Limitations
Our study has some limitations. The cross-sectional design precludes
longitudinal analysis, and the focus on a single set of guidelines may
not be generalizable to other fields or countries. The payment data was
extracted from a secondary database maintained by a non-profit research
organization, which includes nearly all personal payment data collected
from each pharmaceutical company. Additionally, there are no legal
regulations requiring pharmaceutical companies to accurately disclose
their payments to physicians in Japan. Therefore, we cannot exclude the
possibility of errors in the payment data disclosed by the companies.