Okike Kanu, Kocher Mininder S, Wei Erin X, Mehlman Charles T, Bhandari Mohit
Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.
N Engl J Med. 2009 Oct 8;361(15):1466-74. doi: 10.1056/NEJMsa0807160.
The recent public reporting of payments made to physicians by manufacturers of orthopedic devices provides an opportunity to assess the accuracy of physicians' conflict-of-interest disclosures.
We analyzed the reports of payments made to physicians by five manufacturers of total hip and knee prostheses in 2007. For each payment recipient who was an author of a presentation or served as a committee member or board member at the 2008 annual meeting of the American Academy of Orthopaedic Surgeons, the disclosure statement was reviewed to determine whether the payment had been disclosed. To ascertain the reasons for nondisclosure, a survey was administered to physicians who had received payments that were not disclosed.
The overall rate of disclosure was 71.2% (245 of 344 payments). For payments that were directly related to the topic of the presentation at the meeting, the rate was 79.3% (165 of 208); for payments that were indirectly related, the rate was 50.0% (16 of 32); and for payments that were unrelated, the rate was 49.2% (29 of 59) (P=0.008). In the multivariate analysis, payments were also more likely to have been disclosed if they exceeded $10,000 (P<0.001), were directed toward an individual physician rather than a company or organization (P=0.04), or included an in-kind component (P=0.002). Among the 36 physicians who responded to the survey regarding reasons for nondisclosure (response rate, 39.6%), the reasons most commonly given for nondisclosure were that the payment was unrelated to the topic of presentation at the annual meeting (38.9% of respondents) and that the physician had misunderstood the disclosure requirements (13.9%); 11.1% reported that the payment had been disclosed but was mistakenly omitted from the program.
In this study of self-reported conflict-of-interest disclosure by physicians at a large annual meeting, the rate of disclosure was 79.3% for directly related payments and 50.0% for indirectly related payments.
近期公开报道了骨科器械制造商向医生支付款项的情况，这为评估医生利益冲突披露的准确性提供了契机。
我们分析了2007年五家全髋关节和膝关节假体制造商向医生支付款项的报告。对于在2008年美国骨科医师学会年会上作为演讲作者或担任委员会成员或董事会成员的每位付款接收者，审查其披露声明以确定该款项是否已被披露。为了确定未披露的原因，对收到未披露款项的医生进行了一项调查。
总体披露率为71.2%（344笔款项中的245笔）。对于与会议上演讲主题直接相关的款项，披露率为79.3%（208笔中的165笔）；对于间接相关的款项，披露率为50.0%（32笔中的16笔）；对于不相关的款项，披露率为49.2%（59笔中的29笔）（P = 0.008）。在多变量分析中，如果款项超过10,000美元（P < 0.001）、是支付给个体医生而非公司或组织（P = 0.04）或包含实物部分（P = 0.002），则更有可能被披露。在就未披露原因进行调查的36位医生中（回复率为39.6%），最常给出的未披露原因是该款项与年会演讲主题不相关（38.9%的受访者）以及医生误解了披露要求（13.9%）；11.1%的受访者报告该款项已被披露但被错误地从程序中遗漏。
在这项对大型年会上医生自我报告的利益冲突披露的研究中，直接相关款项的披露率为79.3%，间接相关款项的披露率为50.0%。
