Abstract
Prevalence and Nature of Conflict of Interest Disclosures in Published Health Technology Assessment Reports
Miro Vukovic,1 Ana Marušić1
Objective
Conflict of interest (COI) disclosures are critical for the transparency of health technology assessment (HTA) reports, which inform health care policy. Previous studies have shown that COI disclosures in biomedical research and clinical guidelines are often incomplete or inconsistent, raising concerns about transparency and potential bias.1-3 However, limited empirical evidence exists on how COIs are disclosed in HTA reports despite their critical role in health care decision-making. Our study aimed to address this gap by systematically examining COI disclosure practices across HTA publications.
Design
We conducted a cross-sectional study of all English-language HTA reports (mini HTA, rapid reviews, and full HTA) from the International HTA Database (https://database.inahta.org/). Reports without accessible full text or not meeting HTA criteria were excluded. Data were extracted from reports published up to December 2023. We documented the presence of COI disclosure sections, their content, and use of standardized forms (eg, International Committee of Medical Journal Editors [ICMJE]) and reviewed adherence to the ICMJE COI reporting guidelines. Two independent reviewers conducted data extraction and coding, with disagreements resolved through discussion. Descriptive statistics were applied to report frequencies and proportions. Based on the study type, the STROBE guideline was followed for reporting.
Results
Of 1218 included HTA reports, 598 (49.1%) were full HTAs, 174 (14.3%) were rapid reviews, and 78 (6.4%) were mini HTAs; 368 reports (30.2%) were excluded due to inaccessibility or duplication. Reports originated from 16 countries, with 330 (38.8%) from England. Overall, COI disclosure sections were present in 679 of 850 reports (79.9%). The lowest reporting was among mini HTAs (49 of 78 [62.8%]) compared with full HTAs (489 or 598 [81.8%]) and rapid reviews (141 of 174 [81.0%]). Only 98 reports (11.5% of included reports) used a standardized disclosure form, with the ICMJE form cited in 90. In another 8 reports, the EUnetHTA Declaration of Interest and Confidentiality Undertaking of Interest statement was used.
Conclusions
While most HTA reports included COI disclosures, practices varied by report type and country. Standardized disclosure tools were rarely used. Further analysis is needed to support the development of harmonized and transparent COI policies across HTA-producing organizations.
References
1. Norris SL, Holmer HK, Ogden LA, Selph SS, Fu R. Conflict of interest disclosures for clinical practice guidelines in the National Guideline Clearinghouse. PLoS One. 2012;7(11):e47343. doi:10.1371/journal.pone.0047343
2. Norris SL, Burda BU, Holmer HK, Ogden LA. Conflicts of interest in clinical practice guideline development: a systematic review. PLoS One. 2011;6(10):e25153. doi:10.1371/journal.pone.0025153
3. Mandrioli D, Kearns CE, Bero LA. Relationship between research outcomes and risk of bias, study sponsorship, and author financial conflicts of interest in reviews of the effects of artificially sweetened beverages on weight outcomes: a systematic review of reviews. PLoS One. 2016;11(9):e0162198. doi:10.1371/journal.pone.0162198
1Centre for Evidence-Based Medicine, University of Split School of Medicine, Split, Croatia, miro.vukovic@mefst.hr.
Conflict of Interest Disclosures
Ana Marušić is a member of the Peer Review Congress Advisory Board but was not involved in the review or decision for this abstract. No other disclosures were reported.