Obesity, the Endocannabinoid System, and Bias Arising from Pharmaceutical Sponsorship 英文参考文献.docVIP

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Obesity, the Endocannabinoid System, and Bias Arising from Pharmaceutical Sponsorship 英文参考文献.doc

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Obesity, the Endocannabinoid System, and Bias Arising from Pharmaceutical Sponsorship 英文参考文献

Obesity,theEndocannabinoidSystem,andBiasArising fromPharmaceuticalSponsorship JohnM.McPartland* DepartmentofOsteopathicManipulativeMedicine,MichiganStateUniversity,EastLansing,Michigan,UnitedStatesofAmerica Abstract Background:Previousresearchhasshownthatacademicphysiciansconflictedbyfundingfromthepharmaceuticalindustry have corrupted evidence based medicine and helped enlarge the market for drugs. Physicians made pharmaceutical- friendly statements, engaged in disease mongering, and signed biased review articles ghost-authored by corporate employees.Thispaper testedthehypothesis thatbiasaffects reviewarticles regardingrimonabant,ananti-obesitydrug thatblocksthecentralcannabinoidreceptor. Methods/PrincipalFindings:AMEDLINEsearchwasperformedforrimonabantreviewarticles,limitedtoarticlesauthored by USA physicians who served as consultants for the company that manufactures rimonabant. Extracted articles were examinedforindustry-friendlybias,identifiedbythreemethods:analysiswithavalidatedinstrumentformonitoringbiasin continuingmedicaleducation(CME);analysisforbiasdefinedasstatementsthatrancontrarytoexternalevidence;anda tally of misrepresentations about the endocannabinoid system. Eight review articles were identified, but only three disclosedauthors’financialconflictsofinterest,despiteeasilyaccessibleinformationtothecontrary.TheTakharCMEbias instrumentdemonstratedstatisticallysignificantbiasinallthereviewarticles.Biasedstatementsthatwerenearlyidentical reappeared inthearticles, includingdiseasemongering, exaggeratingrimonabant’sefficacy andsafety, lack ofcriticisms regarding rimonabant clinical trials, and speculations about surrogate markers stated as facts. Distinctive and identical misrepresentationsregardingtheendocannabinoidsystemalsoreappearedinarticlesbydifferentauthors. Conclusions: The findings are characteristic of bias that arises from financial conflicts of interest, and suggestive of ghostwritingbyacommonauthor.Resolutionsforthisscenarioareproposed. C