Comparison of Conflict of Interest (COI) Disclosures to Publicly Reported Industry Payments for Presenters at the American Society of Radiation Oncology (ASTRO) Annual Meeting: Can we Do Better?

Abstract

The ASTRO annual meeting is the largest US academic forum for radiation oncology. Proper conflict of interest (COI) disclosure by speakers is essential to research integrity. We examine presentations at ASTRO annual meetings to evaluate COI disclosure and compare these disclosures to payments reported on the Centers for Medicare and Medicaid Services Open Payments (OP) database. In this abstract, we report on disclosure discrepancies and quantitative monetary thresholds of these discrepancies. The first presentation of each podium, scientific, presidential symposium, educational and panel session from the 2014-2016 ASTRO virtual meetings was arbitrarily selected. Each presentation was examined 1) for the presence of a COI slide and 2) for the disclosures listed. For each presenter, disclosures were cross-referenced with the OP database in the prior year in the categories of consulting, research, and faculty/speaking fees. Disclosures were determined to be discrepancies if a speaker did not list all the companies from which they received a payment as reported on the OP database, or if no COI slide was present. Of the 401 total presentations examined, 264 were US MDs, and 16.4% of US MDs underreported industry funding. When examining individual payments for all US presenters, 96 payments were reported on the OP database in the aforementioned categories: 53 of these payments were not disclosed and 43 payments were accurately disclosed. Of the presentations with discrepancies, 32.6% did not have a COI slide, 39.5% failed to disclose any OP companies, and 27.9% disclosed some but not all OP companies. Mean payment was $34,264 (median: $4,000; range: $96-$488,931), mean discrepancy was $30,300 (median: $2,925; range: $96-$488,931) and mean disclosed payment was $39,151 (median: $5,000; range: $750-$400,000). Research payments were the largest with a mean of $71,167 (median: $13,566; range: $160-$488,931). Among discrepancies, 49.1% were for research, 30.2% for consulting, and 20.8% for faculty/speaking fees. Three-quarters of the lowest third of all payments ($96-$2000) were not disclosed with the majority (75%) of these discrepancies occurring in presentations with COI slides while 45.3% of the upper two thirds of payments were not disclosed with 41.3% occurring in presentations with COI slides. A large minority of presenters underreported COIs. Payments of lower amounts were more often underreported. Limitations of our study include the small sample size and potential errors in reporting on OP. Nearly a third of discrepancies were due to absent COI slides, suggesting inadequate understanding of disclosure protocols. Guidelines should be revised with an emphasis on the dollar amount relevant for disclosing industry payments.