Evidence map›Paper›PMID 29439079›Full record

ArticleBMJ open2018

Primary outcome switching among drug trials with and without principal investigator financial ties to industry: a cross-sectional study.

Christopher W Jones, Benjamin S Misemer, Timothy F Platts-Mills, Rosa Ahn, Alexandra Woodbridge, Ann Abraham, Susan Saba, Deborah Korenstein, Erin Madden, Salomeh Keyhani

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 1 country.

Christopher W JonesDepartment of Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey, USA.
Benjamin S MisemerDepartment of Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey, USA.
Timothy F Platts-MillsDepartment of Emergency Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.
Rosa AhnSchool of Medicine, Oregon Health and Science University, Portland, Oregon, USA.
Alexandra WoodbridgeSchool of Medicine, Tulane University, New Orleans, Louisiana, USA.
Ann AbrahamNorthern California Institute for Research and Education, San Francisco, California, USA.
Susan SabaNorthern California Institute for Research and Education, San Francisco, California, USA.
Deborah KorensteinDepartment of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York City, USA.
Erin MaddenNorthern California Institute for Research and Education, San Francisco, California, USA.
Salomeh KeyhaniDepartment of Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA.
Northern California Institute for Research and Education · USCooper Medical School of Rowan University · USMemorial Sloan Kettering Cancer Center · USOregon Health & Science University · USTulane University · USUniversity of California, San Francisco · USUniversity of North Carolina at Chapel Hill · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
Comparative Effectiveness of Carotid Artery Revascularization vs Medical TherapyR01HL114563 · NHLBI · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI KEYHANI, SALOMEH · 2013 to 2018
$3.6M
An Evaluation of Novel Domains for Predicting 30-Day ReadmissionR01HL116522 · NHLBI · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI KEYHANI, SALOMEH · 2013 to 2017
$3.3M
NCI NIH HHS P30 CA008748NHLBI NIH HHS R01 HL114563NHLBI NIH HHS R01 HL116522
6 · The paper itself

Abstract

objectivesTo determine the relationship between manufacturer-related financial ties among investigators of published drug trials and rates of discrepant registered and published primary trial outcomes.

designCross-sectional study.

settingHuman subjects drug trials published in 'core clinical' MEDLINE journals in 2013. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary study endpoint was the presence of a prospectively registered, clearly defined primary outcome that matched the published primary outcome for each included trial. Secondary outcomes included assessments of registration timing and quality, and the impact of outcome discrepancies between registration and publication on the statistical significance of the included trials.

resultsOf 192 included trials, 134 (70%) were positive and 58 (30%) were negative. Financial ties were present between first or last authors and drug manufacturers for 130 trials (68%), of which 78% were positive, versus 53% of trials with no financial ties that were positive. Clearly defined, prospectively registered outcomes that matched the published outcomes were present in just 76 of the 192 trials (40%). After adjusting for study start date and sample size, the observed relationship between investigator financial ties and the presence of a match between prospectively registered and published primary outcomes was of borderline statistical significance (OR 2.12, 95% CI 0.998 to 4.50). Studies with financial ties present were more likely than studies without ties to have been prospectively registered (78%vs48%, P<0.001) and were more likely to have prospectively registered a clearly defined primary outcome(62%vs35%, P<0.001).

conclusionsLess than half of the trials in this cohort were prospectively registered with a clear primary outcome that was consistent with the primary outcome reported in the published manuscript. The presence of investigator financial ties was associated with higher quality registration practices, though this association diminished after adjusting for factors that impact registration quality.

Indexed as

Clinical Trials as TopicConflict of InterestCross-Sectional StudiesDrug IndustryEthics, ResearchHumansLogistic ModelsRegistriesResearch PersonnelResearch ReportResearch Support as Topicclinicaltrials.govconflict of interesttrial registration

Identifiers

PMID29439079
PMCPMC5829948
OpenAlexW2790253891

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.