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Physicians and conflicts of interest

International Journal of Clinical Medicine 2014年第16期5卷 956-965页

作者： Deborah Pimentel Maria-Jesia Vieira Joao Pedro Declerc FSNeves Manoel Juvenal da Costa-Neto Lais Costa Souza Oliveira Department of Medicine Universidade Federal de SergipeAracajuBrazil Universidade Tiradentes AracajuBrazil Postgraduate Program in Health Sciences Universidade Federal de SergipeAracajuBrazil Universidade Federal de Sergipe AracajuBrazil

In medical practice, the most commonly observed conflicts of interest are the ones existing in the relations between professionals and industries linked to health or between the former and health services. These relations are no longer a partnership in search of the best to be offered to patients and tend to take up a commercial role, in a seduction game where, each one, in their own manner, seeks benefits. The purpose of this study is to analyze the existence of these conflicts of interest, in an exploratory and qualitative study, with physician focal groups. The results were grouped in two categories: benefits received by physicians and the justifications provided by them for the establishment of these partnerships. The most common benefits are: percentages over orthoses and prosthetics received by the industry;discounts and credits on rent or condominium fees for exam indications and procedures;rewards offered by the pharmaceutical industry for the indication of their products. Physicians have pointed out as main determinants for ethical missteps that involve conflicts of interest, the character and family formation as well as the lack of denunciations. The fact that efficient and widespread laws for resolution of conflicts of interest do not exist makes it necessary to recognize their existence with mechanisms of management and transparency, perhaps as the only way to avoid negative interference in physician behavior.

关键词： Ethics Physicians conflicts of interest

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The Impact of Competition on Analysts’Forecasts:A Simple Agent-Based Model

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Journal of Systems Science & Complexity 2020年第6期33卷 1980-1996页

作者： ZHANG Jin XIONG Xiong AN Yahui FENG Xu College of Management and Economics Tianjin UniversityTianjin 300072China School of Economics Tianjin University of CommerceTianjin 300134China College of Management and Econonics Tianjin UniversityTianjin 300072China

This paper builds an agent-based model to study the impact of analyst competition on analyst *** strategies(a catering strategy and a pressure strategy)are used to model analysts conflicts of interest between listed corporations and institutional *** finding suggests that the relationship between competition and analyst optimism is ***-level competition generates more analyst unbiased ***,the condition of no competition or high-level competition generates more analyst optimistic *** empirical test also confirms that analysts issue less biased earnings forecasts under the condition of low-level competition.

关键词： Agent-based model analyst forecasts conflicts of interest

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Diagnostic and clinical significance of antigen-specific pancreatic antibodies in inflammatory bowel diseases: A meta-analysis

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World Journal of Gastroenterology 2020年第2期26卷 246-265页

作者： Konstantinos Gkiouras Maria G Grammatikopoulou Xenophon Theodoridis Eirini Pagkalidou Evangelia Chatzikyriakou Anna G Apostolidou Eirini I Rigopoulou Lazaros I Sakkas Dimitrios Petrou Bogdanos Department of Rheumatology and Clinical Immunology Faculty of MedicineSchool of Health SciencesUniversity of ThessalyBiopolisLarissa GR41110Greece Faculty of Medicine School of Health SciencesAristotle University of ThessalonikiUniversity CampusThessaloniki GR54124Greece Department of Nutritional Sciences and Dietetics School of Health SciencesInternational Hellenic UniversitySindos CampusThessaloniki GR57400Greece Laboratory of Hygiene Social and Preventive Medicine and Medical StatisticsFaculty of MedicineSchool of Health SciencesAristotle University of ThessalonikiUniversity CampusThessaloniki GR54124Greece Laboratory of Clinical Neurophysiology AHEPA University HospitalFaculty of MedicineAristotle University of ThessalonikiUniversity CampusThessaloniki GR54124Greece Department of Medicine and Research Laboratory of Internal Medicine University Hospital of LarissaBiopolisLarissa GR41110Greece Division of Transplantation Immunology and Mucosal BiologyMRC Centre for TransplantationKing's College London Medical SchoolLondon GR41110United Kingdom

BACKGROUND Non-invasive criteria are needed for Crohn’s disease(CD)diagnosis,with several biomarkers being *** of individual diagnostic test accuracy studies assessing the diagnostic value of pancreatic autoantibodies-to-glycoprotein-2(anti-GP2)tests for the diagnosis of CD appear *** To systematically review and meta-analyze evidence on the diagnostic accuracy of anti-GP2 tests in patients with suspected/confirmed *** An electronic search was conducted on PubMed,Cochrane-CENTRAL and grey literature(CRD42019125947).The structured research question in PICPTR format was“Population”including patients with symptoms akin to CD,the“Index test”being anti-GP2 testing,the“Comparator”involved standard CD diagnosis,the“Purpose of test”being diagnostic,“Target disorder”was CD,and the“Reference standard”included standard clinical,radiological,endoscopical,and histological CD diagnostic *** was assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool and hierarchical models were employed to synthesize the *** Out of 722 studies retrieved,15 were *** studies had industry-related conflicts-of-interest,and most included healthy donors as controls(spectrum bias).For the combination of IgA and/or IgG anti-GP2 test,the summary sensitivity was 20%(95%confidence interval:10%-29%)at a median specificity of 97%.If the test was applied in 10000 suspected patients,9669 would be true negatives and in 26,the diagnosis would be *** this hypothetical cohort,the anti-GP2 would fail to produce a diagnosis for 81.3%of the positive *** summary points of sensitivity and high specificity were estimated for the IgG or IgA anti-GP2 *** results were observed when the analyses were restricted using specific cut-offs,or when ulcerative colitis patients were used as *** Anti-GP2 tests demonstrate low sensitivity and high *** results indicate that caution is required

关键词： Inflammatory bowel disease Gastrointestinal disease Evidence-based diagnosis Sensitivity Specificity Ulcerative colitis conflicts of interest Metaregression Industry bias

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目前的溃疡性结肠炎和克罗恩病治疗指南是否有一个规范的制定流程?

