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Special Communication |

Descriptions and Interpretations of the ACCORD-Lipid Trial in the News and Biomedical Literature:  A Cross-Sectional Analysis

Nicholas S. Downing, AB1; Theresa Cheng, AB2; Harlan M. Krumholz, MD, SM3,4,5,6; Nilay D. Shah, PhD7; Joseph S. Ross, MD, MHS4,5,6,8
[+] Author Affiliations
1Student, Yale University School of Medicine, New Haven, Connecticut
2student, The Mayo Medical School, Mayo Clinic, Rochester, Minnesota
3Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut
4The Robert Wood Johnson Foundation Clinical Scholars Program, Yale University School of Medicine, New Haven, Connecticut
5Section of Health Policy and Administration, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut
6Center for Outcomes Research and Evaluation, Yale–New Haven Hospital, New Haven, Connecticut
7Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota
8Section of General Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
JAMA Intern Med. 2014;174(7):1176-1182. doi:10.1001/jamainternmed.2014.1371.
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The lipid component of the Action to Control Cardiovascular Risk in Diabetes (ACCORD-Lipid) trial was a landmark, publicly funded study demonstrating that fenofibrate, when added to statin therapy, was not associated with improved cardiovascular outcomes among patients with diabetes mellitus. We performed a cross-sectional study of all articles describing the results of ACCORD-Lipid in the news and biomedical literature in the 15 months following its publication. For articles published in biomedical journals, we determined whether there was an association between authors’ conflicts of interest and trial interpretation. We identified 67 news articles and 141 biomedical journal articles discussing ACCORD-Lipid. Approximately 30% of news and biomedical journal articles described fenofibrate as ineffective, whereas nearly 20% concluded it was effective. Among articles making a recommendation, approximately 50% of news and 67% of biomedical journal articles supported continued fibrate use. Authors with conflicts of interest were more likely to describe fenofibrate as effective (27.1% vs 8.9%; relative risk, 3.03; 95% CI, 1.22-7.50; P = .008) and support continued fibrate use (77.4% vs 45.8%; 1.69; 1.07-2.67; P = .006). The ACCORD-Lipid trial was described inconsistently in news and biomedical journal articles, possibly creating uncertainty among patients and physicians. In addition, conflicts of interest were associated with more favorable trial interpretation.

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Consolidated Standards for Reporting of Trials Flow Diagram

Identification and selection of news articles and biomedical journal articles on the Action to Control Cardiovascular Risk in Diabetes (ACCORD)–Lipid trial for study inclusion.

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