Industry Funding and Self-Declared Conflict of Interest in Hand Surgery Publications

Abstract

Accurate financial disclosure is essential to prevent bias in scientific reporting. We aimed (1) to document the extent of industry financial payments to hand surgery literature authors and (2) to uncover discrepancies in author self-declared conflict of interest (COI). We screened all scientific and review articles published in 2017 from the American editions of 4 peer-reviewed journals (Journal of Hand Surgery [JHS], Journal of Bone and Joint Surgery [JBJS], Plastic and Reconstructive Surgery [PRS], and Journal of the American Academy of Orthopaedic Surgeons [JAAOS]) to identify authors of hand, wrist, elbow, and peripheral nerve topics. We compared self-reported disclosures with industry-reported payments on the Centers for Medicare and Medicaid Services' Open Payments Database (OPD) for 3 years prior to publication or per journal policy. We individually examined each for relevance of the corporate payer to the article's subject matter. We found 630 eligible authors from 395 articles. The total amount of industry-reported payments over 3 years prior to publication was $24,396,607.80. The median total payments per author per year was $118.40, with interquartile range from $0 to $1,364; 68% of authors received some industry payment; the most common being food and beverage (66% of authors). Senior authors received significantly more industry payments (median, $2,985.67/y) than first and middle authors ($70.27 and $113.17, respectively). Of all authors examined, 58% had undisclosed payments, but only 14% were relevant to the article subject matter. Authors in JAAOS & JBJS, senior authors, and those receiving more than $500,000 from industry were less likely to accurately report all payments. Industry payments to hand surgery authors were lower than those reported to other orthopedic specialties and tended to be concentrated in a few authors receiving large amounts. Relevant COI disclosure inaccuracies are infrequent within hand surgery literature. Uniform policies of complete disclosure across journals may remove author judgment regarding payment relevance to published material and help eliminate remaining COI errors. Authors may reference the OPD prior to submitting disclosures to prevent potential discrepancies and identify errors within the database. Relationships with industry offer opportunities for innovation, education, and research, but overlooking COI self-reporting may erode confidence in the academic integrity of the hand surgery literature.