Physicians, patients, and study participants believe researchers' financial ties to industry decrease the quality of evidence, and patients say that such ties influence professional behavior and should be disclosed, a review of studies has found.
For some, knowledge of the researchers' financial ties to industry would affect their willingness to participate in studies, wrote Dr. Cary Gross of Yale University, New Haven, Conn., and colleagues (Arch. Intern. Med. 2010;170:675–82).
“When any financial tie was disclosed, there was a reduction in the perceived quality of research” among participants and physicians, they reported. Patients believed that financial ties decreased the quality of clinical care and affected prescribing behavior.
The investigators reviewed 11 original quantitative studies of the views of patients, research participants, and journal readers about financial ties and perceptions of quality.
In studies of patient perception of cost, 26%–76% said they believed that gifts to physicians increase the cost of care; fewer patients thought professional gifts were a problem.
“In a 2009 study of 903 patients contacted by telephone, 9% disapproved of physicians receiving free drug samples and 16% disapproved of free medical texts, compared with disapproval rates of 55% and 68%, respectively, for paid dinners and golf tournaments,” Dr. Gross and his colleagues wrote.
In other studies, when asked to rate disclosure statements, respondents said researchers with financial ties were less trustworthy and less important than were those without such ties.
For some potential trial participants, disclosure of financial ties affected their willingness to participate. “Three studies reported that prospective research participants were least willing to participate in a hypothetical clinical trial when a researcher equity ownership was disclosed,” wrote Dr. Gross and his colleagues. “Of note, the participants also reported less trust in researchers after disclosure of financial ties.”
In an editorial, Eric Campbell, Ph.D., of Harvard University, Boston, said public disclosure seems like a likely first step toward a more active government and health care institution role in evaluating and managing physician-industry relationships (Arch. Intern. Med. 2010;170:667).
“This will likely be seen by some physicians as a direct assault on their sense of professional identity and autonomy,” he wrote. But the transparency “will help prevent the further erosion of public trust in the medical profession.”
The review was funded in part by a Doris Duke Clinical Research Fellowship. Dr. Gross and a coauthor disclosed ties to Genzyme Corp. Dr. Campbell did not report any financial disclosures.