title: Industry-supported meta-analyses compared with meta-analyses with non-profit or no support: differences in methodological quality and conclusions.
abstract: BACKGROUND
  Studies have shown that industry-sponsored meta-analyses of drugs lack scientific rigour and have biased conclusions. However, these studies have been restricted to certain medical specialities. We compared all industry-supported meta-analyses of drug-drug comparisons with those without industry support.
  
  
  METHODS
  We searched PubMed for all meta-analyses that compared different drugs or classes of drugs published in 2004. Two authors assessed the meta-analyses and independently extracted data. We used a validated scale for judging the methodological quality and a binary scale for judging conclusions. We divided the meta-analyses according to the type of support in 3 categories: industry-supported, non-profit support or no support, and undeclared support.
  
  
  RESULTS
  We included 39 meta-analyses. Ten had industry support, 18 non-profit or no support, and 11 undeclared support. On a 0-7 scale, the median quality score was 6 for meta-analyses with non-profit or no support and 2.5 for the industry-supported meta-analyses (P < 0.01). Compared with industry-supported meta-analyses, more meta-analyses with non-profit or no support avoided bias in the selection of studies (P = 0.01), more often stated the search methods used to find studies (P = 0.02), searched comprehensively (P < 0.01), reported criteria for assessing the validity of the studies (P = 0.02), used appropriate criteria (P = 0.04), described methods of allocation concealment (P = 0.05), described methods of blinding (P = 0.05), and described excluded patients (P = 0.08) and studies (P = 0.15). Forty percent of the industry-supported meta-analyses recommended the experimental drug without reservations, compared with 22% of the meta-analyses with non-profit or no support (P = 0.57).In a sensitivity analysis, we contacted the authors of the meta-analyses with undeclared support. Eight who replied that they had not received industry funding were added to those with non-profit or no support, and 3 who did not reply were added to those with industry support. This analysis did not change the results much.
  
  
  CONCLUSIONS
  Transparency is essential for readers to make their own judgment about medical interventions guided by the results of meta-analyses. We found that industry-supported meta-analyses are less transparent than meta-analyses with non-profit support or no support.
authors.affiliation: The Nordic Cochrane Centre, Department 3343, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. awj@cochrane.dk
authors.forename: Anders W
authors.initials: AW
authors.lastname: Jørgensen
authors.forename: Katja L
authors.initials: KL
authors.lastname: Maric
authors.forename: Britta
authors.initials: B
authors.lastname: Tendal
authors.forename: Annesofie
authors.initials: A
authors.lastname: Faurschou
authors.forename: Peter C
authors.initials: PC
authors.lastname: Gøtzsche
mesh_terms: D015982:Bias; D004341:Drug Evaluation / Q000592:standards*; D004345:Drug Industry; D006801:Humans; D015201:Meta-Analysis as Topic; D009939:Organizations, Nonprofit; D016032:Randomized Controlled Trials as Topic; D012109:Research Support as Topic; D012196:Review Literature as Topic; D014837:Voluntary Health Agencies / Q000592:standards*
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