Conflicts of interest and physicians’ attitudes towards hydroxychloroquine as a treatment against COVID-19 A replication and extension of Roussel & Raoult (2020)

Hydroxychloroquine (HCQ) and its use as a treatment against COVID-19 have been at the center of heated debates. Some claim that physicians’ hostility towards HCQ was partly orchestrated by rival pharmaceutical companies seeking to promote their own treatment. In favor of this hypothesis, Roussel and Raoult (2020) have presented the results of a study in which they find a perfect positive correlation (ρ = 1.00) between French physicians’ attitudes towards HCQ and their conflict of interest with Gilead Sciences - the company that has promoted Remdesivir (REM) as a treatment against COVID-19. However, Roussel and Raoult’s study suffers from serious methodological shortcomings, among which is the fact that the statistical methods they employed might tend to artificially inflate correlations. In this study, we use a similar method and sample, but correct for their study’s original shortcomings: we provide a detailed, pre-registered method for collecting and coding data, computer inter-rater agreement and use a wide array of appropriate statistical methods to achieve a more reliable estimate the association between conflicts of interest and physicians’ attitudes towards HCQ. We conclude that Roussel and Raoult’s conclusion was misguided and that financial conflicts of interest were not the main predictors of the attitudes of physicians when compared to other factors, such as academic affiliation. Moreover, compared to other pharmaceutical companies, there was no specific link between attitudes towards HCQ and conflicts of interest with Gilead Sciences.