A conflict of interest (COI) is a situation in which a person has competing loyalties or interests that make it difficult to fulfil his or her duties impartially. Conflict of interest is not categorically improper in itself but requires proper management. A SCOPUS literature search was performed for publications on the efficacy/safety of Phospho-Di-Esterase Inhibitors (PDEIs) for treating erectile dysfunction. A categorization tool (CoOpCaT) was used to review and classify the publications as supportive/not-supportive for the discussed active ingredient and reporting or not reporting a COI for that specific drug or for the remaining PDEIs (i.e. competitors). Multivariable binary logistic regression was performed. In the 419 selected records the prevalence of supportive opinions was higher when a COI for the index label was declared. The CoOpCaT showed good internal consistency, discriminative validity and intra/inter-rater agreement. The strongest predictor for a supportive opinion was the total number of financial COIs for the index label. A mild protective effect of the total number of financial COIs for any competitor label was noted. Financial COIs have frequently been associated with bias, and the measures currently adopted to restrain it lack effectiveness. Some evidence for monitoring and/or compensating this bias is reported here, but the ultimate solution remains distant.
Journal of bioethical inquiry. 2016 Jul 14 [Epub ahead of print]
Rafael Boscolo-Berto, Massimo Montisci, Silvia Secco, Carolina D'Elia, Rosella Snenghi, Guido Viel, Santo Davide Ferrara
Department of Cardiac, Thoracic and Vascular Sciences, Section of Legal Medicine, University Hospital of Padova, Via Falloppio 50, Padova, 35121, Italy. ., Department of Cardiac, Thoracic and Vascular Sciences, Section of Legal Medicine, University Hospital of Padova, Via Falloppio 50, Padova, 35121, Italy., Department of Urology, Ospedale Niguarda Cà Granda, Piazza Ospedale Maggiore 3, Milano, 20162, Italy., Department of Urology, University of Verona, Piazzale Scuro 10, Verona, 37134, Italy., Department of Cardiac, Thoracic and Vascular Sciences, Section of Legal Medicine, University Hospital of Padova, Via Falloppio 50, Padova, 35121, Italy., Department of Cardiac, Thoracic and Vascular Sciences, Section of Legal Medicine, University Hospital of Padova, Via Falloppio 50, Padova, 35121, Italy., Department of Cardiac, Thoracic and Vascular Sciences, Section of Legal Medicine, University Hospital of Padova, Via Falloppio 50, Padova, 35121, Italy.