1
|
Erivan R, Hacquart T, Villatte G, Descamps S, Dartus J, Boisgard S. What are the rates and validity of French authors' conflicts of interest disclosures in Orthopaedics & Traumatology: Surgery & Research? Analysis of the year 2017 with comparison versus the Transparence.sante.gouv.fr database. Orthop Traumatol Surg Res 2021; 107:103080. [PMID: 34592417 DOI: 10.1016/j.otsr.2021.103080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/20/2021] [Accepted: 08/03/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Authors are responsible for their own Disclosure of Interests in submitting to Orthopaedics & Traumatology: Surgery & Research (OTSR). Disclosure may be incomplete or false, by deliberate or unintended omission. Omission may impact the analysis of results or at least the reader's perception of it. The rate of validity of disclosure in OTSR is not known, and we therefore conducted a bibliometric study on articles published in 2017, in order to: 1) determine the proportion of articles in which authors disclose interests; and 2), when interests are disclosed, to assess their validity by comparison against the Transparence.gov.fr database. HYPOTHESIS Disclosure rates exceed 75%. MATERIAL AND METHOD We analyzed all articles published in OTSR in 2017, and extracted those with at least one French author. We also analyzed data from the Transparence.gouv.fr corporate declaration database, for comparison with the authors' own disclosures in each article. Significant interest was defined by a €1000 threshold, although higher thresholds (>€5000, >€10,000 and >€100,000) were also investigated. RESULTS In 2017, 337 articles were published in OTSR, 210 of which had at least 1 French author. Of these, 201 (95.7%) had at least 1 author with significant interest (>€1000) according to the Transparence data. In 189 of these 201 articles (94%), authors had failed to disclose at least 1 direct or indirect conflict of interest. This omission rate fell to 22/45 (48.9%) for more substantial interests, which were more faithfully disclosed. At the €1000 threshold, in only 8/201 articles (4%) did authors disclose all their interests with perfect validity, but this rate increased up to 25/45 (55.5%) at higher thresholds. At the €1000 threshold, 66 of the 201 articles cited the trade-name of interest, resulting in 54/66 (82%) correct disclosure of direct interest; this rate increased up to 25/26 (96%) at higher thresholds. DISCUSSION At a threshold of €1000, the rate of complete and valid disclosure was 4% and the rate of omission 94%. At higher thresholds, rates were better, with just 48.9% omission and, above all, 55.5% validity, even if these rates were lower than hypothesized (75%). Authors and editors need to take greater care. Disclosures were often made, but incompletely, and authors need reminding that they must disclose not only interests related to the article in question but also all interests that might directly or indirectly influence their interpretation of the results reported, allowing readers to make up their own minds. LEVEL OF EVIDENCE IV; systematic retrospective study.
Collapse
Affiliation(s)
- Roger Erivan
- CNRS, SIGMA Clermont, ICCF, Université Clermont Auvergne, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France.
