Industry Funding, and Clinical Practice Guidelines for Anticancer Drugs

Tibau, Ariadna; Bedard, Philippe L.; Srikanthan, Amirrtha; Ethier, Josee-Lyne; Vera‐Badillo, Francisco; Templeton, Arnoud J.; Ocaña, Alberto; Šeruga, Boštjan; Barnadas, Agustí; Amir, Eitan

doi:10.1200/jco.2014.57.8898

Cited by 46 publications

(49 citation statements)

References 44 publications

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“…More recent studies showed that 30% of plenary session abstracts at the American Society for Clinical Oncology (ASCO) annual meeting had an author reporting stock ownership (22), and 14% of authors of cancer clinical practice guidelines and consensus statements reported stock ownership (41). While we found that the prevalence of ownership interest is limited to few physicians, medical and radiation oncologists were two to three times as likely to hold HRR ¼ hospital referral region; IRR ¼ incidence rate ratio; OR ¼ odds ratio.…”

Section: Discussionmentioning

confidence: 99%

“…The impact of financial relationships on physician behavior and patient perception in oncology remains controversial. An analysis of consensus statements on oncology drugs suggested that drug endorsement was more common when authors had financial conflicts of interest with the drug's manufacturer (41). A study of oncology abstracts showed that the majority of studies on economic analyses with financial disclosures supported the sponsor's product (42).…”

Section: Articlementioning

confidence: 99%

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Distribution and Patterns of Industry-Related Payments to Oncologists in 2014

Marshall

Moy

Jackson

et al. 2016

JNCI J Natl Cancer Inst

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Background: Industry-physician collaboration is critical for anticancer therapeutic development, but financial relationships introduce conflicts of interest. We examined the specialty variation and context of physician payments and ownership interest among oncologists. Methods: We performed a population-based multivariable analysis of 2014 Open Payments reports of industry payments to US physicians matched to physician and practice data, including sex, specialty, practice location, and sole proprietor status. Payment data were aggregated per physician and compared by specialty (medical, radiation, surgical, and nononcology), and practice location linked with spending level (low, average, and high). Primary outcomes included likelihood, mean annual amount, and number of general payments. Secondary outcomes included likelihood of holding ownership interests and receipt of royalty/license payments. Estimates for each outcome were determined using multivariable models, including logistic regression for likelihood and linear regression with gamma distribution and log-link for value, adjusted for physician specialty, sex, sole proprietor status, and practice spending. All statistical tests were two-sided. Results: In 2014, there were 883 438 physicians, including 22 712 oncologists, licensed to practice in the United States. Among oncology specialties, 52.4% to 63.0% of physicians received a general payment in 2014, totaling $76 million, $4 million, and $5 million to medical, radiation, and surgical oncology, respectively. The median annual per-physician payment to medical oncologists was $632 (IQR ¼ 136-2500), compared with $124 (IQR ¼ 39-323) in radiation oncology and $250 (IQR ¼ 84-1369) in surgical oncology. After controlling for physician and practice characteristics, oncologists were 1.09 to 1.75 times as likely to receive a general payment compared with nononcologists (overall P < .001). There was a 67.6% difference (95% confidence interval [CI] ¼ 63.6 to 71.5, P < .001) in the mean annual value of payments between medical oncology and nononcology specialties (vs À92.7%, 95%CI ¼ À100.2 to À85.0, P < .001] for radiation oncology). Medical and radiation oncologists were more likely to hold ownership interest (adjusted OR ¼ 3.72, 95% CI ¼ 3.22 to 4.27, and 2.27, 95% CI ¼ 1.65 to 3.03, respectively, P < .001 both comparisons). Conclusions: In 2014, industry-oncologist financial relationships were common, and their impact on oncology practice should be further explored.

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Section: Discussionmentioning

confidence: 99%

Section: Articlementioning

confidence: 99%

Distribution and Patterns of Industry-Related Payments to Oncologists in 2014

Marshall

Moy

Jackson

et al. 2016

JNCI J Natl Cancer Inst

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“…Fourth, ASCO CPGs do not include recommendations of specific drugs by name; therefore, it was not possible to address the association between FCOIs and the endorsement of drugs. Prior data from a broader group of published CPGs and consensus statements have shown that FCOIs with companies marketing a particular drug are associated with higher odds of endorsement of that drug . Fifth, our sample size of guidelines was small and provided limited power.…”

