Identify predictors of Industry-Sponsored Speakers’ Bureau (ISSB) disclosures among authors in the Neurology section of point of care informatics databases.

ISSBs represent a high-risk conflict of interest (COI), yet only 38% of US allopathic medical schools explicitly prohibit faculty participation. This is particularly relevant given recent cases like Biohaven’s settlement of $60 million for using speaker fees to promote its migraine drug. Online point-of-care medical informatics resources are frequently used by physicians to quickly access medical data in the clinical setting. This study evaluates associations between demographic factors, institutional ISSB policies, and article topics on ISSB disclosures among authors contributing to Neurology articles in a large point of care informatics database.

We analyzed authors in the Neurology section categorizing them as “conflicted authors” (CA) and “non-conflicted authors” (NCA), based on ISSB disclosure. Data included academic rank, affiliated institution, and their institution’s COI policy. Policies were coded as explicitly prohibited, discouraged, prohibited with exceptions/permitted with conditions, explicitly permitted, ISSBs not addressed, excluded, or no policy available.

Of 794 unique authors, 7% were conflicted. Academic rank distribution among CA and NCA were similar (p=0.4435). International affiliation was associated with ISSB conflicts: 16.13% non-US institution CA rate vs. 5.28% US institution CA rate (p<0.0001). Authors from institutions with policies explicitly permitting ISSB participation were significantly more likely to be conflicted when compared with authors from institutions explicitly prohibiting ISSBs (CA: 12.28% vs 2.3%, p < 0.0001). Subsections with the highest ISSB conflict rates included Demyelinating Disease (32%), Epilepsy and EEG (26%), and Neuroophthalmology (23%). Neurodegenerative Diseases and Neurological Systems had none.

Author ISSB disclosure is associated with international affiliation and, among US authors, explicitly permissive medical school COI policies. There was no association with academic rank. Higher conflict rates in certain subsections suggest concentrated industry influence.