Reporting of conflict of interests, source of funding, and ethics committee approval in randomized trials of three clinical specialties published in Spanish language

Background: Confidence in the results reported by randomized clinical trials (RCTs) depends mainly on the internal validity of the trial and its conduct, but also on other aspects related to health research such as the complete reporting of conflicts of interest (COI), funding sources and approval by ethics committees. Bias in the study results may arise from any one of these elements. Prior studies have explored the reporting of these items in the medical literature, but there are no reports on RCTs published in Spanish and Latin American journals. This study aimed to evaluate the reporting of COIs, funding sources, and approval by ethics committees of RCTs published in Spanish and Latin American journals in dentistry, geriatrics and neurology. Methods: We did a systematic retrospective survey of all RCTs published from 1990 to 2018 in dentistry, neurology, and geriatrics journals published in Spain and Latin America and included in the BADERI database (Iberoamerican journals and trials database by its initials in Spanish). We completed with hand searching. We included RCTs with a recoverable full text published between 1990 and 2018. We extracted data on sources of funding, COI statements, and ethics reviews. The extraction of these items in the RCTs included was done independently by two pairs of reviewers and in parallel for each article, with a third independent reviewer resolving discrepancies. We analysed compliance for each item. Results: We identified RCTs in 69 journals from Spain and Latin American countries. Dentistry accounted for 75% (n = 52) of the journals, neurology 20.6% (n = 14), and geriatrics 4.4% (n = 3). Of the total number of RCTs included in this study (n = 392), only 102 (26%) reported the presence or absence of a COI, 103 (26%) studies reported funding, and 43 (36%) included the ethics committee approval. Conclusions: RCTs published in the Spanish language in dentistry, neurology, and geriatrics had poor compliance with the reporting of a COI, source of funding, and ethics committee approval. Future research should evaluate the accuracy and completeness of COI statements and their relationship to the funding source and direction of the results.

Conflictos de interés y corrección política. Reflexiones para médicos en tiempos moralmente débi / Conflicts of interest and political correctness. Reflections for doctors in morally weak times

En Medicina, intereses enfrentados a los valoressuperiores que sustentan su práctica con frecuencia nossumergen en desafíos éticos que debemos afrontar: Entretales intereses destacan los de carácter político, económico ymediático. En el presente ensayo se presentan y discuten trescasos de relevancia histórica y se analizan las cuestiones moralesconcernientes a cada uno(AU)

In medicine, interests opposed to the higher values that support its practice oen immerse us in ethical challengesthat we must face: Among such interests, those of a political,economic and media nature stand out. In this essay three casesof historical relevance are presented and discussed and the moralquestions concerning each one are analyzed(AU)

Antivacina, fosfoetanolamina e Mineral Miracle Solution (MMS): mapeamento de fake sciences ligadas à saúde no Facebook / Anti-vaccine, phosphoethanolamine and Mineral Miracle Solution (MMS): mapping of health-related fake sciences on Facebook / Antivacina, fosfoetanolamina y Mineral Miracle Solution (MMS): mapeo de fake sciences relacionadas con la salud en Facebook

A partir de uma abordagem multimetódos baseada em pesquisa qualitativa de observação não-participante, análise de conteúdo e técnicas de snowballing de recomendação algorítmica, a proposta deste artigo é mapear a circulação de três disputas de informação científica ligadas à saúde em páginas e grupos brasileiros no Facebook ­ movimento antivacina, fosfoetanolamina e Mineral Miracle Solution (MMS). Os resultados apontam para um campo de disputa no qual a autoridade científica é um valor relevante, sendo recorrentemente acionada como signo de convencimento junto ao público. Ainda, as fake sciences são um campo de disputa que envolvem 1) interesses comerciais em torno da crença em soluções rápidas e alternativas, 2) implicações jurídicas em torno do discurso pelo direito à informação e acesso a esses tratamentos alternativos, 3) sistema de reputação na busca por interseção na formulação de políticas e a alocação de recursos públicos e 4) uma descrença nas instituições epistêmicas, fazendo os sujeitos acreditarem apenas em experiências individuais baseadas no discurso de testemunho.

