Don't ask, don't tell: Financial disclosure lacking in literature on stents

DURHAM, NC – Most published research about coronary stents does not reveal information about authors’ financial relationships that might bias their interpretation of scientific data, according to researchers at Duke University Medical Center.

Coronary stents are the basis of a multi-billion dollar industry, yet the scientific community remains divided over if, when and how they should be used.

Dr. Kevin Weinfurt, a member of the Duke Clinical Research Institute, tracked every article written about stents in biomedical literature in 2006. He found 746 articles written by 2985 authors in 135 journals. Eighty-three percent of those articles did not contain any disclosure statements at all.

Weinfurt says he was astonished by the extent of the problem.

“We actually did our own, informal Internet search on authors who expressly stated they had no interests to disclose and found that some of them held membership on stent manufacturers’ advisory boards, or were consultants for stent makers and companies that made drugs related to stent use. One person had even founded a company that made stents, and yet had not disclosed that information,” says Weinfurt.

The study appears in the online journal PLoS ONE.

Weinfurt says the study results are troubling because disclosure and transparency in research reports may be more important than ever. While two respected professional organizations representing medical editors’ interests – the International Committee of Medical Journal Editors and the World Association of Medical Editors – encourage disclosure of authors’ financial interests, Weinfurt notes that some journals don’t ask for the information and some authors don’t volunteer it.

When potential conflicts aren’t reported, policy makers and the public lose their trust in medical research, says Weinfurt. This may be especially critical for those seeking trustworthy information about potentially life-saving devices, like coronary stents.

Stents are flexible metal tubes inserted into coronary arteries that help maintain healthy blood flow, often used in the wake of a heart attack. There are basically two types of stents: bare metal stents and drug-eluting stents, and the medical and scientific communities have been debating for years over which may be superior.