Financial conflicts of interest bias recommendations for influenza meds

1. Authors who reported a financial conflict of interest (COI) were more likely to submit a favorable review of neuraminidase inhibitor (NI) use.

2. Authors with financial COIs were less likely to discuss publication bias than those without financial COIs.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Many authors of scientific articles declare financial conflicts of interest (COI), which often arise due to their relationships with pharmaceutical or medical device companies. COIs have the potential to create a significant reporting bias, particularly when a study’s findings affect the affiliated company. Neuraminidase inhibitors (NI) are used for the prevention and treatment of influenza, but their effectiveness has been the subject of much controversy during the last decade. This study examined several systematic reviews of the use of NIs for both prophylaxis and treatment to examine how financial COIs influenced the study authors’ recommendations. The vast majority of the COI articles offered favorable assessments of NI use, while very few of the non-COI articles gave the same assessment. COIs also affected the reporting of publication bias; of the articles that examined addressed publication bias, only one of them had an author with a financial COI. These findings are limited in that the authors could not tell which of the assessments about NI efficacy is most accurate, nor could they determine the reasons behind the different conclusions reached by authors with or without financial COIs.

Click to read the study, published today in the Annals of Internal Medicine

Relevant Reading: The value of neuraminidase inhibitors for the prevention and treatment of seasonal influenza: A systematic review of systematic reviews

In-Depth [overview of systematic reviews]: The authors conducted a literature search for systematic reviews that analyzed the efficacy of neuraminidase inhibitors used for either prophylaxis or treatment of influenza. They also conducted extensive searches on each article’s authors to find any potential financial conflicts of interest. Two independent screeners were provided with redacted copies of each article and scored them as being either “favorable” or “unfavorable” toward the use of NIs. The agreement between these screeners was 86% (p<0.001). Twenty-six articles met the inclusion criteria, and a total of 37 assessments on the use of NIs for either prophylaxis or treatment were contained within these articles. Eight of assessments (22%) were written by authors with a financial COI, and 88% of these were favorable toward the use of NIs (compared to 17% of the COI-free assessments). Among reviewers without financial COIs, 79% discussed publication bias, while only 14% of reviewers with financial COIs mentioned it in their articles.

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