Section: Discussionmentioning

confidence: 97%

“…Conflicts of interest (COIs) are defined as conditions under which professional judgment concerning a primary interest (eg, patient welfare or the validity of research) may be influenced by a secondary interest (eg, financial gain) . It is known that financial conflicts of interest (FCOIs) can influence the way that information is presented in publications, CPGs, and educational meetings …”

Section: Introductionmentioning

confidence: 99%

Undisclosed financial conflicts of interest among authors of American Society of Clinical Oncology clinical practice guidelines

Saleh

Majeed

Tibau

et al. 2019

Cancer

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Background Clinical practice guidelines (CPGs) are crucial to the practice of evidence‐based medicine. Declared author financial conflicts of interest (FCOIs) are common in CPGs and have been associated with endorsement of treatment. Less is known about undeclared FCOIs. Methods The American Society of Clinical Oncology (ASCO) website was searched to identify all CPGs for systemic therapy published between August 2013 and June 2018. Data on self‐reported author FCOIs and funding sources were extracted. The Open Payments database was then searched to identify compensation to CPG authors. Concordance between declared and undeclared but verified FCOIs was assessed with Cohen's κ. Results For 26 CPGs, 314 nonduplicate authors were identified; 184 of these authors (59%) disclosed FCOIs. Among the remaining 130 authors, data in Open Payments were unavailable for 71 authors (non‐US residents or authors affiliated with a nonprofit organization). Among the 59 authors who declared no FCOIs and for whom Open Payments data were available, 55 (93%) had received payment from industry. The κ value for agreement between disclosed and verified FCOIs was 0.092. Among the 243 authors with FCOIs verifiable via Open Payments, 239 (98%) received payment from industry. Thirty‐four authors (62%) received more than $1000 in nonresearch funding, and 19 (35%) received more than $5000. Among the 52 first and last authors, 44 (85%) received payment from industry; 14 of these payments (32%) were not declared. Conclusions FCOIs among authors of ASCO CPGs are common and are not disclosed by a substantial proportion of authors with Open Payments data. Improved transparency of FCOIs should become standard practice among CPG authors. Professional societies and journal editors need to create a mechanism to verify self‐reported FCOIs.

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“…Guidelines vary in their relevance to specific clinical practice, [1][2][3][4][5] their use of evidence, [6][7][8][9][10][11][12][13][14] and the role of other factors on the process of drafting recommendations. [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Tools are available to evaluate the quality of clinical practice guidelines. [33][34][35][36][37][38] These tools, however, are designed in part to guide guideline development and are difficult to use by nonresearchers without extensive training.…”

Section: Introductionmentioning

confidence: 99%

Developing a Clinician Friendly Tool to Identify Useful Clinical Practice Guidelines: G-TRUST

et al. 2017

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BACKGROUND Clinicians are faced with a plethora of guidelines. To rate guidelines, they can select from a number of evaluation tools, most of which are long and difficult to apply. The goal of this project was to develop a simple, easyto-use checklist for clinicians to use to identify trustworthy, relevant, and useful practice guidelines, the Guideline Trustworthiness, Relevance, and Utility Scoring Tool (G-TRUST).METHODS A modified Delphi process was used to obtain consensus of experts and guideline developers regarding a checklist of items and their relative impact on guideline quality. We conducted 4 rounds of sampling to refine wording, add and subtract items, and develop a scoring system. Multiple attribute utility analysis was used to develop a weighted utility score for each item to determine scoring.RESULTS Twenty-two experts in evidence-based medicine, 17 developers of high-quality guidelines, and 1 consumer representative participated. In rounds 1 and 2, items were rewritten or dropped, and 2 items were added. In round 3, weighted scores were calculated from rankings and relative weights assigned by the expert panel. In the last round, more than 75% of experts indicated 3 of the 8 checklist items to be major indicators of guideline usefulness and, using the AGREE tool as a reference standard, a scoring system was developed to identify guidelines as useful, may not be useful, and not useful. CONCLUSIONThe 8-item G-TRUST is potentially helpful as a tool for clinicians to identify useful guidelines. Further research will focus on its reliability when used by clinicians.

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Author Financial Conflicts of Interest, Industry Funding, and Clinical Practice Guidelines for Anticancer Drugs

Cited by 46 publications

References 44 publications

Distribution and Patterns of Industry-Related Payments to Oncologists in 2014

Distribution and Patterns of Industry-Related Payments to Oncologists in 2014

Undisclosed financial conflicts of interest among authors of American Society of Clinical Oncology clinical practice guidelines

Developing a Clinician Friendly Tool to Identify Useful Clinical Practice Guidelines: G-TRUST

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