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1.
BMC Med Ethics ; 25(1): 22, 2024 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-38378633

RESUMO

BACKGROUND: Financial interactions between pharmaceutical companies and physicians lead to conflicts of interest. This study examines the extent and trends of non-research payments made by pharmaceutical companies to board-certified allergists in Japan between 2016 and 2020. METHODS: A retrospective analysis of disclosed payment data from pharmaceutical companies affiliated with the Japanese Pharmaceutical Manufacturers Association was conducted. The study focused on non-research payments for lecturing, consulting, and manuscript drafting made to board-certified allergists from 2016 to 2020. We performed descriptive analyses on payment data. Trends were analyzed using generalized estimating equation models. RESULTS: Of the 3,943 board-certified allergists, 2,398 (60.8%) received non-research payments totaling $43.4 million over five years. Lecturing fees comprised 85.7% ($37.2 million) of the total payment amounts. For allergists who received at least one payment, the median amount per allergist was $3,106 (interquartile range: $966 - $12,124), in contrast to a mean of $18,092 (standard deviation: $49,233) over the five-year span. The top 1% and 10% of these allergists accounted for 20.8% and 68.8% of all non-research payments, respectively. The annual payment amounts significantly increased by 7.2% annual increase (95% CI: 4.4 - 10.0%, p < 0.001) each year until 2019, but saw a significant decrease in 2020 amid the COVID-19 pandemic. CONCLUSION: The majority of allergists received non-research payments, with a notable concentration among a small group. Payments increased annually until the pandemic's onset, which coincided with a substantial decrease. Further research is needed to explore the implications of these financial interactions on clinical practice and patient care in Japan.


Assuntos
Alergistas , Pandemias , Humanos , Estudos Transversais , Japão , Estudos Retrospectivos , Indústria Farmacêutica , Preparações Farmacêuticas , Conflito de Interesses , Revelação
3.
BMJ ; 384: e076902, 2024 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-38199616

RESUMO

OBJECTIVE: To assess the extent and types of financial ties to industry of panel and task force members of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision (DSM-5-TR), published in 2022. DESIGN: Cross sectional analysis. SETTING: Open Payments database, USA. PARTICIPANTS: 92 physicians based in the US who served as members of either a panel (n=86) or task force (n=6) on the DSM-5-TR with information recorded in the Centers for Medicare and Medicaid Services Open Payments database during 2016-19. This period was chosen to include the year that development of the DSM-5-TR began and the three years preceding, a time consistent with previous research on conflicts of interest and consistent with the American Psychiatric Association's disclosure requirements for the fifth revision (DSM-5) of the manual. MAIN OUTCOME MEASURES: Type and amount of compensation the panel and task force members of DSM-5-TR received during 2016-19. RESULTS: After duplicate names had been removed, 168 individuals were identified who served as either panel or task force members of the DSM-5-TR. 92 met the inclusion criteria of being a physician who was based in the US and therefore could be included in Open Payments. Of these 92 individuals, 55 (60%) received payments from industry. Collectively, these panel members received a total of $14.2m (£11.2m; €13m). One third (33.3%) of the task force members had payments reported in Open Payments. CONCLUSIONS: Conflicts of interest among panel members of DSM-5-TR were prevalent. Because of the enormous influence of diagnostic and treatment guidelines, the standards for participation on a guideline development panel should be high. A rebuttable presumption should exist for the Diagnostic and Statistical Manual of Mental Disorders to prohibit conflicts of interest among its panel and task force members. When no independent individuals with the requisite expertise are available, individuals with associations to industry could consult to the panels, but they should not have decision making authority on revisions or the inclusion of new disorders.


Assuntos
Conflito de Interesses , Medicare , Idoso , Humanos , Estados Unidos , Estudos Transversais , Manual Diagnóstico e Estatístico de Transtornos Mentais , Comitês Consultivos
7.
J Pediatr Orthop ; 44(3): e303-e309, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38145392

