Prevalence of disclosed and undisclosed financial conflicts of interest among systematic review authors regarding the management of proximal humerus fractures


  • Cole Verble
  • Matt
  • Arjun Reddy
  • Michael Anderson
  • Michael Weaver
  • Micah Hartwell
  • Matt Vassar


Background: A systematic review is an important evidence synthesis technique used to collate results from individual studies, such as treatments for proximal humerus fractures. Therefore it is necessary to minimize bias in systematic reviews, including financial COIs. Financial bias has been shown to result in unreliable assessments of credibility, which is why transparency with COI is essential for accurate assessments of research.

Objective: The aim of this study was to characterize the influence of financial bias on the results and conclusions of systematic reviews of proximal humerus fracture treatments and to characterize the nature of disclosed and undisclosed COIs.

Methods: Ovid MEDLINE and Ovid Embase databases were searched to locate systematic reviews covering proximal humerus fracture treatments. Following these searches, title and abstract screening was performed in a duplicate, masked fashion. Data from the final reviews were extracted in a triplicate manner. The data from the final reviews included various author and article characteristics. These characteristics can be found under the Data extraction paragraph. All authors were screened for non-disclosed COIs.

Results: We found no relationship between authorial COI and the results and conclusions of the systematic reviews. Among the 17 included systematic reviews, 7 (41.2%) had at least one non-disclosed COI. Of the 7 reviews with a non-disclosed COI, 2 (28.6%) were found to have a high risk of bias.

Conclusions: Findings from this study have limited generalizability due to our small sample size. More studies are needed to fully elucidate the effect of financial bias on the results and conclusions of systematic reviews.