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Scientific Articles   |    
Relationship Between Declared Funding Support and Level of Evidence
Shahryar Noordin, MBBS, FCPS1; James G. Wright, MD, MPH, FRCSC2; Andrew Howard, MD, MSc, FRCSC2
1 Department of Surgery, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi, Pakistan. E-mail address: shahryar.noordin@gmail.com
2 Departments of Surgery (J.G.W. and A.H.) and Health Promotion, Management and Evaluation (A.H.), The Hospital for Sick Children, 555 University Avenue, Room 1254, Toronto, M5G 1X8 ON, Canada. E-mail address for J.G. Wright: James.wright@sickkids.ca. E-mail address for A. Howard: Andrew.howard@sickkids.ca
View Disclosures and Other Information
Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from the R.B. Salter Chair in Surgical Research. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Investigation performed at The Hospital for Sick Children, Toronto, Ontario, Canada

Copyright ©2010 American Society for Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Jul 07;92(7):1647-1651. doi: 10.2106/JBJS.I.00224
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Abstract

Background: 

The relationship between industry and the orthopaedic community is under increasing scrutiny. Industry traditionally has funded a substantial amount of the orthopaedic research published in this and other journals. The objective of the present study was to investigate associations between the level of evidence and declared source(s) of funding in papers published in the American volume of The Journal of Bone and Joint Surgery.

Methods: 

All articles published in the American volume of The Journal of Bone and Joint Surgery from January 2003 to December 2007 were reviewed by a single individual. Primary research papers with an assigned level of evidence were assessed with regard to source of funding, subject area, and results. The association between source of funding and level of evidence was described with use of contingency tables and chi-square tests.

Results: 

Of 886 studies with an assigned level of evidence, 246 were funded by industry, of which 124 (50%) were graded as Level-IV evidence. Among 274 studies funded by governments, foundations, or universities, only seventy-nine (29%) were graded as Level-IV evidence. Among 366 studies with no funding declared, 209 (57%) were graded as Level-IV evidence. The association between industry funding and a lower level of evidence was significant (p < 0.0001).

Conclusions: 

While industry funded a larger number of studies than any other single source in this journal, the level of evidence of industry-funded studies was lower that that for studies funded by governments, foundations, or universities. Improving the scientific quality of industry-funded research might increase the quality of evidence for making orthopaedic decisions.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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