Healthy Skepticism Library item: 14312
Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.
Publication type: news
O'Riordan M.
Industry-Sponsored Trials More Widely Cited Than Not-for-Profit Studies
Heartwire 2008 Sep 10
http://www.medscape.com/viewarticle/580356
Full text:
September 10, 2008 (Boston, MA) – Cardiovascular clinical trials sponsored by industry are more likely to be cited in future medical publications than studies performed by not-for-profit organizations, a new study has shown [1]. Efforts should be made to ensure that important trials conducted by government agencies, such as the National Institutes of Health (NIH), are more widely disseminated to the cardiovascular community, say investigators.
“As a researcher, my core belief is that high-quality research gets done by the NIH and by industry, and the quality of our patients’ lives will improve if this information is transmitted to the medical community,” senior investigator Dr Paul Ridker (Brigham and Women’s Hospital, Boston, MA) told heartwire. “What we observed is that the translation to practice is more rapid and thorough for industry-funded studies. We hope there can be a mechanism to do a better job promoting the findings of federally funded studies as well.”
The results of the study, with first author Dr David Conen (Brigham and Women’s Hospital), are published online September 8, 2008 in Circulation.
Responding to High-Quality Work
In 2006, Ridker and colleagues published a study showing that cardiovascular clinical trials funded by for-profit sponsors were significantly more likely to have positive results than trials reported by not-for-profit funding sources. He told heartwire that while the initial publication has an impact on clinical practice, how often the paper is cited in subsequent medical publications also has an effect on physician behavior.
The purpose of this study, explained Ridker, was to examine how the cardiovascular community responded to high-quality research funded by different sources. To do so, the Harvard researchers analyzed 303 consecutive superiority trials of cardiovascular medicine published between January 1, 2000 and July 30, 2005 in the Journal of the American Medical Association, the Lancet, and the New England Journal of Medicine. They then determined the number of citations per publication per year, a metric used to ascertain how the medical community was responding to the findings.
Investigators observed that industry-funded studies had more citations per publication per year than NIH- or other federally funded studies. This was true in all settings except for one: industry-funded studies were not cited as frequently when the studies failed to show a benefit.
Citations Per Publication Per Year According to Funding Source Clinical trials All trials combined (n=303) Not-for-profit funding (n=104) Not-for-profit and for-profit joint funding (n=62) For-profit funding (n=137) p
All trials 36 29 37 46 0.0007
Trial outcome
New therapy worse 37 41 13 33 0.048
No difference 29 24 40 28 0.06
New therapy better 41 25 36 52 0.0006
In their paper, the authors note that pharmaceutical and device companies are able to transmit the positive results to thought leaders through pharmaceutical representatives as well as through sponsored symposia at medical meetings. The for-profit organizations have better media-outreach programs in place, ensuring wider press coverage that ultimately increases the citation rate. These companies also invest more resources to increase the number of secondary publications for a trial, leading to more exposure of the initial study.
“The question is whether the NIH should also have a budget to help promote the findings of its studies,” said Ridker. “I don’t think the pharmaceutical promotional efforts are a bad thing. I just think that it puts federally funded studies at a disadvantage. Without promotion at all, we just don’t translate medicine into practice.”
Ridker said he thinks efforts to promote federally funded clinical trials can be done, as evidenced by the most highly cited clinical trial in the literature during the study period. The Women’s Health Initiative (WHI), an NIH-funded study that showed that hormone-replacement therapy had more health risks than benefits in healthy postmenopausal women, has been cited more than 700 times annually since its publication in 2002. A substantial public-health campaign by the federal government ensured that primary-care physicians knew the results of trial, said Ridker, showing that “it can be done.”
During the five-year study period of this trial, Ridker received research funding support from multiple not-for-profit organizations and for-profit companies. Conen reports no conflicts.
Conen D, Torres J, and Ridker PM. Differential citation rates of major cardiovascular clinical trials according to source of funding. Circulation 2008; DOI: 10.1161/circulationaha.108.794016. Available at: http://circ.ahajournals.org.
