Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT 06520, USA.
J Bone Joint Surg Am. 2011 Jul 6;93(13):e75. doi: 10.2106/JBJS.J.01411.
Physician disclosure of potential conflicts of interest is currently controversial. To address this issue, orthopaedic societies have implemented a variety of guidelines related to potential conflict-of-interest disclosure. Transparency is crucial to address the concerns about potential conflict-of-interest disclosure. Nonetheless, prior studies have noted substantial discrepancies in disclosures to societies for individual authors who present their research work at multiple conferences. Our goal was to evaluate the ability of orthopaedic surgeons to interpret disclosure policy statements regarding project-specific or global disclosure instructions.
The disclosure policy statements of the ten conferences most frequently attended by this group were collected, and selected statements were compiled into a questionnaire survey that was administered to orthopaedic faculty and trainees at our institution. Subjects were asked to read each statement and identify whether they interpreted the policy to be requesting project-specific disclosures (potential conflict of interest related to the research work in the abstract being submitted) or global disclosure (inclusive of all potential conflicts of interest, including those not associated with the abstract being submitted). The correct responses were identified by communicating with the individual societies and determining the responses desired by the society.
The study had a 100% return rate from seventeen orthopaedic faculty, twenty-five orthopaedic residents and fellows, and twenty-five medical students. The average number of incorrect responses to the ten questions was 2.8. Forty-six percent of respondents had three or more incorrect responses, 24% had two incorrect responses, 19% had one incorrect response, and 10% had no incorrect responses. There was no significant difference in responses between those of different training levels. Subjects were no more likely to answer a project-specific question incorrectly than they were to answer a global question incorrectly.
This study clearly demonstrated a discrepancy between what societies intend to identify with disclosure policies and what the orthopaedist interprets is intended. Almost half of those completing the survey did not correctly understand the intention of three or more of the policies, even with expected study intent bias. This study showed that the language used in disclosure policy statements and the lack of a uniform policy may be a cause of substantial discrepancies in potential conflict-of-interest disclosure.
医生披露潜在利益冲突目前存在争议。为了解决这个问题，骨科协会已经制定了各种与潜在利益冲突披露相关的指南。透明度对于解决潜在利益冲突披露的担忧至关重要。然而，先前的研究已经注意到，在多位作者在多个会议上展示其研究工作的情况下，向各协会披露的情况存在很大差异。我们的目标是评估骨科医生解读特定项目或总体披露指令的披露政策声明的能力。
收集了该组最常参加的十个会议的披露政策声明，并将选定的声明汇编成一份问卷调查，分发给我们机构的骨科教师和学员。要求受试者阅读每条声明，并确定他们是否将政策解释为要求特定项目的披露（与提交的摘要中的研究工作相关的潜在利益冲突）或总体披露（包括所有潜在利益冲突，包括与提交的摘要无关的利益冲突）。通过与各个协会沟通并确定协会希望的答复，确定了正确的答复。
这项研究从 17 名骨科教师、25 名骨科住院医师和研究员以及 25 名医学生中获得了 100%的回复率。对十个问题的错误回答平均为 2.8 个。46%的受访者有三个或更多错误回答，24%有两个错误回答，19%有一个错误回答，10%没有错误回答。不同培训水平的受访者的回答没有显著差异。回答特定项目的问题错误的可能性与回答总体问题错误的可能性没有差异。
这项研究清楚地表明，协会意图通过披露政策确定的内容与骨科医生理解的意图之间存在差异。即使存在预期的研究意图偏差，完成调查的人中仍有近一半没有正确理解三个或更多政策的意图。这项研究表明，披露政策声明中使用的语言以及缺乏统一的政策可能是潜在利益冲突披露存在重大差异的原因。