| | - Thomas Hacquart
- Université Clermont Auvergne, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Guillaume Villatte
- CNRS, SIGMA Clermont, ICCF, Université Clermont Auvergne, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Stéphane Descamps
- CNRS, SIGMA Clermont, ICCF, Université Clermont Auvergne, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Julien Dartus
- ULR 4490, Département Universitaire de Chirurgie Orthopédique et Traumatologique, University Lille, CHU de Lille, 59000 Lille, France
| | - Stéphane Boisgard
- CNRS, SIGMA Clermont, ICCF, Université Clermont Auvergne, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| |
Collapse
|
2
|
Somerson JS, Comley MC, Mansi A, Neradilek MB, Matsen FA. Industry payments to authors of Journal of Shoulder and Elbow Surgery shoulder arthroplasty manuscripts are accurately disclosed by most authors and are not significantly associated with better reported treatment outcomes. J Shoulder Elbow Surg 2020; 29:667-673. [PMID: 31899091 DOI: 10.1016/j.jse.2019.09.045] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/26/2019] [Accepted: 09/30/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Author transparency in disclosing potential conflicts of interest when reporting outcomes for shoulder arthroplasty implants is important. Using the Centers for Medicare & Medicaid Services Open Payments Program (OPP) database, we analyzed articles in the Journal of Shoulder and Elbow Surgery to evaluate (1) discrepancies between the stated conflicts of interest and associated payments recorded in the database, (2) the magnitude and types of payments received, and (3) possible relationships between industry financial support and positive study outcomes. METHODS Articles reporting clinical outcomes of shoulder arthroplasty from 2016 and 2017 were reviewed. Articles identifying a specific shoulder arthroplasty implant and having at least 1 author based in the United States were included. Payment types, amounts, and sources were extracted from disclosure statements in the manuscript and considered relevant if they were received from the implant manufacturer. Published disclosure statements were compared against the OPP database. Study outcomes demonstrating a clinical benefit were considered "positive." Payments to authors reporting positive outcomes were compared with those reporting nonpositive outcomes. RESULTS Implant manufacturers provided $16,051,261 to authors of shoulder arthroplasty publications over a 2-year period. Approximately half of senior authors (46%) received royalty payments, more than 90% of which ($14,910,873; 93%) were reported in disclosure statements. Although authors of articles with positive outcomes received greater payments than those reporting nonpositive outcomes, these differences were not statistically significant. CONCLUSION The majority of author disclosure statements accurately reflected the OPP data. Payments were not significantly associated with positive outcomes reported for the specific implant.
Collapse
Affiliation(s)
- Jeremy S Somerson
- Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, Galveston, TX, USA.
| | - Matthew C Comley
- Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, Galveston, TX, USA
| | - Ahmed Mansi
- School of Medicine, The University of Texas Medical Branch, Galveston, TX, USA
| | | | - Frederick A Matsen
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA
| |
Collapse
|
3
|
González-Mariño MA. Evidencia sobre conflictos de intereses en medicina. REVISTA DE LA FACULTAD DE MEDICINA 2020. [DOI: 10.15446/revfacmed.v68n1.73475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. La principal responsabilidad de los médicos es la de actuar en beneficio de los pacientes; sin embargo, existen situaciones en las cuales surgen intereses secundarios que pueden afectar este compromiso y generar conflictos de intereses.Objetivo. Analizar las revisiones sistemáticas y los metaanálisis actualmente disponibles en la literatura sobre el conflicto de intereses en medicina para sintetizar la información al respecto.Materiales y métodos. Se realizó una búsqueda en las bases de datos MEDLINE y LILACS mediante la siguiente estrategia de búsqueda: revisiones sistemáticas y metaanálisis sobre conflictos de intereses en medicina publicados en revistas científicas seriadas; no se aplicaron restricciones de idioma o año de publicación. Los estudios que cumplieron con los criterios de inclusión fueron agrupados según la actividad médica evaluada; además, de cada uno de ellos se extrajo la cantidad y el tipo de estudios y las conclusiones.Resultados. Se seleccionaron 29 publicaciones que se agruparon en estudios basados en artículos de investigación, en guías de práctica clínica, en la práctica clínica, y en publicaciones orientadas a los pacientes.Conclusiones. Los estudios originales incluidos en las revisiones sistemáticas y los metaanálisis analizados en el presente estudio no siempre reportan los conflictos de intereses; sin embargo, cuando estos se mencionan, hay una tendencia a presentar resultados que favorecen el medicamento o la tecnología del patrocinador.