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Gastroenterology Report 2021年第5期9卷 408-417,I0001,I0002页

作者： Alexander Goldowsky Rohan Sen Gila Hoffman Joseph D Feuerstein Department of Medicine Beth Israel Deaconess Medical CenterBostonMAUSA Department of Gastroenterology and Hepatology Beth Israel Deaconess Medical CenterBostonMAUSA

背景:国际上各个胃肠病协会都会发布各自的溃疡性结肠炎(UC)和克罗恩病(CD)治疗指南,以帮助临床医生为患者提供高水平诊治。我们对这些指南进行了分析,评估其用于形成推荐意见的证据质量及强度、证据分级的方法学、疾病特异性推荐意见... 详细信息

背景:国际上各个胃肠病协会都会发布各自的溃疡性结肠炎(UC)和克罗恩病(CD)治疗指南,以帮助临床医生为患者提供高水平诊治。我们对这些指南进行了分析,评估其用于形成推荐意见的证据质量及强度、证据分级的方法学、疾病特异性推荐意见的差异、制定指南期间存在的利益冲突以及指南更新计划。方法:我们于2019年4月,使用“溃疡性结肠炎”、“克罗恩病”和“指南”作为关键词在PubMed中进行系统检索,并在国际各个胃肠病协会的官网搜索UC和CD指南。由两名作者对12个协会的指南进行研读,采用卡方检验比较各个指南间的证据等级、推荐强度和报道的利益冲突之间的差异,采用线性回归模型评估作者数量与推荐意见数量之间的关系。结果:28部指南纳入分析,其中25部(89%)采用了三种不同的评价系统对证据水平进行分级,另有2部(7%)采用了一种未知的证据水平评价方法。3部(11%)指南没有做利益冲突的声明;3部(11%)指南提供了指南更新的时间表。在1265条推荐意见中,246条(19%)没有报道证据等级或明确指出该意见是基于专家意见。UC推荐意见中有135条(22%)被标注为“弱推荐”或“有条件推荐”,95条(16%)并没有给出推荐强度。CD推荐意见中有242条(37%)被标注为“弱推荐”或“有条件推荐”,151条(23%)没有给出推荐强度。结论:大多数UC和CD指南的制定是基于比较低甚至非常低的证据等级,而且某些治疗方面的推荐意见各个指南间缺乏同质性,加之一些利益冲突未进行声明,进一步削弱了指南的价值。

关键词： Crohn’s disease ulcerative colitis inflammatory bowel disease guidelines conflicts of interest

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分析师利益冲突、乐观偏差与股价崩盘风险

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统计与精算 2012年第6期 127-140页

作者：许年行江轩宇伊志宏徐信忠

“股价崩盘风险”是当前金融危机背景下财务学的一个研究热点。本文使用2003-2010年中国A股上市公司的数据，研究分析师乐观偏差是否影响上市公司股价崩盘风险，并考察分析师面临的“利益冲突”是否会加剧乐观偏差对股价崩盘风险的影响... 详细信息

“股价崩盘风险”是当前金融危机背景下财务学的一个研究热点。本文使用2003-2010年中国A股上市公司的数据，研究分析师乐观偏差是否影响上市公司股价崩盘风险，并考察分析师面临的“利益冲突”是否会加剧乐观偏差对股价崩盘风险的影响。研究发现：（1）分析师乐观偏差与上市公司未来股价崩盘风险之间显著正相关，且此关系在“牛市”更为显著；（2）机构投资者持股比例越高，机构投资者数量越多，公司存在再融资行为，以及来自前五大佣金收入券商的分析师比例越高，分析师乐观偏差与崩盘风险之间的正向关系就更为显著，说明“利益冲突”会加剧两者的关系。本文的研究对于全面认识分析师在资本市场中的作用，以及如何降低我国股价崩盘风险、促进股市平稳发展具有重要的理论和现实意义。

关键词：分析师乐观偏差利益冲突股价崩盘风险 analyst optimism conflicts of interest stock price crash risk

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科学活动中利益冲突的公开

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科学技术哲学 2011年第3期 93-97页

作者：文剑英

公开是对利益冲突进行控制时最常用和最先采用的措施。然而研究表明，鲜有科学家公开承认其处于利益冲突状态。之所以如此，既因为利益冲突公开政策本身存在问题，也因为科学家对自己的利益冲突实际上毫无察觉。深化对利益冲突公开本身... 详细信息

公开是对利益冲突进行控制时最常用和最先采用的措施。然而研究表明，鲜有科学家公开承认其处于利益冲突状态。之所以如此，既因为利益冲突公开政策本身存在问题，也因为科学家对自己的利益冲突实际上毫无察觉。深化对利益冲突公开本身的认识、对科学家进行相关教育和制定科学合理的政策措施，是充分发挥公开作用的必要措施。

关键词：利益冲突察觉公开 conflicts of interest awareness disclosure

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