From a multi-method approach based on qualitative research of non-participant observation, content analysis and snowballing techniques with algorithmic recommendation, the purpose of this article is to map the circulation of three scientific information disputes related to health on pages and groups on Facebook ­ anti-vaccine movement, phosphoethanolamine and Mineral Miracle Solution (MMS). The results point to a field of dispute in which scientific authority is a relevant value in these spaces, being repeatedly used as a sign of convincing the public. Still, fake sciences are a field of dispute that involve 1) commercial interests around the belief in quick and alternative solutions, 2) legal implications around the discourse for the right to information and access to the alternative treatments, 3) system of reputation in the search for intersection in the formulation of policies and the allocation of public resources and 4) a disbelief in epistemic institutions, making subjects believe only in individual experiences based on the testimony discourse.

Desde un enfoque de métodos múltiples basado en la investigación cualitativa de observación no participante, análisis de contenido y técnicas de snowballing con recomendación algorítmica, el propósito de este artículo es mapear la circulación de tres disputas de información científica relacionadas con la salud en páginas y grupos en Facebook: movimiento antivacunas, fosfoetanolamina y solución de milagro mineral (MMS). Los resultados apuntan a un campo de disputa en el que la autoridad científica es un valor relevante en estos espacios, y se usa repetidamente como un signo de convencer al público. Aún así, las fake sciences son un campo de disputa que involucra 1) intereses comerciales, en torno a la creencia en soluciones rápidas y alternativas, 2) implicaciones legales en torno al discurso sobre el derecho a la información y el acceso a estos tratamientos alternativos, 3) sistema de reputación en la búsqueda de intersección en la formulación de políticas y la asignación de recursos públicos y 4) una incredulidad en las instituciones epistémicas, haciendo que los sujetos crean solo en experiencias individuales basadas en el discurso del testimonio.

A Proposal for Educational Curriculum on Conflicts of Interest from Undergraduate through Postgraduate and Continuing Health Professions Education / 医学教育

To ensure public trust in health professions, it is imperative for health professionals to understand the concept of conflict of interest (COI) in health professions education and manage it appropriately. However, there are not enough formal curricula on COI in health professions education in Japan. We propose an educational curriculum on COI in health professions education which focuses on relationship between physicians and for-profit corporations. We hope that this proposed curriculum stimulates educational activities on the ground while taking context into account. We also hope the proposed curriculum leads to the formal incorporation of COI in health professions education and educational policies nationwide.

Nephrologists between power and vulnerability in times of technology / O Nefrologista entre o poder e a vulnerabilidade em tempos tecnológicos

ABSTRACT The doctor-patient relationship is often discussed from the perspective of patient vulnerability. Little attention is given to the vulnerability of nephrologists in their professional practice, a reality often affected by profound cultural transformation arising from technological development. Nephrology is based on research and procedure instrumentalization, both permeated with technology. In addition, the relationship between nephrologists and institutions is governed by market rules. Recent data showed a shortage of new nephrologists and the need to improve the technical training of new professionals, foster the establishment of interventional nephrology, and attract more graduating physicians to this medical specialty. Bioethics offers a different perspective on the issue, since it takes the subjective concerns of medical doctors and the social environments they participate in into consideration in order to enhance their ethical autonomy. These ideas may be discussed as part of undergraduate or specialization programs, thus reinforcing the acknowledgement of vulnerability as a condition and of the relevance of adopting a reflective attitude toward the events of everyday life that interact with the morality of nephrologists, so that risks are adequately faced having bioethical parameters as a reference.

