A metaresearch study finds unclear impact of institutional conflicts of interest on conclusions of studies investigating volume–outcome relationships
Notice bibliographique
Résumé
OBJECTIVES: This study aimed to explore institutional conflicts of interest (COIs) in volume-outcome studies investigating whether higher hospital volume is associated with better patient outcomes. STUDY DESIGN AND SETTING: We used a sample of studies (n = 68) included in a systematic review on the hospital volume-outcome relationship in total knee arthroplasty. For studies in which at least one of the study authors was affiliated with a hospital, we contacted the study authors by email to obtain their institutional volume and to survey them about their opinion on institutional COIs. We categorized the studies' conclusions (positive vs nonpositive) and authors' hospital volume (high, intermediate, low). We compared conclusions for high- vs intermediate-/low-hospital volume categories. RESULTS: Of the 29 hospital-affiliated authors contacted, 20 replied. Authors from high-volume institutions were more likely to conclude that a hospital volume-outcome relationship existed compared to authors from intermediate- or low-volume institutions, although this was not statistically significant (odds ratio, 2.0; 95% CI: 0.21-18.7). Six out of 17 authors (35%) believed that institutional factors such as the case volume were (very) likely to influence the study design, analysis, or conclusions of research in the field of volume-outcome studies; four of 17 (24%) were neutral; and seven of 17 (41%) believed that this was (very) unlikely. CONCLUSION: This is the first study explicitly investigating institutional financial interests with benefit through increasing services provided by the institution. The findings suggest the possibility that institutional COI may influence the conclusions of volume-outcome studies, although the results are inconclusive. Surveyed authors had divergent opinions on whether institutional factors are likely to influence research integrity. Further research is needed to investigate institutional COIs. PLAIN LANGUAGE SUMMARY: This study examined COIs in research, focusing on benefits to the institution rather than to individual researchers. Authors might publish results in favor of their hospital to increase the amount of a service provided, such as surgery. We looked at 68 studies. These studies investigated whether hospitals performing more knee replacement surgeries had better patient outcomes. We found that authors from hospitals with many knee surgeries were more likely to report positive conclusions compared to those from lower-volume hospitals. We also surveyed study authors working at hospitals to get their views on COIs. Out of the 20 authors who responded, 35% thought institutional factors likely influenced study conclusions, 24% were neutral, and 41% thought this influence was unlikely. Our findings suggest that it is possible that COIs through researchers' institutions may affect study conclusions, but more research is needed to understand this issue better.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,267 | 0,621 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,008 | 0,030 |
| Bibliométrie | 0,010 | 0,011 |
| Études des sciences et des technologies | 0,002 | 0,004 |
| Communication savante | 0,010 | 0,009 |
| Science ouverte | 0,004 | 0,005 |
| Intégrité de la recherche | 0,005 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; l’étiquette directe de Gemma et le classifieur distillé Codex s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».