A Comparison of DSM-IV and DSM-5 Panel Members' Financial Associations with Industry: A Pernicious Problem Persists

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Abstract

Lisa Cosgrove and Sheldon Krimsky examine the new competing interest disclosure policy of the American Psychiatric Association (APA) and report that DSM panel members still have considerable financial conflicts of interest.

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Most cited references 31

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Scope and impact of financial conflicts of interest in biomedical research: a systematic review.

Justin E Bekelman, Cary Gross, Yan. Li (2003)

Despite increasing awareness about the potential impact of financial conflicts of interest on biomedical research, no comprehensive synthesis of the body of evidence relating to financial conflicts of interest has been performed. To review original, quantitative studies on the extent, impact, and management of financial conflicts of interest in biomedical research. Studies were identified by searching MEDLINE (January 1980-October 2002), the Web of Science citation database, references of articles, letters, commentaries, editorials, and books and by contacting experts. All English-language studies containing original, quantitative data on financial relationships among industry, scientific investigators, and academic institutions were included. A total of 1664 citations were screened, 144 potentially eligible full articles were retrieved, and 37 studies met our inclusion criteria. One investigator (J.E.B.) extracted data from each of the 37 studies. The main outcomes were the prevalence of specific types of industry relationships, the relation between industry sponsorship and study outcome or investigator behavior, and the process for disclosure, review, and management of financial conflicts of interest. Approximately one fourth of investigators have industry affiliations, and roughly two thirds of academic institutions hold equity in start-ups that sponsor research performed at the same institutions. Eight articles, which together evaluated 1140 original studies, assessed the relation between industry sponsorship and outcome in original research. Aggregating the results of these articles showed a statistically significant association between industry sponsorship and pro-industry conclusions (pooled Mantel-Haenszel odds ratio, 3.60; 95% confidence interval, 2.63-4.91). Industry sponsorship was also associated with restrictions on publication and data sharing. The approach to managing financial conflicts varied substantially across academic institutions and peer-reviewed journals. Financial relationships among industry, scientific investigators, and academic institutions are widespread. Conflicts of interest arising from these ties can influence biomedical research in important ways.

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The Dirt on Coming Clean: Perverse Effects of Disclosing Conflicts of Interest

George Loewenstein, Don A. Moore, Daylian M. Cain (2005)

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Conflict of interest in the debate over calcium-channel antagonists.

Henry Thomas Stelfox, Grace Chua, Keith O'Rourke … (1998)

Physicians' financial relationships with the pharmaceutical industry are controversial because such relationships may pose a conflict of interest. It is unknown to what extent industry support of medical education and research influences the opinions and behavior of clinicians and researchers. The recent debate over the safety of calcium-channel antagonists provided an opportunity to examine the effect of financial conflicts of interest. We searched the English-language medical literature published from March 1995 through September 1996 for articles examining the controversy about the safety of calcium-channel antagonists. Articles were reviewed and classified as being supportive, neutral, or critical with respect to the use of calcium-channel antagonists. The authors of the articles were asked about their financial relationships with both manufacturers of calcium-channel antagonists and manufacturers of competing products (i.e., beta-blockers, angiotensin-converting-enzyme inhibitors, diuretics, and nitrates). We examined the authors' published positions on the safety of calcium-channel antagonists according to their financial relationships with pharmaceutical companies. Authors who supported the use of calcium-channel antagonists were significantly more likely than neutral or critical authors to have financial relationships with manufacturers of calcium-channel antagonists (96 percent, vs. 60 percent and 37 percent, respectively; P<0.001). Supportive authors were also more likely than neutral or critical authors to have financial relationships with any pharmaceutical manufacturer, irrespective of the product (100 percent, vs. 67 percent and 43 percent, respectively; P< 0.001). Our results demonstrate a strong association between authors' published positions on the safety of calcium-channel antagonists and their financial relationships with pharmaceutical manufacturers. The medical profession needs to develop a more effective policy on conflict of interest. We support complete disclosure of relationships with pharmaceutical manufacturers for clinicians and researchers who write articles examining pharmaceutical products.

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Author and article information

Journal

Journal ID (nlm-ta): PLoS Med

Journal ID (publisher-id): PLoS

Journal ID (pmc): plosmed

Title: PLoS Medicine

Publisher: Public Library of Science (San Francisco, USA )

ISSN (Print): 1549-1277

ISSN (Electronic): 1549-1676

Publication date Collection: March 2012

Publication date (Print): March 2012

Publication date (Electronic): 13 March 2012

Volume: 9

Issue: 3

Electronic Location Identifier: e1001190

Affiliations

[1 ]Edmond J. Safra Center for Ethics, Harvard University, Cambridge, Massachusetts, United States of America

[2 ]Department of Counseling Psychology, University of Massachusetts, Boston, Massachusetts, United States of America

[3 ]Department of Urban and Environmental Policy and Planning, and Department of Public Health and Community Medicine, Tufts University, Medford, Massachusetts, United States of America

Author notes

* E-mail: lcosgrove@ 123456ethics.harvard.edu

Analyzed the data: LC SK. Wrote the first draft of the manuscript: LC. Contributed to the writing of the manuscript: LC SK. ICMJE criteria for authorship read and met: LC SK. Agree with manuscript results and conclusions: LC SK.

The Essay section contains opinion pieces on topics of broad interest to a general medical audience.

Article

Publisher ID: PMEDICINE-D-11-03049

DOI: 10.1371/journal.pmed.1001190

PMC ID: 3302834

PubMed ID: 22427747

SO-VID: 9604bd90-8512-4b7d-8986-2559f635f4a5

Copyright © Cosgrove, Krimsky. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

A Comparison of DSM-IV and DSM-5 Panel Members' Financial Associations with Industry: A Pernicious Problem Persists

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Most cited references 31

Scope and impact of financial conflicts of interest in biomedical research: a systematic review.

The Dirt on Coming Clean: Perverse Effects of Disclosing Conflicts of Interest

Conflict of interest in the debate over calcium-channel antagonists.

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