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Conflict of interest in psychiatry

Tony Hillis Wing, West London Mental Health NHS Trust, Uxbridge Road, Southall, Middlesex UB1 3EU, e-mail: ahmer{at}doctors.org.uk

Pradeep Arya, Specialist Registrar in General Adult Psychiatry

St Mary’s Higher Training Scheme in Psychiatry, St Charles Hospital

Duncan Anderson, Specialist Registrar in Forensic Psychiatry

Three Bridges Medium Secure Unit, West London Mental Health NHS Trust

Rafey Faruqui, Specialist Registrar in General Adult Psychiatry

West London Mental Health NHS Trust and Honorary Research Fellow, Imperial College London

AIMS AND METHOD

To study the association between study support and outcome in randomised controlled trials (RCTs) of psychotropic drugs, we reviewed all RCTs published in four psychiatry journals over a 5-year period. Chi-squared tests were used to analyse the association between RCT support and outcome, and logistic regression to determine which variable best predicted outcome.

RESULTS

A significantly higher proportion of manufacturer-supported RCTs (125/138, 91%, 95% CI 88-93) had a positive outcome than non-manufacturer-supported RCTs (39/50, 78%, 95% CI 72-84; P=0.02). Having an employee author almost guaranteed a positive outcome (56/58, 97%, 95%CI94 -99).

CLINICAL IMPLICATIONS

Outcomes of drug RCTs have a significant association with support by the manufacturer of the experimental drug. Systematic reviews and meta-analyses based on these RCTs may be biased in favour of newer drugs.

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