S2977 Industry-Sponsored Speakers’ Bureau Conflicts of Interest Among UpToDate® Gastroenterology and Hepatology Authors: Associations and Policy Implications

Introduction: Industry-sponsored speakers’ bureaus (ISSBs) pose significant conflicts of interest (COIs) as pharmaceutical companies typically employ physicians in a long-term contract for product promotion. Yet only 38% of US allopathic medical schools explicitly prohibit faculty participation in ISSBs. UpToDate® is a widely used medical resource database that includes ISSB disclosures. This study evaluates associations between authors’ ISSB disclosures, demographic factors, institutional policies, and article topics within UpToDate®’s Gastroenterology and Hepatology section. Methods: We analyzed all authors in UpToDate®’s Gastroenterology and Hepatology section categorizing them as “conflicted” or “non-conflicted,” based on ISSB disclosure. Data includes authors’ academic rank, affiliated institutions, and institutional COI policies. Policies regarding faculty ISSB participation were coded as: explicitly prohibited, discouraged, prohibited with exceptions, explicitly permitted, not addressed, or no policy available. Chi-square tests were used to compare categorical variables and independent t-tests were utilized to compare continuous variables. Results: Of 796 authors, 8.5% were conflicted and 91.5% were non-conflicted. Academic rank distribution was similar (P = 0.5440). Non-US institutional affiliation predicted higher rates of ISSB participation (20.0% non-US institutions vs 6.4% US institutions (P < 0.0001). There was no statistically significant difference in rates of conflicted authors when comparing those from institutions explicitly prohibiting ISSB participation (5.2%) and all others (7.9%; P = 0.1829) including: discouraged, prohibited with exceptions, explicitly permitted, no available policy, or not addressed. Of 2677 articles, 22.5% had at least 1 conflicted author. Subspecialties with the highest ISSB conflict rates included Pancreatic Disease (61.0%), Liver Transplantation (58.1%), and Gastrointestinal Endoscopy (56.2%). Acid Peptic Disease (8.1%), Gastrointestinal Diseases (7.2%), and Pediatric Hepatology (0%) had the lowest rates. Conclusion: In UpToDate®’s Gastroenterology and Hepatology section, non-US institutional affiliation predicted higher rates of ISSB participation. Institutional COI policies explicitly prohibiting ISSBs were not associated with lower rates of ISSB participation. The large variance in conflicted article rates between subsections suggests concentrated industry influence.