Conflict of interest’s influence on systematic reviews of chronic pain management with opioids

Conner Polson, Parker Siex, J Michael Anderson, Michael Weaver, William Roberts, Micah Hartwell, Matt Vassar

Research output: Contribution to conferencePosterpeer-review

Abstract

Background: Chronic pain is an increasing cause of distress and disability in the general population. Treatment of chronic pain is based on clinical guidelines, many of which are derived from systematic reviews. One treatment of note -the use of opioid analgesics to treat chronic pain- has become increasingly controversial due to the risk: benefit ratio. Therefore, it is imperative that systematic reviews regarding the treatment of chronic pain with opioids are accurate and without significant bias. Previous research suggests that industry bias, in the form of author conflicts of interest (COI) and industry sponsorship, may influence the direction of reported results and conclusions of medical research. We sought to determine whether author COI (disclosed or undisclosed) 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: MEDLINE (Ovid) and Embase (Ovid) were searched to find systematic reviews and meta-analyses pertaining to the management of chronic non-cancer pain with analgesic opioids. Study sponsorship was determined using the funding statement provided in each systematic review. Similarly, 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. Initial results were screened and data extraction was performed by C.P. and P.S. in a masked, duplicate fashion. All discrepancies were resolved by group consensus with third-party adjudication available, if necessary. For reproducibility, our study materials and protocol have been made available on the Open Science Framework.

Results: Following title and abstract screening and full-text review, eight systematic reviews authored by 83 authors met our eligibility criteria and were included in our study. 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 statistically significant association between the presence of a COI and the favorability of results (p = 0.64) or conclusions (p = 0.07).

Conclusion: COI are common and frequently undisclosed among systematic review authors investigating opioid analgesics for the management of chronic non-cancer pain, although we did not find that these author-industry relationships had a significant influence on the favorability of results and conclusions. We recommend that future studies expand their eligibility criteria in an effort to increase the sample size.
Original languageAmerican English
Pages75
StatePublished - 22 Feb 2021
EventOklahoma State University Center for Health Sciences Research Days 2021: Poster presentation - Oklahoma State University Center for Health Sciences Campus, Tulsa, United States
Duration: 22 Feb 202126 Feb 2021

Conference

ConferenceOklahoma State University Center for Health Sciences Research Days 2021
Country/TerritoryUnited States
CityTulsa
Period22/02/2126/02/21

Keywords

  • Conflicts of Interest
  • Industry Sponsorship
  • Industry Bias
  • Systematic Review

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