Evaluating the relationship between financial conflicts of interest among systematic reviews of authors of alprazolam use and the nature of the results and conclusions of these reviews

Alprazolam FCOI in Systematic Reviews


  • Preston Hall
  • Jason Beaman Oklahoma State University Center for Health Sciences
  • Bryce Naberhaus Oklahoma State University Center for Health Sciences
  • Cindy Do Oklahoma State University Center for Health Sciences


Introduction: A financial conflict of interest (FCOI) is present when an individual receives financial compensation related to the material being published. Since FCOIs are a reducible cause of bias and systematic reviews (SR) have an important role in clinical care, this study aims to determine the associations between the funding and the findings of systematic reviews involved with alprazolam use.


Methods: A systematic search of PubMed, Scopus, and Embase was conducted to retrieve SRs and meta-analyses involving alprazolam use.  All search results were screened in a double-blinded fashion to determine which articles met the inclusion criteria. Data extraction, determination of favorability of results and conclusion/discussion sections regarding alprazolam use, and bias assessment were performed for each included article. Undisclosed financial ties of each author were then searched for using multiple modalities. Lastly, the presence or absence of a FCOI was determined. 


Results: 6 (40%) of 15 articles which had favorable results for alprazolam had at least one author with a FCOI. 4 (50%) of the 8 discussion/conclusion sections that were favorable for alprazolam had at least one author with a FCOI. Of these 4 articles, 2 articles were rated as having a high risk of bias. 


Discussion: Despite the relatively high percentage (43%) of systematic reviews and meta-analyses whose results or discussion/conclusion sections were favorable for alprazolam containing authors with financial conflict of interests, only 10 articles contained authors with FCOIs. The small number of FCOIs found reflects the need for better oversight of payment reporting to maintain the validity and the integrity of peer-reviewed research.


Keywords: Financial Conflict of Interest (FCOI), Disclosures, Alprazolam, Benzodiazepines, Bias, Misuse, PRISMA, Spin, Systematic Review (SR), Addiction






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