Impact of Commercial Funding and Outcomes on Article Publication

First Study of Peer-Reviewed Hip and Knees Articles Tested Against Orthopaedic Variables


CHICAGO, IL--(Marketwire - June 19, 2007) - A first-ever study about how commercial funding may affect the inclusion in peer-reviewed journals has been published in the June 2007 issue of the Journal of Bone and Joint Surgery (JBJS). The Department of Orthopaedics and Sports Medicine at the University of Washington Medical Center in Seattle conducted the survey. "In the past, research of this kind has only been analyzed for published papers," said Joseph R. Lynch, MD, from the Center. "Our research team wanted to use strict criteria and variables to see if we could determine if there was any bias that affect the acceptance of submissions."

The researchers collaborated with the staff from JBJS, who during a period of 17 months collected manuscripts about hip or knee arthroplasty that were submitted to the publication. The studies were blinded before being reviewed by researchers.

Two-hundred and nine manuscripts were evaluated for study design, quality and outcomes. Analyses were done to identify any association between study outcomes and scientific factors (sample size, study quality and level of evidence) as well as non-scientific factors (funding source and country of origin) and the acceptance of the articles. Evidence-based medicine, study-quality criteria was used. Funding categories were commercial, noncommercial or philanthropic as well as non-funded or other. Research results determined:

--  Commercial funding was not found to be associated with a positive
    study outcome.
--  Studies with a positive outcome were no more likely to be published
    than were those with a negative outcome.
--  Studies with a negative outcome were of higher quality and included
    larger sample sizes.
--  Commercially-funded and U.S.-based studies were more likely to be
    published, even though they were not associated with higher quality, larger
    sample sizes or lower levels of evidence.
--  Commercially-funded studies submitted for review were not more likely
    to conclude with a positive outcome than were non-funded studies.
    
"Our findings contradict most previous research analyses, where there was a higher proportion of articles published with positive outcomes," said Dr. Lynch. "This despite the increased emphasis that orthopaedic surgeons place on evidence-based approaches such as meta-analysis, cost-benefit modeling and decision analysis, all of which depend entirely on the absence of systematic biases and influences from nonscientific factors in the review process."

In the current study, 208 articles were funded (54 commercially funded and 40 of those had a positive outcome). A total of 143 articles had received no funding (99 with a positive outcome). Of all articles with a positive outcome, 45 were accepted for publication. In comparison, 18 of the 49 studies with a non-positive outcome were accepted.

"The strengths of our study were that we reviewed submitted manuscripts within a subspecialty," said Dr. Lynch. "It appears that the peer-reviewed process does not suffer from severe positive outcome bias and the impact of commercial funding on research is less pronounced that previously suspected. It is quite conceivable, however, that the findings in the present report cannot be generalized to other subspecialties within or outside of orthopaedic surgery."

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