A review and analysis of previously published studies finds that patients, researchers and journal readers believe financial relationships between medicine and industry should be disclosed, partly because over concerns that financial ties may influence research and clinical care, according to a report in the latest issue of theArchives of Internal Medicine.
Despite a demand for disclosure, little is known about how financial info affects decision-making, according to the report, which reviewed 20 original studies assessing the attitudes of patients, researchers and journal readers toward financial disclosures. And it's not clear that financial disclosure will have much effect on the willingness to participate in research.
Of these studies, 11 assessed financial ties and perceptions of quality. “In clinical care, patients believed financial ties decreased the quality and increased the cost of care,” the authors write. “In research, financial ties affected perceptions of study quality. In two studies, readers’ perceptions of journal article quality decreased after disclosure of financial ties.”
Eight studies evaluated the acceptability of financial ties. In these studies, patients were more likely to view personal gifts to clinicians as unacceptable than professional gifts. “Patients were concerned that these gifts affect the cost and quality of care and that these gifts influence clinical judgment,” the authors write.
In six of 10 studies examining the importance of disclosure, most patients and research participants reported believing financial ties should be disclosed. In the other four, about one-fourth of these populations believed ties should be disclosed. “Although many disclosure recipients want to know about financial ties, fewer believed that disclosure would affect their decision-making,” the authors continue. “Most research participants were not concerned about physician financial ties with industry, with as few as 7 percent reporting concern in one study.”
“As information on physician and researcher financial ties becomes more publicly available, further research is needed to explore the optimal format for widespread consumer use and the effect on patient decision-making in clinical care and research,” they conclude.
In the interest of financial disclosure, two of the authors have revelations to make: Steve Joffe of the Harvard Medical School has served as a paid member of a data and safety monitoring committee for Genzyme, and Cary Gross of the Yale Comprehensive Cancer Center has served as an expert witness, although specifics aren't offered.
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