• Hidden influence? Unmasking co...

Treffer: Hidden influence? Unmasking conflicts of interest from randomized clinical trials on spinal cord stimulation for chronic pain.

Title:
Hidden influence? Unmasking conflicts of interest from randomized clinical trials on spinal cord stimulation for chronic pain.
Authors:
D'Souza RS; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA DSouza.Ryan@mayo.edu., Klasova J; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA., Kleppel DJ; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA., Prokop L; Mayo Clinic Libraries, Mayo Clinic Minnesota, Rochester, Minnesota, USA., Hussain N; Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Source:
Regional anesthesia and pain medicine [Reg Anesth Pain Med] 2026 Jan 05; Vol. 51 (1), pp. 17-24. Date of Electronic Publication: 2026 Jan 05.
Publication Type:
Journal Article
Language:
English
Journal Info:
Publisher: BMJ Country of Publication: England NLM ID: 9804508 Publication Model: Electronic Cited Medium: Internet ISSN: 1532-8651 (Electronic) Linking ISSN: 10987339 NLM ISO Abbreviation: Reg Anesth Pain Med Subsets: MEDLINE
Imprint Name(s):
Publication: 2018- : [London, United Kingdom] : BMJ
Original Publication: Secaucus, NJ : Churchill Livingstone, c1998-
MeSH Terms:
Chronic Pain*/therapy , Chronic Pain*/diagnosis , Conflict of Interest*/economics , Randomized Controlled Trials as Topic*/ethics , Randomized Controlled Trials as Topic*/economics , Randomized Controlled Trials as Topic*/methods , Spinal Cord Stimulation*/economics , Spinal Cord Stimulation*/methods , Spinal Cord Stimulation*/ethics, Humans ; Cross-Sectional Studies ; Disclosure
Contributed Indexing:
Keywords: Analgesia; ETHICS; Spinal Cord Stimulation
Entry Date(s):
Date Created: 20241008 Date Completed: 20260106 Latest Revision: 20260106
Update Code:
20260107
DOI:
10.1136/rapm-2024-105903
PMID:
39379095
Database:
MEDLINE

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Background: Randomized clinical trials (RCTs) are considered the gold standard for evaluating the efficacy of healthcare interventions. However, conflicts of interest (COIs) can compromise the scientific integrity in these trials. This study characterized COIs in RCTs on spinal cord stimulation for chronic pain, focusing on the prevalence, disclosure, and monetary value of COIs.
Methods: This cross-sectional study analyzed RCTs published from January 1, 2013 to July 27, 2023. Primary outcomes included the presence, disclosure, and monetary value of COIs, while secondary outcomes assessed the presence of direct/indirect COIs, sponsor access to data, and associations between COIs and select variables, including journal impact factor, publication year, and study outcomes.
Results: Of 38 RCTs, 30 (78.9%) reported COIs. On average, 35.6% of authors per RCT had at least one COI, with a mean of 0.7 COIs per author. The mean annual monetary value of COIs was US$41,157.83 per author per RCT. 29 RCTs (76.3%) had undisclosed COIs, with an average of 24.2% of authors per RCT having undisclosed COIs. Sponsor access to data was reported in 67.6% of RCTs. No associations were observed between the mean percentage of authors with COIs and the monetary value of COIs and select dependent variables (impact factor, publication year, and study outcomes).
Conclusions: A substantial majority of RCTs reported COIs with many authors having undisclosed conflicts, highlighting the need for stringent COI disclosure guidelines to maintain research integrity. Expanding COI registry systems globally and increasing non-industry funding are crucial steps toward enhancing transparency and reducing biases in medical research.
(© American Society of Regional Anesthesia & Pain Medicine 2026. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Competing interests: RSD received investigator-initiated grant funding from Nevro and Saol Therapeutics paid to his institution.