Conflicts of Interest Among Authors of Systematic Reviews Regarding the Management of Chronic Non-Cancer Pain with Opioids Analgesics.

OBJECTIVE: We sought to determine whether author conflict of interest (disclosed or undisclosed) or industry sponsorship influenced the favorability of reporting of systematic reviews and meta-analyses investigating the use of opioid analgesics for the management of chronic non-cancer pain. METHODS: Our search included the MEDLINE (Ovid) and Embase (Ovid) databases. Study sponsorship was determined using the funding statement provided in each systematic review. Author COI information was extracted from the COI disclosure statement. This information was cross-referenced with information available on the CMS Open Payments Database, Dollars for Profs, Google Patents, the United States Patent and Trademark Office (USPTO), and previously published COI disclosures. RESULTS: Eight systematic reviews authored by 83 authors were included. Of these authors, 19 (23.0%) were found to have a COI, of which the majority (17/19; 89.5%) had at least one undisclosed COI. Despite nearly one-quarter of authors having a COI, we found no association between the presence of a COI and the favorability of results (P = 0.64) or conclusions (P = 0.07). CONCLUSIONS: COI are common and frequently undisclosed among systematic review authors investigating opioid analgesics for the management of chronic non-cancer pain. Despite a high prevalence of COI, we did not find that these author-industry relationships had a significant influence on the favorability of results and conclusions; however, our findings should be considered a lower bound estimate of the true influence author COI have on outcomes of pain medicine systematic reviews secondary to the low sample size included in the present study.

Evaluation of spin in the abstracts of systematic reviews and meta-analyses covering surgical management, or quality of life after surgical management, of osteoarthritis of the knee.

Objective: Our primary objective was to identify the prevalence of spin - misleading reporting practices that overemphasize benefit or underemphasize harm - within the abstracts of systematic reviews and meta-analyses focused on surgical management of osteoarthritis of the knee. Methods: A search string was developed to search Ovid MEDLINE and Ovid Embase for articles pertaining to surgical management, or quality of life after surgical management, of osteoarthritis of the knee. Titles and abstracts were screened according to our protocol, developed a priori, followed by full-text evaluation for spin in included articles. Study characteristics were simultaneously extracted with spin data and each included study received an AMSTAR-2 quality appraisal. All procedures were performed by two examiners in a masked, duplicate fashion. Results: Of the 1419 articles returned, 96 systematic reviews qualified for inclusion. 35.4% of the included abstracts (34/96) contained at least one type of spin with a total of 36 occurrences (two abstracts contained two types of spin). Selective reporting favoring benefit (type 3; 15/36, 41.7%) was the most prevalent followed by selective reporting of harms (type 6; 7/36, 19.4%). None of the abstracts contained spin types 2, 4, or 8. We found no significant association between spin and either AMSTAR-2 rating or extracted study characteristics. Conclusion: Of the included systematic reviews and meta-analyses, 35.4% contained spin in their abstract. To improve the reliability of systematic reviews and meta-analyses, researchers should act to minimize spin in future abstracts.