Study links funding sources to positive findings at scientific meetings

Allison Gandey

December 10, 2004

Dec 10, 2004

Baltimore, MD - Researchers have found that 100% of industry-sponsored studies recently presented at the annual scientific meeting of a medical professional society reported findings that support product use. The study, by Drs Thomas Finucane and Chad Boult (Johns Hopkins School of Medicine, Baltimore, MD), appears in the December 1, 2004 American Journal of Medicine [ 1 ].

"The overwhelming nature of this finding was a little surprising," Finucane told rheumawire . "But then again, it would be surprising if the results didn't favor the product. On reflection, it makes sense."

I would be astonished if this were true of only one medical society.

In the present analysis, the researchers reviewed the abstracts of all papers and posters presented at the annual meeting of a medical professional society. Two independent raters classified each study of a drug as either positive (favoring the drug studied) or negative and as either funded by a pharmaceutical company or not. The group computed  and 2 statistics to evaluate the agreement between the raters as well as the association between the results and the sponsorship of the study.

The authors agreed not to name the medical society to protect the anonymity of individual researchers and to avoid having to request the permission of every presenter. Finucane said that he and Boult are considering the possibility of conducting a second larger study of two societies that they could name in their research.

The investigators write that many studies of commercial products are submitted for possible presentation at the annual meetings of medical professional societies. They point out that those that are accepted and presented earn scientific credibility and are often cited in commercial promotional materials designed to influence the prescribing behavior of physicians. And the results of one to two thirds of such presentations are later published in journals.

Finucane and Boult found that it was easy to obtain an invitation to present research—84% of abstracts submitted were presented at the meeting. Among abstracts presented, industry support greatly increased the odds of a result favorable to the drug being studied. A result favorable to the drug studied was reported by all industry-supported studies, compared with two thirds of studies not industry-supported (p=0.0007).

The association between pharmaceutical funding and research findings

Funding
Studies (n=48)
Positive results
Negative results
Supported by pharmaceutical companies
30
30
0
Not supported by pharmaceutical companies
18
12
6



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The researchers point out that 3 well-known forms of bias may have contributed to the findings. For example, there may have been a positive-outcome bias—the tendency for reviewers and editors to select studies that report positive findings. Biases may also result from the efforts of pharmaceutical companies to promote their products. These efforts may include supporting biased study designs, controlling access to and analysis of study data, and censoring or "spinning" the results. The investigators add that potential bias may also stem from conflicts between investigators' duty to conduct research objectively and their desire for professional recognition and financial reward.

They add, "The factors that limit the inferences that can be drawn from our study include the sample size (data from only one meeting of one professional society), the inability to definitively rule out pharmaceutical support of six negative studies, and incomplete information on the quality of the studies that were presented and on the abstracts that were rejected or withdrawn from presentation at the meeting."

In an interview with rheumawire , Finucane added, "I would be astonished if this were true of only one medical society. Drug companies corrupt science in a way that is directly harmful to patients." He continued, "I find it regrettable that companies take money from patients impoverished from having to pay for their medicines to offer free dinners to physicians."

The recommended steps are eminently reasonable and hopelessly inadequate.

The researchers call for full disclosure, policies against outcome bias, and educational opportunities that may help manage industry-academia conflicts of interest that could otherwise jeopardize the credibility of pharmaceutical research presented at scientific meetings.

In an accompanying editorial, Dr Seth Landefeld (University of California, San Francisco and the San Francisco VA Medical Center) writes, "The recommended steps are eminently reasonable and hopelessly inadequate" [ 2 ]. He explains, "Disclosure of financial conflicts of interest likely has limited effects and may not eliminate bias or its effects on practice. Changing the criteria for selection of studies for presentation may have little effect when virtually all studies are accepted for presentation. Education and training are often ineffective in eliminating bias, and the detection of bias may be difficult, as indicated by the failure of peer review to eliminate the evidence of commercial bias in published papers."


Call for an independent public funding institute

Landefeld argues that a National Institute of Pharmaceutical Research could award grants based on independent peer review, similar to review by the National Institutes of Health, rather than by a for-profit contract research organization. This independent agency could be funded by pooled resources from the pharmaceutical industry, and regulations might require the US Food and Drug Administration to consider only evidence resulting from research supported by the independent public funding mechanism or an equivalent body.

"With compelling evidence that the knowledge base produced by commercially sponsored research is biased, with evidence that physicians do not reliably detect bias in information presented to them, with no evidence that bias in individual studies is reliably detected and discounted, and with repeated examples of manufacturers using potentially biased evidence largely to promote sales," Landefeld writes, "what commercially supported research can be trusted?"

He argues that credibility is essential for commercially supported research to achieve its tremendous potential to advance science and improve medical care. "And elimination of commercial bias is necessary for research to be credible."


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Sources

  1. Finucane TE and Boult CE. Association of funding and findings of pharmaceutical research at a meeting of a medical professional society. Am J Med 2004; 117:842-845.

  2. Landefeld CS. Commercial support and bias in pharmaceutical research. Am J Med 2004; 117:876-878.


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