RESUMO

BACKGROUND: Analysis of industry payments to pediatric orthopaedic surgeons last occurred in 2017. We investigated payments to pediatric orthopaedic surgeons from 2015 to 2021 to understand surgeon characteristics associated with increased industry payments. METHODS: Open Payments Database datasets from 2015 to 2021 were queried for nonresearch payments to pediatric orthopaedic surgeons. Annual aggregates and subcategories were recorded. For surgeons receiving payments in 2021, the Hirsch index (h-index), gender, and US census division were found using the Scopus database, Open Payments Database, and online hospital profiles, respectively. χ 2 , Fisher exact, Mann-Whitney U , and t tests were used to compare surgeons in the top 25%, 10%, and 5% payment percentiles to the bottom 75%, 90%, and 95%, respectively. RESULTS: Payments rose 125% from 2015 to 2021. Education, royalties, and faculty/speaker increased most, while travel/lodging, honoraria, charitable contributions, and ownership interest decreased. Only royalties increased from 2019 to 2021. In 2021, of 419 pediatric orthopaedic surgeons receiving industry payments, men received greater median aggregate payments than women ($379.03 vs. $186.96, P =0.047). There were no differences in gender proportions between the top 75% and bottom 25% ( P =0.054), top 10% and bottom 90% ( P =0.235), and top 5% and bottom 95% ( P =0.280) earning comparison groups. The h-index was weakly positively correlated with industry payments ( rs =0.203, P <0.001). Mean h-indices in the 75th ( P <0.001, 95% CI: 2.62-7.65), 90th ( P =0.001, 95% CI: 3.28-13.03), and 95th ( P =0.005, 95% CI: 4.25-21.11) percentiles were significantly higher. Proportions of surgeons from the Middle Atlantic and West South Central in the 90th ( P =0.025) and 95th percentiles ( P =0.033), respectively, were significantly lower compared to all other regions. A higher proportion of surgeons from the Pacific were placed in the 90th ( P =0.004) and 95th ( P =0.024) percentiles. CONCLUSIONS: Industry payments to pediatric orthopaedic surgeons rose from 2015 to 2021. Most categories fell from 2019 to 2021, which may be related to the SARS-CoV-19 pandemic. In 2021, though gender was not related to aggregate payment percentile, location in select US census divisions and h-index was. LEVEL OF EVIDENCE: Level II-Retrospective study.


Assuntos
Cirurgiões Ortopédicos , Ortopedia , Cirurgiões , Masculino , Humanos , Feminino , Criança , Estados Unidos , Estudos Retrospectivos , Indústrias , Bases de Dados Factuais , Conflito de Interesses
8.
J Prev Med Hyg ; 64(3): E358-E366, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38126000

RESUMO

Background: Rational drug prescription (RDP) is one of the main components of the healthcare systems. Irrational prescribing can bring about numerous negative consequences for the patients and governmental agencies. This study aims to analyze the involvement of stakeholders in rational drug prescribing, their position (opponent or proponent), and the rationale behind it. Methods: This was a qualitative study conducted in 2019. Semi-structured face-to-face interviews were conducted with 40 stakeholders. Purposive and snowball sampling techniques with maximum heterogeneity were adopted to select the interviewees. Data was analyzed by MAXQDA software using thematic approach. Results: Iranian Food and Drug Administration employs the highest authority on the rational prescribing policy. Although the Ministry of Health and Medical Education, the Social Security Organization as one of the main health insurance organizations, pharmaceutical companies, and the Medical Council of the Islamic Republic of Iran, are among agencies that have great authority to improve rational prescribing, they fail to act professionally as they have conflicting interests. Remarkably, the Iran Food and Drug Administration, insurance organizations, family physicians, and patients, highly support the rational prescribing policy while the pharmaceutical companies display the least support for it. Conclusions: To make the prescription and using drugs more rational, policy makers should focus on different sources of conflicts of interest that different actors have. They should devise legal, behavior and financial policies accordingly to lessen or at least neutralize these conflicting interests, otherwise achieving RDP would be impossible in short and long terms.


Assuntos
Conflito de Interesses , Países em Desenvolvimento , Prescrições de Medicamentos , Humanos , Atenção à Saúde , Irã (Geográfico) , Preparações Farmacêuticas , Saúde Pública
9.
Environ Sci Technol ; 57(48): 19066-19077, 2023 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-37943968

RESUMO

Pollution by chemicals and waste impacts human and ecosystem health on regional, national, and global scales, resulting, together with climate change and biodiversity loss, in a triple planetary crisis. Consequently, in 2022, countries agreed to establish an intergovernmental science-policy panel (SPP) on chemicals, waste, and pollution prevention, complementary to the existing intergovernmental science-policy bodies on climate change and biodiversity. To ensure the SPP's success, it is imperative to protect it from conflicts of interest (COI). Here, we (i) define and review the implications of COI, and its relevance for the management of chemicals, waste, and pollution; (ii) summarize established tactics to manufacture doubt in favor of vested interests, i.e., to counter scientific evidence and/or to promote misleading narratives favorable to financial interests; and (iii) illustrate these with selected examples. This analysis leads to a review of arguments for and against chemical industry representation in the SPP's work. We further (iv) rebut an assertion voiced by some that the chemical industry should be directly involved in the panel's work because it possesses data on chemicals essential for the panel's activities. Finally, (v) we present steps that should be taken to prevent the detrimental impacts of COI in the work of the SPP. In particular, we propose to include an independent auditor's role in the SPP to ensure that participation and processes follow clear COI rules. Among others, the auditor should evaluate the content of the assessments produced to ensure unbiased representation of information that underpins the SPP's activities.


