Identifying gaps using the EPICOT+ framework and exploring the association between funding sources and author conclusions in primary nutrition research addressing non-communicable diseases from Cochrane nutrition reviews : a descriptive-analytical cross-sectional study
Date
2021-03
Authors
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Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY : Background: With the rise in non-communicable diseases (NCDs) globally, we aimed to summarise the research gaps and describe the adequacy of the reporting of future research recommendations in Cochrane reviews of nutrition interventions addressing NCDs. We also aimed to explore the influence of funding sources and author- sponsor financial ties on author conclusions in a subset of primary studies included in these reviews.
Methods: Two researchers independently screened a Cochrane nutrition reviews database (n=470, July 2015) to identify reviews addressing four NCDs (cardiovascular diseases, cancer, chronic respiratory diseases and diabetes). The “implications for research” section of eligible reviews was analysed using the evidence, population, intervention, comparison, outcome, timeframe, study design and burden of disease (EPICOT+) framework to describe the extent of reporting of research recommendations and to summarise gaps. A purposive sample of English full-text studies included in reviews addressing alternative nutrition supplements were analysed to assess reporting of conflict of interest (COI), funding sources and author-sponsor financial ties, and to explore influences of funding sources and author-sponsor financial ties on author conclusions.
Results: Ninety-eight eligible reviews were analysed. The EPICOT+ reporting was as follows: evidence 34/98 (33.7%), population 68/98 (69.4%), intervention 90/98 (91.8%), comparison 26/98 (26.5%), outcomes 78/98 (79.6%), study design 85/98 (86.7%), time frame 52/98 (53.1%), and burden of disease 7/98 (7.1%). Studies requiring better quality, different interventions, and outcomes in low- and middle-income countries (LMICs) were highlighted. Seven reviews addressed alternative nutrition supplements, including 51 eligible primary studies. Conflicts of interest were disclosed in 10/51 (19.2%); funding in 27/51 (51.9%), of which, 11/27 (40.7%) were industry and 16/27 (59.3%) were non-industry sponsors; and author-sponsor financial ties in 9/51 (13.4%), of which 1/9 (11.1%) was industry and 8/9 (88.9%) were non-industry. There was no association between authors making favourable conclusions and having industry sponsors and author-sponsor financial ties (8/12) compared with non-industry sponsors and no author-sponsor financial ties (10/24), (Fisher exact p =0.289).
Conclusions: EPICOT+ items were not well reported in most reviews. Future studies of better quality, different interventions, outcomes or populations in LMICs are needed. Authors should disclose all COI, funding sources and author-sponsor financial ties. Possible influences of funding sources and author-sponsor financial ties on author conclusions needs further investigation.
AFRIKAANSE OPSOMMING : Geen opsomming beskikbaar.
AFRIKAANSE OPSOMMING : Geen opsomming beskikbaar.
Description
Thesis (MSc)--Stellenbosch University, 2021.
Keywords
Chronic diseases -- Research, Nutrition -- Research, Systematic reviews (Medical research), Cochrane Collaboration, Research gaps, UCTD