Relationship between Research Outcomes and Risk of Bias, Study Sponsorship, and Author Financial Conflicts of Interest in Reviews of the Effects of Artificially Sweetened Beverages on Weight Outcomes: A Systematic Review of Reviews

Mandrioli, Daniele; Kearns, Cristin; Bero, Lisa

doi:10.1371/journal.pone.0162198

Cited by 136 publications

(122 citation statements)

References 54 publications

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“…Another systematic review investigating reviews of the effects of artificially sweetened beverages on weight found that sponsorship and authors’ financial COI introduced bias influencing the outcomes of reviews that could not be explained by other sources of bias. Although our study found an increase in negative studies published over time, the large majority of studies published (78% in 2008) were positive studies[6]. …”

Section: Discussionmentioning

confidence: 74%

Review and Analysis of Publication Trends over Three Decades in Three High Impact Medicine Journals

et al. 2017

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ContextOver the past three decades, industry sponsored research expanded in the United States. Financial incentives can lead to potential conflicts of interest (COI) resulting in underreporting of negative study results.ObjectiveWe hypothesized that over the three decades, there would be an increase in: a) reporting of conflict of interest and source of funding; b) percentage of randomized control trials c) number of patients per study and d) industry funding.Data sources and Study SelectionOriginal articles published in three calendar years (1988, 1998, and 2008) in The Lancet, New England Journal of Medicine and Journal of American Medical Association were collected.Data ExtractionStudies were reviewed and investigational design categorized as prospective and retrospective clinical trials. Prospective trials were categorized into randomized or non-randomized and single-center or multi-center trials. Retrospective trials were categorized as registries, meta-analyses and other studies, mostly comprising of case reports or series. Study outcomes were categorized as positive or negative depending on whether the pre-specified hypothesis was met. Financial disclosures were researched for financial relationships and profit status, and accordingly categorized as government, non-profit or industry sponsored. Studies were assessed for reporting COI.Results1,671 original articles were included in this analysis. Total number of published studies decreased by 17% from 1988 to 2008. Over 20 year period, the proportion of prospective randomized trials increased from 22 to 46% (p < 0.0001); whereas the proportion of prospective non-randomized trials decreased from 59% to 27% (p < 0.001). There was an increase in the percentage of prospective randomized multi-center trials from 11% to 41% (p < 0.001). Conversely, there was a reduction in non-randomized single-center trials from 47% to 10% (p < 0.001). Proportion of government funded studies remained constant, whereas industry funded studies more than doubled (17% to 40%; p < 0.0001). The number of studies with negative results more than doubled (10% to 22%; p<0.0001). While lack of funding disclosure decreased from 35% to 7%, COI reporting increased from 2% to 84% (p < 0.0001).ConclusionImproved reporting of COI, clarity in financial sponsorship, increased publication of negative results in the setting of larger and better designed clinical trials represents a positive step forward in the scientific publications, despite the higher percentage of industry funded studies.

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Section: Discussionmentioning

confidence: 74%

Review and Analysis of Publication Trends over Three Decades in Three High Impact Medicine Journals

et al. 2017

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“…Concerns have been raised about bias in such work, with skewing of findings towards industry benefit. For example, evidence for substantial bias has been identified in industry sponsored research on health effects of sugar sweetened beverages3536 and artificial sweeteners 37. Evidence for bias in industry sponsored research on other nutritional topics is less strong, with a non-significant trend towards about 30% higher likelihood of favourable conclusions 38.…”

Section: Vested Interestsmentioning

confidence: 99%

Dietary guidelines and health—is nutrition science up to the task?

Mozaffarian

Forouhi

2018

BMJ

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“…The opposite occurred with reviews sponsored by competitor food companies (e.g., the sugar industry), which were more likely to report negative results compared to nonsponsored reviews. Importantly, the authors estimated that “almost half of the reviews had authors that failed to disclose relevant conflicts of interest with the food industry” [56]. These findings underscore the substantial and complex nature of bias from conflicts of interest in ASB research.…”

Section: Current Evidence Regarding the Health Impact Of Asbsmentioning

confidence: 99%