Collapse
|
4
|
Choo KJ, Yi PH, Burns R, Mohan R, Wong K. Variable Reporting by Authors Presenting Arthroplasty Research at Multiple Annual Conferences. J Arthroplasty 2017; 32:315-319. [PMID: 27369303 DOI: 10.1016/j.arth.2016.05.068] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 05/27/2016] [Accepted: 05/27/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Prior studies have demonstrated discrepancies in financial conflict of interest (COI) disclosure among authors presenting research at multiple spine and sports medicine conferences. The purpose of this study was to quantify the variability of self-reported financial disclosures of individual authors presenting at multiple arthroplasty conferences during the same year. METHODS The author disclosure information published for the 2012 annual meetings of the American Academy of Orthopaedic Surgeons (AAOS), American Association of Hip and Knee Surgeons, the Hip Society, and the Knee Society were compiled. We tabulated the author disclosures, the number of companies/entities represented, and the types of disclosures reported. The disclosures made by authors presenting at more than one meeting were then compared for discrepancies. RESULTS Of the 209 authors who presented at both the AAOS and American Association of Hip and Knee Surgeons meetings, 79 (37.79%) demonstrated discrepancies in their disclosures with 7 (8.8%) reporting no disclosures to the AAOS. Of the 84 authors who presented at both the AAOS and Hip Society meetings, 1 (1.19%) had discrepancies in their disclosures. Of the 52 authors who presented at both the AAOS and Knee Society meetings, 2 (3.84%) had discrepancies in their disclosures. CONCLUSION There is variability in reported financial COIs by authors presenting at multiple arthroplasty conferences within the same year. Further work is warranted to improve transparency of COI disclosures among arthroplasty surgeons presenting research at national meetings.
Collapse
Affiliation(s)
- Kevin J Choo
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California
| | - Paul H Yi
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California
| | - Robert Burns
- Boston University School of Medicine, Boston, Massachusetts
| | - Rohith Mohan
- Boston University School of Medicine, Boston, Massachusetts
| | - Kevin Wong
- Boston University School of Medicine, Boston, Massachusetts
| |
Collapse
|
5
|
Harris JD, Erickson BJ, Cvetanovich GL, Abrams GD, McCormick FM, Gupta AK, Verma NN, Bach BR, Cole BJ. Development of a Valid and Reliable Knee Articular Cartilage Condition-Specific Study Methodological Quality Score. Orthop J Sports Med 2014; 2:2325967113512606. [PMID: 26535295 PMCID: PMC4555619 DOI: 10.1177/2325967113512606] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Condition-specific questionnaires are important components in evaluation of outcomes of surgical interventions. No condition-specific study methodological quality questionnaire exists for evaluation of outcomes of articular cartilage surgery in the knee. PURPOSE To develop a reliable and valid knee articular cartilage-specific study methodological quality questionnaire. STUDY DESIGN Cross-sectional study. METHODS A stepwise, a priori-designed framework was created for development of a novel questionnaire. Relevant items to the topic were identified and extracted from a recent systematic review of 194 investigations of knee articular cartilage surgery. In addition, relevant items from existing generic study methodological quality questionnaires were identified. Items for a preliminary questionnaire were generated. Redundant and irrelevant items were eliminated, and acceptable items modified. The instrument was pretested and items weighed. The instrument, the MARK score (Methodological quality of ARticular cartilage studies of the Knee), was tested for validity (criterion validity) and reliability (inter- and intraobserver). RESULTS A 19-item, 3-domain MARK score was developed. The 100-point scale score demonstrated face validity (focus group of 8 orthopaedic surgeons) and criterion validity (strong correlation to Cochrane Quality Assessment score and Modified Coleman Methodology Score). Interobserver reliability for the overall score was good (intraclass correlation coefficient [ICC], 0.842), and for all individual items of the MARK score, acceptable to perfect (ICC, 0.70-1.000). Intraobserver reliability ICC assessed over a 3-week interval was strong for 2 reviewers (≥0.90). CONCLUSION The MARK score is a valid and reliable knee articular cartilage condition-specific study methodological quality instrument. CLINICAL RELEVANCE This condition-specific questionnaire may be used to evaluate the quality of studies reporting outcomes of articular cartilage surgery in the knee.
