The Impact of Financial Conflict of Interest on Surgical Research: An Observational Study of Published Manuscripts

  • Deepa V. Cherla
  • Cristina P. Viso
  • Oscar A. Olavarria
  • Karla Bernardi
  • Julie L. Holihan
  • Krislynn M. Mueck
  • Juan Flores-Gonzalez
  • Mike K. Liang
  • Sasha D. Adams
Original Scientific Report

Abstract

Background

Substantial discrepancies exist between industry-reported and self-reported conflicts of interest (COI). Although authors with relevant, self-reported financial COI are more likely to write studies favorable to industry sponsors, it is unknown whether undisclosed COI have the same effect. We hypothesized that surgeons who fail to disclose COI are more likely to publish findings that are favorable to industry than surgeons with no COI.

Methods

PubMed was searched for articles in multiple surgical specialties. Financial COI reported by surgeons and industry were compared. COI were considered to be relevant if they were associated with the product(s) mentioned by an article. Primary outcome was favorability, which was defined as an impression favorable to the product(s) discussed by an article and was determined by 3 independent, blinded clinicians for each article. Primary analysis compared incomplete self-disclosure to no COI. Ordered logistic multivariable regression modeling was used to assess factors associated with favorability.

Results

Overall, 337 articles were reviewed. There was a high rate of discordance in the reporting of COI (70.3%). When surgeons failed to disclose COI, their conclusions were significantly more likely to favor industry than surgeons without COI (RR 1.2, 95% CI 1.1–1.4, p < 0.001). On multivariable analysis, any COI (regardless of relevance, disclosure, or monetary amount) were significantly associated with favorability.

Conclusions

Any financial COI (disclosed or undisclosed, relevant or not relevant) significantly influence whether studies report findings favorable to industry. More attention must be paid to improving research design, maximizing transparency in medical research, and insisting that surgeons disclose all COI, regardless of perceived relevance.

Notes

Compliance with ethical standards

Conflicts of interest

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health.

Supplementary material

268_2018_4532_MOESM1_ESM.docx (18 kb)
Supplementary material 1 (DOCX 17 kb)

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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Deepa V. Cherla
    • 1
    • 2
  • Cristina P. Viso
    • 1
  • Oscar A. Olavarria
    • 1
  • Karla Bernardi
    • 1
    • 2
  • Julie L. Holihan
    • 1
    • 2
  • Krislynn M. Mueck
    • 1
    • 2
  • Juan Flores-Gonzalez
    • 1
  • Mike K. Liang
    • 1
    • 2
  • Sasha D. Adams
    • 1
  1. 1.Department of SurgeryUniversity of Texas Health Science Center at HoustonHoustonUSA
  2. 2.Center for Surgical Trials and Evidence-Based Practice (C-STEP)University of Texas Health Science Center at HoustonHoustonUSA

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