RESUMO A vulnerabilidade do paciente é sempre foco de maior atenção quando se analisa a relação médico-paciente. Pouca ênfase é dirigida à vulnerabilidade do nefrologista em relação à própria prática profissional, frequentemente afetada pelas profundas transformações culturais decorrentes do desenvolvimento tecnológico. A atividade da Nefrologia é embasada na pesquisa e na instrumentalização dos procedimentos, ambos permeados pela tecnologia. Além disso, os relacionamentos com instituições são regidos por regras mercadológicas. Dados recentes constatam a escassez de novos nefrologistas, fato que mobiliza a proposta de melhorar a capacitação técnica de novos nefrologistas, favorecendo o estabelecimento da Nefrologia Intervencionista e o implemento durante a graduação médica de ferramentas que aumentem a atratividade por tal especialidade. A Bioética lança um olhar diferente sobre essa questão, pois considera aspectos subjetivos relacionados ao profissional e ao seu entorno social com o intuito de potencializar sua autonomia ética. Essa proposição pode ser considerada durante a graduação e a especialização para o reconhecimento da sua condição de vulnerabilidade e da importância de uma atitude reflexiva que levaria a perceber as incidências cotidianas que agem sobre a moral do nefrologista, para ser possível enfrentar adequadamente os riscos baseado em parâmetros bioéticos.

Minutes of the 11th Chinese National Congress on Parkinson's Disease and Movement Disorders / 中华神经科杂志

We summarized the main information of the 11th Chinese National Congress on Parkinson's Disease and Movement Disorders which was successfully convened in Chengdu on May 3-5, 2018. The topics about Parkinson's disease were assorted based on mechanisms, diagnosis, natural history and treatment. Other movement disorders such as dystonia and atypical parkinsonism were also mentioned. Outstanding oral presentations and posters were awarded by the academic committee.

Declaraciones de conflictos de interés en las publicaciones biomédicas: estudio de cuatro revistas clínicas españolas / Conflicts of interest disclosure in biomedical publications: study of four Spanish clinical journals / Declarações de conflitos de interesse em publicações biomédicas: estudo de quatro revistas clínicas espanholas

La declaración de las relaciones financieras y personales de los investigadores con las compañías farmacéuticas es percibida como un paso esencial en la gestión de los potenciales conflictos de interés. El objetivo del estudio fue evaluar las declaraciones de conflictos de interés en cuatro revistas biomédicas españolas publicadas en castellano: Atención Primaria, Medicina Clínica, Revista Clínica Española y Revista Española de Cardiología. Se analizaron las publicaciones de 2012 calificadas por las revistas como "Editorial", "Artículo original", "Documento de consenso", "Revisión" y "Artículo especial". De 412 artículos, 315 (76%) presentaron declaración de conflictos de interés. Por revista, el 73% de los artículos de Atención Primaria, el 68% de Medicina Clínica, el 60% de Revista Clínica Española y el 100% de Revista Española de Cardiología tenía declaración de conflictos de interés. Solo el 12% de las declaraciones describía alguna actividad susceptible de generar conflicto de interés, mientras que el resto afirmaba no tener. Además de una variabilidad considerable en la frecuencia de declaración de conflictos de interés, la presencia de actividades declaradas es baja. Parece necesario mejorar la uniformidad y transparencia de las políticas de declaración de conflictos de interés.

Disclosure of financial relationships between researchers and pharmaceutical companies is seen as an essential step in the management of potential conflicts of interest. The objective of the study was to evaluate the frequency of conflicts of interest disclosure in four Spanish biomedical journals: Atención Primaria, Medicina Clínica, Revista Clínica Española and Revista Española de Cardiología. Publications qualified as "Editorial", "Original Article", "Consensus Document", "Review" and "Special article" in 2012 were analyzed. Of 412 articles, 315 (76%) had a conflict of interest statement. By journal, 73% of the articles in Atención Primaria, 68% in Medicina Clínica, 60% in Revista Clínica Española and 100% in Revista Española de Cardiología had disclosure of conflicts of interest. Only 12% of disclosures reported activities, while the rest maintains "No conflict of interest". In addition to a considerable variability in the frequency of conflicts of interest disclosure, the presence of activities disclosed is low. It would be necessary to improve the consistency and transparency of the policy declaration of conflicts of interest.