Assuntos
Conflito de Interesses , Ecossistema , Humanos , Poluição Ambiental , Biodiversidade
10.
Wiad Lek ; 76(10): 2283-2287, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37948727

RESUMO

OBJECTIVE: The aim: To study the features of legal regulation of preventing conflicts of interest in the healthcare field in foreign countries in order to propose improvements to national legislation. PATIENTS AND METHODS: Materials and methods: The methodological basis of the article is a set of methods and techniques of scientific knowledge. Methods of theoretical analysis, system-analytical, comparative-legal methods provided us with the opportunity to characterize the features of the legal regulation of preventing conflicts of interest in the area under study. RESULTS: Results: The common features of preventing conflicts of interest in the healthcare field in foreign countries are: (1) a combination of mandatory, recommendatory, ethical and legal norms that define a number of requirements, restrictions and prohibitions in this area; (2) different levels of legal regulation of conflicts of interest (international, national, regional, local); (3) two approaches to determining the content of conflict of interest: general (the conflict is defined the same for all cases) and differentiated (the conflict of interest is determined by each area, taking into account its specifics). The debatable and problematic issues of conflict prevention in the national healthcare system are analyzed, and amendments to the medical legislation are proposed. CONCLUSION: Conclusions: Prevention of conflict of interest in the healthcare field should be considered as a specific group of public legal relations and an independent subject of legal regulation arising from the norms of the legislation of most foreign countries.


Assuntos
Conflito de Interesses , Setor de Assistência à Saúde , Humanos , Atenção à Saúde , Internacionalidade
12.
PLoS One ; 18(11): e0293808, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37917603

RESUMO

Medical students are potential marketing targets for pharmaceutical companies because established prescribing habits are not easily altered. In 2014, Bruno Etain and several other researchers published a paper which investigated the knowledge of and opinions on potential conflict of interest (COI) with regard to preclinical and clinical students enrolled in medical schools in France and residents working in hospitals. An empirical survey study with Korean medical students concerning their educational experiences and views on conflicts of interest and comparing and contrasting the results with Etain's study of French medical students. Receipt of direct or indirect financial offerings from pharmaceutical industries was not properly recognised as COI by the medical students. Therefore, strengthening education on COI and implementing institutional improvements for COI disclosure are essential to prevent bias caused by COI and enhance awareness levels regarding COI.


Assuntos
Estudantes de Medicina , Humanos , Atitude do Pessoal de Saúde , Revelação , França , Conflito de Interesses , República da Coreia , Preparações Farmacêuticas
13.
PLoS One ; 18(11): e0288052, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37917605

RESUMO

We examine climate-related disclosures in a large sample of reports published by banks that officially endorsed the recommendations of the Task Force for Climate-related Financial Disclosures (TCFD). In doing so, we introduce a new application of the zero-shot text classification. By developing a set of fine-grained TCFD labels, we show that zero-shot analysis is a useful tool for classifying climate-related disclosures without further model training. Overall, our findings indicate that corporate climate-related disclosures increased after the launch of the TCFD recommendations and following individual endorsements. However, there are marked differences in the extent of reporting by recommended disclosure topic, suggesting that some recommendations have not yet been fully met. Our findings yield important conclusions for the design of climate-related disclosure frameworks.


Assuntos
Conflito de Interesses , Revelação , Publicações
14.
PLoS One ; 18(11): e0290022, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37910526

RESUMO

INTRODUCTION: Although hospitals are key health service providers, their financial ties to drug companies are little understood. We examine non-research pharmaceutical industry payments to English National Health Service (NHS) trusts-hospital groupings providing secondary and tertiary care. METHODS: We extracted data from the industry-run Disclosure UK database, analysing it descriptively and using the Jonckheere-Terpstra test to establish whether a statistically significant time trend existed in the median values of individual payments. We explained payment value and number per trust with random effects models, using selected trust characteristics as predictors. RESULTS: Drug companies reported paying £60,253,421 to 234 trusts, representing between 90.0% and 92.0% of all trusts in England between 2015 and 2018. As a share of payments to all healthcare organisations, the number of payments rose from 38.6% to 39.5%, but their value dropped from 33.0% to 23.6%. The number of payments for fees for service and consultancy and contributions to costs of events increased by 61.5% and 29.4%. The median payment value decreased significantly for trusts overall (from £2,250.8 to £1,758.5), including those with lower autonomy from central government; providing acute services; and from half of England's regions. The random effects model showed that acute trusts received significantly more money on average than trusts with all other service profiles; and trusts from East England received significantly less than those from London. However, trusts enjoying greater autonomy from government did not receive significantly more money than others. Trusts also received significantly less money in 2018 than in 2015. CONCLUSION: NHS trusts had extensive pharmaceutical industry ties but were losing importance as payment targets relative to other healthcare organisations. Industry payment strategies shifted towards events sponsorship, consultancies, and smaller payments. Trusts with specific service and geographical profiles were prioritised. Understanding corporate payments across the health system requires more granular disclosure data.


Assuntos
Revelação , Medicina Estatal , Conflito de Interesses , Inglaterra , Indústria Farmacêutica
15.
J Am Acad Child Adolesc Psychiatry ; 62(12): 1387-1391, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38035917

RESUMO

In keeping with the Journal's policies,1 we provide a listing of disclosures for all members of the editorial masthead and the ad hoc and guest editors (marked with an asterisk) as of September 15, 2023. This list, based on annually updated signed statements on file in the editorial office, includes all biomedical financial interests and potential conflicts of interest disclosed for the previous 24 months and the foreseeable future.


Assuntos
Conflito de Interesses , Revelação , Humanos
16.
Dtsch Arztebl Int ; 120(41): 690, 2023 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-37970670
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