Industry-Sponsored Speakers’ Bureaus Among UpToDate Contributors: An In-Progress Analysis on Prevalence, Financial Magnitude, and Institutional Compliance

Marcus Milani, MS – University of Minnesota Medical School; Jack Wieberdink, BS – University of Minnesota Medical School; Brandon Semke, BS – University of Minnesota Medical School; Jonathan Alpern, MD – Department of Medicine, Division of Infectious Diseases – Minneapolis VA; David Satin, MD – Department of Family Medicine and Center for Bioethics – University of Minnesota

Abstract: Industry-sponsored speakers’ bureaus (ISSBs) pose a significant conflict of interest (COI), particularly when pharmaceutical companies exert control over educational content. Although many medical centers discourage faculty participation, policies vary widely, and compliance remains uncertain. UpToDate, the most widely used English-language clinical decision support tool worldwide, prohibits Deputy Editors from ISSB participation but imposes no such restrictions on authors. Given the influence UpToDate has on clinician behavior, understanding the extent of these relationships could help guide institution and clinician use of UpToDate.
This study consists of three phases. Phase 1, which has been completed, involved identifying UpToDate authors with ISSB disclosures and assessing prevalence by specialty, status as clinician, academic rank, and institution. Phase 2, to be completed June 2025, analyzes the relevance of ISSB-author relationships by connecting ISSB companies with products named. The financial magnitude of these relationships is assessed using Open Payments data. Phase 3, to be completed September 2025, evaluates institutional COI policies on ISSBs and author compliance. Descriptive statistics and regression analyses will examine associations between specialty, status as clinician, academic rank, relevance of disclosures, and financial magnitude.
Preliminary data suggests 7-12% of UpToDate authors disclose participation in ISSBs, with variation by specialties. By quantifying ISSB participation among UpToDate authors and assessing compliance with their institutions’ policies, we hope to inform policy development for medical institutions, mitigate COIs, and improve transparency in medical education and practice. Audience members will be presented with study data and asked for their interpretation, conclusions, study dissemination strategies, and recommended next steps.

Keywords: Industry-Sponsored Speakers’ Bureaus & UpToDate Conflict of Interest