A declaração das relações financeiras e pessoais de pesquisadores com empresas farmacêuticas é vista como um passo essencial na gestão dos potenciais conflitos de interesse. O objetivo do estudo foi avaliar as declarações de conflitos de interesses em quatro revistas biomédicas espanholas publicadas em castelhano: Atención Primaria, Medicina Clínica, Revista Clínica Española e Revista Española de Cardiología. Foram analisadas as publicações de 2012 classidicadas pelas revistas enquanto: "Editor", "Artigo Original", "Documento de consenso", "Revisão" e "Artigo especial". De 412 artigos, 315 (76%) apresentaram declaração de conflitos de interesses. Por revista, 73% dos artigos de Atención Primaria, 68% de Medicina Clínica, 60% da Revista clínica Española e 100% da Revista Espanhola de Cardiologia tinham declaração de conflitos de interesses. Apenas 12% das declrações descrevia qualquer atividade suscetível a gerar conflito de interesses, enquanto o resto alegou não ter. Ademais de uma considerável variabilidade na frequência de declaração de conflitos de interesses, a presença de atividades declaradas é baixa. Parece necessário melhorar a uniformidade e a transparência das políticas de declaração de conflito de interesses.

Conflito de Interesses em Eventos de Educação Médica Continuada (EMC): o que Palestrantes e Ouvintes Consideram Importante que Seja Declarado? / Conflicts of Interest at Continuing Medical Education Events: What do Speakers and Listeners Believe must be Declared?

RESUMO Introdução As companhias farmacêuticas representam a principal fonte de inovações terapêuticas na medicina, daí têm participação importante em eventos de educação médica continuada (EMC). Objetivos Conhecer as concepções de médicos (palestrantes ou ouvintes) acerca do significado dos conflitos de interesses em eventos de EMC e que tipo de relação deveria ser declarado. Metodologia Médicos que atuam numa universidade brasileira responderam a um questionário com perguntas abertas e fechadas. Os dados qualitativos foram analisados de acordo com uma análise de conteúdos, e os quantitativos submetidos a análise estatística apropriada. Resultados Setenta e seis médicos responderam ao questionário; 55,3% consideram o conflito de interesses como uma situação, enquanto 44,7% o consideram um comportamento. Além do financiamento de pesquisa relacionada ao tema da palestra, mais da metade dos participantes apontou outros seis tipos de relacionamento indústria/palestrante cuja declaração é desejável. Cinquenta por cento dos palestrantes e 18% dos ouvintes acreditam estar bem preparados para lidar com as indústrias farmacêuticas. Considerações finais Escolas médicas, Conselho Federal de Medicina e Associação Médica Brasileira deveriam trabalhar para aprimorar a compreensão dos médicos acerca do tema e criar regras claras sobre o que deveria ser declarado.

ABSTRACT Introduction Pharmaceutical companies are the main source of therapeutic innovations in medicine, thus playing an important role in continuing medical education (CME). Objectives To study physicians’thoughts on conflicts of interests at CME events. Methodology Physiciansworkingat a Brazilian public university responded to a questionnaire featuring open and closed questions, with qualitative data studied according to a content analysis and quantitative data subjected to a proper statistical analysis. Results 76 physicians answered the questionnaire, with 55.3% considering conflicts of interests to constitute‘situations’ and 44.7% seeingthem as a form of‘behavior’. Besides financial support for research related to the presentations, the majority of participants pointed to six other kinds of industry/speaker relationship in which a declaration should be mandatory. Only 50% of speakers and 18% of listeners feel prepared to deal with pharmaceutical companies’ issues. Final considerations Medical schools and medical representative entities should work toward improving physicians’ understanding of this issue and creating objective rules on what must be declared.

