4/8 Authors with #FinancialInterests are more likely to publish positive results
A @CochraneLibrary review of nearly 200 RCTs published in major journals found 68% had personal financial ties between principal investigators, drugmakers bit.ly/3MOhyv9
5/8 How a study is designed can shape packaging of takeaway messages to prescribers
Commercial influence on trial design can include:
✅Nature of the hypothesis
✅Choice of comparators
✅Outcome definitions
✅What results are ultimately reported (or not)
6/8 Professional healthcare groups often counsel members to identify and avoid actual, potential or perceived COIs
@CMA_Docs: Doctors have responsibility to ensure "collaboration with industry primarily serves the interests of their patients & the public" bit.ly/3sU3dFu
7/8 Therapeutics Initiative (TI) approach to COI
The TI is an independent org'n, separate from gov't, pharma, other vested interests
We believe independent evidence assessments of drug therapies are needed to ⚖️ industry-sponsored information sources ti.ubc.ca/letter136
8/8 Back to Kirsten's conference
Post-presentation, she gives the organizers feedback: "Please aim for unconflicted speakers next time"
She also plans to seek high quality #prescribing information, primarily evidence from unconflicted systematic reviews ti.ubc.ca/letter136
✅Fewer than 2% of urine cultures meaningfully impact choice of treatment or need for follow-up
✅Most guidelines recommend against culture for
symptomatic uncomplicated #UTIs
2/6 Consistent evidence that minority of pts get clinically meaningful pain relief from any dose of:
✅#Cyclobenzaprine (at best 1/4)
✅#Duloxetine (at best 1/6)
✅#Gabapentin / #Pregabalin (at best 1/6)
A 2021 Canadian systematic review found NNT (numbers needed to treat) of 6-7 for "clinically meaningful benefit" (defined as ≥30% reduction in pain or pain & function)