本文由小咖机器人翻译整理

期刊来源：BMJ

原文链接：https://doi.org/10.1136/bmj-2023-076902

摘要内容如下：

客观

评估2022年出版的美国精神病学协会《精神疾病诊断与统计手册》第五版（DSM-5-TR）的专家组和工作组成员与行业的财务联系的程度和类型。

设计

横截面分析。

设置

开放支付数据库，美国。

参与者

来自美国的92名医生在2016-19年期间担任DSM-5-TR小组（n=86）或工作组（n=6）的成员，其信息记录在医疗保险和医疗补助服务中心开放支付数据库中。选择这段时间是为了包括DSM-5-TR的开发开始的那一年和之前的三年，这段时间与之前关于利益冲突的研究一致，也符合美国精神病学协会对手册第五次修订版（DSM-5）的披露要求。

主要结局指标

2016-19年期间，DSM-5-TR小组和工作组成员收到的赔偿类型和金额。

结果

在删除重复姓名后，确定了168名担任DSM-5-TR小组或工作组成员的个人。92人符合美国医生的纳入标准，因此可以纳入开放支付。在这92人中，有55人（60%）从工业界领取报酬。这些小组成员总共收到了1420万美元（1120万英镑；1300万欧元）。三分之一（33.3%）的工作队成员在未结付款中报告了付款情况。

结论

DSM-5-TR小组成员之间的利益冲突非常普遍。由于诊断和治疗指南的巨大影响，指南制定小组的参与标准应该很高。《精神疾病诊断与统计手册》应该存在一个可反驳的推定，以禁止其小组和工作组成员之间的利益冲突。当没有具备必要专业知识的独立个人时，与行业有关联的个人可以向专家小组咨询，但他们不应对修订或纳入新的疾病拥有决策权。

英文原文如下：

Abstracts

OBJECTIVE  To assess the extent and types of financial ties to industry of panel and task force members of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision (DSM-5-TR), published in 2022.

DESIGN  Cross sectional analysis.

SETTING  Open Payments database, USA.

PARTICIPANTS  92 physicians based in the US who served as members of either a panel (n=86) or task force (n=6) on the DSM-5-TR with information recorded in the Centers for Medicare and Medicaid Services Open Payments database during 2016-19. This period was chosen to include the year that development of the DSM-5-TR began and the three years preceding, a time consistent with previous research on conflicts of interest and consistent with the American Psychiatric Association's disclosure requirements for the fifth revision (DSM-5) of the manual.

MAIN OUTCOME MEASURES  Type and amount of compensation the panel and task force members of DSM-5-TR received during 2016-19.

RESULTS  After duplicate names had been removed, 168 individuals were identified who served as either panel or task force members of the DSM-5-TR. 92 met the inclusion criteria of being a physician who was based in the US and therefore could be included in Open Payments. Of these 92 individuals, 55 (60%) received payments from industry. Collectively, these panel members received a total of $14.2m (£11.2m; €13m). One third (33.3%) of the task force members had payments reported in Open Payments.

CONCLUSIONS  Conflicts of interest among panel members of DSM-5-TR were prevalent. Because of the enormous influence of diagnostic and treatment guidelines, the standards for participation on a guideline development panel should be high. A rebuttable presumption should exist for the Diagnostic and Statistical Manual of Mental Disorders to prohibit conflicts of interest among its panel and task force members. When no independent individuals with the requisite expertise are available, individuals with associations to industry could consult to the panels, but they should not have decision making authority on revisions or the inclusion of new disorders.

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