Conflicts of interest in orthopaedic surgery: The intertwining of orthopaedic surgery, peer review publications and corporate sponsorship

Conflicts of interest in medicine has created deep concerns about the integrity of medicine and raised doubts about the trustworthiness of the medical professional. New stories of conflict of interest in medicine have become a commonplace. The interactions between the medical professional and the biomedical device as well as the pharmaceutical industry has become so pervasive that the primary interest of the medical professional in protecting and promoting the welfare of the patient has been compromised. The professional judgement and actions have been influenced by secondary interests, the major fungible and quantifiable being financial interest. The industry influence not only affects the way we practice orthopaedics but also affects medical education and peer review publications. Peer review publications have been shown to exaggerate benefits of the industry products while at the same time downplaying the risks. These conflicts of interest in orthopaedic surgery are particularly common in spinal and joint replacement surgery where joint replacement has been described as a ‘fashion trade’. The introduction of new products appears to be an uncontrolled experiment which has been hijacked by large corporations. This article explores the unhealthy pervasive interaction between the orthopaedic surgeon and the medical devices as well as the pharmaceutical industry. It highlights how the biomedical and the pharmaceutical industry dominate all aspects of the healthcare system. With its wealth and political clout, its influence is present everywhere, from the use of devices and drugs, research, publications, trials, education and even formulation of CGPs.

A Questionnaire Survey about Potential Conflict of Interest in Pharmacist’s Practice / 社会薬学

Relationships between physicians and pharmaceutical companies have received considerable attention regarding the professionalism of health care professionals in recent years. Pharmacists may also have a conflict of interest if they are provided some benefits from pharmaceutical companies. We conducted a survey of pharmacists in hospitals, clinics, and pharmacies in mid 2011. The response rate was 58.8％（235/400）. Most pharmacists（94％） reported some type of relationship with pharmaceutical companies, which included receiving ballpoint pens and notebooks（88.5％）, or receiving food in a meeting（56.6％）. Managerial level pharmacists received more “textbooks and guidelines”, “gifts” than other pharmacists. The results of this survey indicate that relationships between pharmacists and companies is common. The formulation of guidelines and more responsible behaviors are needed.

Addressing conflicts of interest in the research paper: a societal demand in contemporary science?

In the last decade, dialogue between science and society has found a forum in an increasing number of publications on topics such as public engagement with science and public trust in science. Concerning the latter, issues that include cases of research misconduct, accountability in research, and conflicts of interest (COIs) have shaped global discussions on the communication of science. In the publication setting, the perception that hiding COIs and/or not managing them well may affect public trust in the research record has grown among editors. We conducted a search for editorials addressing COIs between 1989 and 2011, using four major databases: Medline/PubMed, Embase, Scopus, and Web of Knowledge. We explored the content of these editorials and the relationship they established between COIs and the public trust in science. Our results demonstrate that the relationship between disclosure of COIs and public trust in science has become a major concern among editors. We, thus, argue that COIs should be discussed more openly and frequently in graduate courses in the sciences, around the globe, not only in biomedical but also in non-biomedical areas. This is a critical issue in contemporary science, as graduate students are the future voices and decision-makers of the research community. Therefore, COIs, especially in the broader context of science and society, merit closer attention from policymakers, researchers, and educators. At times of great expectations for public engagement with science, mishandling of COIs may have undesirable consequences for public engagement with science and confidence in the scientific endeavor.

Conflitos de interesse na pesquisa, produção e divulgação de medicamentos / Conflicts of interest in the research, production and dissemination of medicines

Analisa o debate sobre os conflitos éticos dos artifícios utilizados pela indústria farmacêutica na pesquisa, produção e divulgação dos medicamentos. Três aspectos são examinados: o envolvimento dos profissionais de medicina com os representantes das indústrias farmacêuticas; o conflito de interesses quanto a sua atuação como patrocinadora de pesquisas científicas; a avaliação de fármacos em seres humanos. Verifica-se que a mensagem para promoção da saúde advém da medicalização; as grandes indústrias farmacêuticas não produzem exclusivamente mercadorias, mas, sobretudo, subjetividades. Dessa forma, descortina-se o tipo de ordem por elas estabelecida.

