Quantification of Conflicts of Interest in an Online Point-of-Care Clinical Support Website

Abstract

Online medical reference websites are utilized by health care providers to enhance their education and decision making. However, these resources may not adequately reveal pharmaceutical-author interactions and their potential conflicts of interest (CoIs). This investigation: 1) evaluated the correspondence of two well-utilized CoI databases: the Centers for Medicare and Medicaid Services Open Payments (CMSOP) and ProPublica Dollars for Docs (PDD) and 2) quantified CoIs among authors of a publically available point of care clinical support website. Two data sources were used: the hundred most common drugs and the top fifty causes of death. These topics were entered into a freely available database. The authors (N = 139) were then input into CMSOP and PDD and compensation and number of payment were determined for 2013-2015. The subset of highly compensated authors that also reported quote: Nothing to disclose, unquote, were further examined. There was a high degree of similarity between CMSOP and PDD for compensation (R2 > 0.998) and payment number (R2 > 0.992). The amount received was 1.4% higher in CMSOP ($4,059,194) than in PDD ($4,002,891). The articles where the authors had received the greatest compensation were in neurology (Parkinsons Disease = $1,810,032), oncology (Acute Lymphoblastic Leukemia = $616,727), and endocrinology (Type I Diabetes = $377,388). Two authors reporting Nothing to disclose received appreciable and potentially relevant compensation. CMSOP and PDD produced almost identical results. CoIs were common among authors but self-reporting may be an inadequate reporting mechanism. Recommendations are offered for improving the CoI transparency of pharmaceutical-author interactions in point-of-care electronic resources.

A Quantitative and Narrative Evaluation of Goodman and Gilman’s Pharmacological Basis of Therapeutics

“…Conflicts of interest (CoIs) were defined as “a set of circumstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by a secondary interest”. 13 The transparency of conflicts of interest has become increasingly ubiquitous for primary sources 14 including clinical trials, 15 undergraduate medical education, 16 continuing medical education, 17 point of care computerized sources, 18 meta-analyses, 19 and clinical practice guidelines. 20 The US Physician Payments Sunshine Act of 2010 required that all compensation (≥ $10) to doctors of medicine, osteopathy, dentistry, dental surgery, podiatry, optometry, and chiropractic medicine (i.e.…”