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What to do with a clinical trial with conflicts of interest
  1. Andreas Lundh1,2,3,4,
  2. Isabelle Boutron5,6,7,
  3. Lesley Stewart8,
  4. Asbjorn Hróbjartsson1,2,3
  1. 1 Centre for Evidence-Based Medicine Odense (CEBMO), Odense University Hospital, Odense, Denmark
  2. 2 Open Patient data Exploratory Network (OPEN), Odense University Hospital, Odense, Denmark
  3. 3 Department of Clinical Research, University of Southern Denmark, Odense, Denmark
  4. 4 Department of Infectious Diseases, Hvidovre Hospital, Hvidovre, Denmark
  5. 5 Equipe METHODS, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153) Inserm, Paris, France
  6. 6 Université Paris Descartes, Paris, France
  7. 7 Cochrane France, Paris, France
  8. 8 Centre for Reviews and Dissemination, University of York, York, UK
  1. Correspondence to Dr Andreas Lundh, ​Centre for Evidence-Based Medicine Odense (CEBMO), Odense University Hospital, 5000 Odense C, Denmark; andreas.hover.lundh{at}rsyd.dk

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Financial considerations, personal conviction and concerns about academic careers may influence how research is designed, conducted and reported.1 This has recently been highlighted in the case of harms from transvaginal mesh devices and cases of research misconduct where pressure to ensure funding and academic prestige have compromised science.2–4 Less dramatic examples are the overinterpretation of study findings or downplaying of harms.5 6 Such practices may be caused by conflicts of interest which can be defined as circumstances that create a risk that professional judgement or actions regarding a primary interest will be unduly influenced by a secondary interest.1

Concern for conflicts of interest are particularly important in clinical trials, as trials play a central role in clinical practice, by providing the basis for regulatory drug and device approval and by producing evidence to guide clinical decision-making and clinical guideline recommendations.1 About 40% of clinical trials and 70% of drug trials are commercially funded, and a similar proportion of drug trials have authors with industry ties, though there is large …

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