This paper analyzes the debate about the ethical conflicts of the methods used by the pharmaceutical industry in the research, production and dissemination of medicines. Three aspects are examined: the involvement of medical professionals with representatives of the pharmaceutical industry; the conflicts of interest regarding their role as sponsors of scientific research; and the evaluation of drugs on human beings. It is seen that the message for health promotion comes from medicalization; the major pharmaceutical industries do not exclusively produce merchandise, but especially subjectivities. In this way, the type of order established by them is revealed.

Conflict of interest declaration: why and what constitutes as responsible and ethical declaration?

This is one among a series of editorials related to ethics in publication. The present editorial deals with a key issue of the declaration of conflicts of interest (COI), which all stake holders, especially authors should be aware of. Such issues are now mandatory ethical requirements and not just for name sake. Broadly speaking, COI comes into existence when someone's position may be influenced by his vested interests. World Association of Medical Editors (WAME) says 'journals have a responsibility to raise awareness and educate the research community about COI.'

Os conflitos de interesses / Conflicts of interest / Los conflictos de intereses

El artículo revisa el concepto de conflicto de intereses con la industria y el modo como este conflicto afecta el trabajo de los profesionales de la salud. Se examinan los conflictos de intereses de carácter colectivo, los conflictos en la investigación, en las publicaciones, en la redacción de guías de buenas prácticas médicas y, de modo cada vez más evidente, en las relaciones de las asociaciones de pacientes con la industria...

This article reviews the concept of conflicts of interest with industry and the way these conflicts affect health care professionals work. Conflicts of interest of collective type in research, publications, writing good medical practice guidelines and with an increasing evidence, the relations of patients associations with industry are examined...

O artigo revisa o conceito de conflito de interesses com a indústria e o modo como este conflito afeta o trabalho dos profissionais da saúde. São examinados os conflitos de interesses de caráter coletivo, os conflitos na investigação científica, nas publicações, na redação de guias de boas práticas médicas e, de modo cada vez mais evidente, nas relações das associações de pacientes com a indústria...

Transparencia en la investigación biomédica: A propósito de los riesgos asociados al uso de Avandia / Transparency in biomedical research: About the risks associated with the use of Avandia

The question of how and when to communicate potential risks associated with new drugs has remained an important focus of tension between the pharmaceutical industry and regulatory entities, such as the American Food and Drug Administration. Recently there has been widespread concern related to the cardiovascular risks associated with the use of Avandia, a rosiglitazone produced by Glaxo Smith Kline. In fact, several metaanalyses involving rosiglitazone provided a relatively consistent message that rosiglitazone increases the risk of myocardial ischemic events. In the present article, we review the controversy regarding the way the pharmaceutical company handled this issue, and we describe examples of inappropriate conduct regarding an industry-sponsored clinical trial with this drug. We raise several important ethical questions related to the way researchers handle conflicts of interest when they are employees of the pharmaceutical industry. Finally, we discuss the requirements to conduct biomedical research funded by the pharmaceutical industry in Chile.

Ethical Issues in Physician-Pharmaceutical Industry Interactions

On April 28, the National Assembly passed 3 bills revising the Medical Act, Pharmaceutical Affairs Act, and Medical Instruments Act which are related to the so-called 'dual punishment system' at its 9th plenary session of the 289th provisional meeting. According to the government timetable, beginning November of this year (2010), doctors will be subject to imprisonment for up to two years or face fines of up to 30 million won when found to have taken financial or non-financial benefits from drug companies. Their license could also be suspended for one year. Interactions between industry and physicians are vital to public health. However, they must be principled partnerships effectively managed to sustain public trust in both partners' commitment to patient welfare and the improvement of health care. Mounting scientific evidence indicates that gifts, favors, and other marketing activities, both explicit and implicit, prejudice independent judgment in unconscious ways. Physicians who receive free gifts from the pharmaceutical industry must consider the ethical dilemmas posed by this practice. These dilemmas are conflict of interest, impairment of objectivity, and the impact of these free gifts on the cost of health care. In order to minimize the likelihood of biased decisions by physicians, pharmaceutical companies should comply with their code of ethics for fair competition, while medical societies should establish an influence-free culture for physicians and optimize the benefits inherent in the principled relationships between medical society and industry.

