The effects of industry funding and positive outcomes in the interpretation of clinical trial results: a randomized trial among Dutch psychiatrists

BMC Med Ethics. 2019 Sep 18;20(1):64. doi: 10.1186/s12910-019-0405-7.

Abstract

Background: Most studies are inclined to report positive rather than negative or inconclusive results. It is currently unknown how clinicians appraise the results of a randomized clinical trial. For example, how does the study funding source influence the appraisal of an RCT, and do positive findings influence perceived credibility and clinical relevance? This study investigates whether psychiatrists' appraisal of a scientific abstract is influenced by industry funding disclosures and a positive outcome.

Methods: Dutch psychiatrists were randomized to evaluate a scientific abstract describing a fictitious RCT for a novel antipsychotic drug. Four different abstracts were created reporting either absence or presence of industry funding disclosure as well as a positive or a negative outcome. Primary outcomes were the perceived credibility and clinical relevance of the study results (10-point Likert scale). Secondary outcomes were the assessment of methodological quality and interest in reading the full article.

Results: Three hundred ninety-five psychiatrists completed the survey (completion rate 45%). Industry funding disclosure was found not to influence perceived credibility (Mean Difference MD 0.12; 95% CI - 0.28 to 0.47, p?) nor interpretation of its clinical relevance (MD 0.14; 95% CI - 0.54 to 0.27, p?). A negative outcome was perceived as more credible than a positive outcome (MD 0.81 points; 95% Confidence Interval (CI) 0.43 to 1.18, p?), but did not affect clinical relevance scores (MD -0.14; 95% CI - 0.54 to 0.27).

Conclusions: In this study, industry funding disclosure was not associated with the perceived credibility nor judgement of clinical relevance of a fictional RCT by psychiatrists. Positive study outcomes were found to be less credible compared to negative outcomes, but industry funding had no significant effects. Psychiatrists may underestimate the influence of funding sources on research results. The fact that physicians indicated negative outcomes to be more credible may point to more awareness of existing publication bias in the scientific literature.

Keywords: Conflict of interest; Credibility; Industry funding; Industry funding disclosure; Methodological quality; Perceived clinical relevance; Perceived credibility; Positive outcome bias; Psychiatrists.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Clinical Trials as Topic / economics*
  • Clinical Trials as Topic / ethics*
  • Conflict of Interest*
  • Drug Industry / economics*
  • Drug Industry / ethics*
  • Humans
  • Netherlands
  • Psychiatry / economics*
  • Psychiatry / ethics*
  • Research Support as Topic / ethics*