Collapse
Affiliation(s)
- Joshua D. Harris
- Houston Methodist Center for Orthopaedics & Sports Medicine, Houston, Texas, USA
- Rush University Medical Center, Chicago, Illinois, USA
| | | | | | - Geoffrey D. Abrams
- Rush University Medical Center, Chicago, Illinois, USA
- Orthopedic Surgery, Stanford University and Veterans Administration–Palo Alto, Palo Alto, California, USA
| | - Frank M. McCormick
- Rush University Medical Center, Chicago, Illinois, USA
- Holy Cross Hospital, Oakland Park, Florida, USA
| | - Anil K. Gupta
- Rush University Medical Center, Chicago, Illinois, USA
- Florida Orthopaedic Institute, Tampa, Florida, USA
| | | | | | - Brian J. Cole
- Rush University Medical Center, Chicago, Illinois, USA
| |
Collapse
|
6
|
Harris JD, Erickson BJ, Abrams GD, Cvetanovich GL, McCormick FM, Gupta AK, Bach BR, Cole BJ. Methodologic quality of knee articular cartilage studies. Arthroscopy 2013; 29:1243-1252.e5. [PMID: 23623292 DOI: 10.1016/j.arthro.2013.02.023] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 01/26/2013] [Accepted: 02/20/2013] [Indexed: 02/02/2023]
Abstract
PURPOSE (1) To evaluate the quality of knee articular cartilage surgery literature using established methodologic quality instruments, and (2) to assess whether study quality has improved with time. METHODS A systematic review was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies of autologous chondrocyte implantation (ACI), osteochondral autograft and allograft transplant, and microfracture were analyzed. Study methodologic quality was assessed by the level of evidence and 9 different methodologic quality questionnaires. Comparisons were made between different surgical technique groups by use of Student's t tests. Assessment of study quality improvement with time was performed by comparison of the Coleman Methodology Score (CMS) from the included studies (2004 to present) and CMS from a prior study assessing quality of articular cartilage studies (1985 to 2004). Furthermore, assessment of study quality improvement with time was performed over the period of the included studies (2004 to present). RESULTS We included 194 studies (11,787 subjects). Most evidence was Level IV (76%) and nonrandomized (91%). ACI was the most commonly reported technique (62% of studies). Only 34% of studies denied the presence of a financial conflict of interest. The mean subject age was 33.5 ± 8.2 years, and the mean length of follow-up was 3.7 ± 2.3 years. By use of study quality questionnaires, the methodologic quality of articular cartilage studies was poor. However, study quality (after 2004) was significantly improved versus that reported from a prior study (before 2004) using the CMS (P < .01). The mean level of evidence, CMS, CONSORT (Consolidated Standards of Reporting Trials) score, and Jadad score showed no significant improvement over the period of the included studies (P > .05). The quality of randomized controlled trials (RCTs) was significantly higher than that of non-RCTs (P < .05). The most common study weaknesses included blinding, subject selection process, study type, sample size calculation, and outcome measures and assessment. CONCLUSIONS The methodologic quality of knee articular cartilage surgery studies was poor overall and also for individual techniques (ACI, osteochondral autograft transplant, osteochondral allograft transplant, and microfracture). However, the overall quality of the investigations in this review (after June 2004) has significantly improved in comparison to those published before 2004. The quality of RCTs was significantly higher than that of non-RCTs. Level of evidence, CMS, CONSORT score, and Jadad score did not significantly improve with later publication date within the period of the studies analyzed. Methodologic quality deficiencies identified in this investigation may be used to guide future articular cartilage studies' design, conduct, and reporting. LEVEL OF EVIDENCE Level IV, systematic review of studies with Levels of Evidence I-IV.
Collapse
Affiliation(s)
- Joshua D Harris
- Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL 60612, USA.
| | | | | | | | | | | | | | | |
Collapse
|