Etica en la medicina actual / Ethics in contemporary medicine

El ejercicio de la medicina se ha regido tradicionalmente por los principios de la ética médica y los aspectos científicos que la definen. Sin embargo, la medicina actual se ve fuertemente influida por aspectos de otra índole como el interés económico, el encarnizamiento terapéutico, la medicina defensiva, la cirugía innecesaria, los conflictos de interés, las alteraciones en la aplicación del consentimiento informado, la relación con la industria farmacéutica, el respeto a la confidencialidad, la ética organizacional, y el ejercicio ético que escapa a la voluntad del profesional médico.

Medical practice has been traditionally ruled by the principles of medical ethics and the scientific aspects that define it. However, today's medical practice is largely influenced by other aspects such as: economic interests, abuse of therapeutics, defensive medicine, unnecessary surgeries and conflicts of interests without excluding alterations in the application of the informed consent, the relation with the pharmaceutical industry, respect of confidentiality, organizational ethics, and the ethical practice that escapes the will of the medical professional.

Source of funding and results of studies of health effects of mobile phone use: systematic review of experimental studies: [review] / Fonte de financiamento e resultados de estudos sobre os efeitos do uso do telefone celular à saúde: revisão sistemática de estudos experimentais: [revisão]

There is concern regarding the possible health effects of cellular telephone use. We conducted a systematic review of studies of controlled exposure to radiofrequency radiation with health-related outcomes (electroencephalogram, cognitive or cardiovascular function, hormone levels, symptoms, and subjective well-being). We searched Embase, Medline, and a specialist database in February 2005 and scrutinized reference lists from relevant publications. Data on the source of funding, study design, methodologic quality, and other study characteristics were extracted. The primary outcome was the reporting of at least one statistically significant association between the exposure and a health-related outcome. Data were analyzed using logistic regression models. Of 59 studies, 12 (20 percent) were funded exclusively by the telecommunications industry, 11 (19 percent) were funded by public agencies or charities, 14 (24 percent) had mixed funding (including industry), and in 22 (37 percent) the source of funding was not reported. Studies funded exclusively by industry reported the largest number of outcomes, but were least likely to report a statistically significant result. The interpretation of results from studies of health effects of radiofrequency radiation should take sponsorship into account.

Foi realizada uma revisão sistemática de estudos de exposição controlada à radiação de radiofreqüência com resultados relacionados à saúde (eletroencefalograma, função cognitiva ou cardiovascular, níveis hormonais, sintomas e bem-estar subjetivo). Foram pesquisados o Embase, Medline e um banco de dados especializado e analisadas listas de referências de publicações relevantes. Foram extraídos dados sobre a fonte de financiamento, desenho do estudo, qualidade metodológica e outras características do estudo. A principal descoberta foi o relato de pelo menos uma associação estatisticamente significativa entre a exposição e um resultado relacionado à saúde. Os dados foram analisados usando-se modelos de regressão logística. De 59 estudos, 12 (20 por cento) foram financiados exclusivamente pela indústria de telecomunicação, 11 (19 por cento), por órgãos públicos ou de caridade, 14 (24 por cento) tiveram financiamentos combinados (inclusive da indústria) e em 22 (37 por cento) a fonte de financiamento não foi notificada. Os estudos financiados exclusivamente pela indústria tiveram o maior número de resultados, mas menos propensão a relatar um resultado significativo. A interpretação dos resultados dos estudos sobre os efeitos da radiação de radiofreqüência à saúde deve levar em conta o patrocínio.

The Ethical Problems in Neurotherapeutics Research / 中国医学伦理学

Three key ethical issues in neurotherapeutics research are discussed: the ethical challenges arising from changes in the financial incentive of researchers and their institutions,risk-benefit analysis on testing innovative interventions,and the research for informed consent.