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外科医生与行业的利益冲突:北美民众对外科医生与行业咨询情况的意见调查

Surgeon-industry conflict of interest: survey of North Americans' opinions regarding surgeons consulting with industry.

作者信息

DiPaola Christian P, Dea Nicolas, Noonan Vanessa K, Bailey Christopher S, Dvorak Marcel F S, Fisher Charles G

机构信息

Department of Orthopaedics, Spine Division, University of Massachusetts Medical Center, 119 Belmont St, Worcester, MA 01605, USA.

Department of Orthopaedics, Division of Spine, University of British Columbia, Blusson Spinal Cord Centre, 6th floor - 818 W. 10th Ave, Vancouver, British Columbia, Canada V5Z 1M9.

出版信息

Spine J. 2014 Apr;14(4):584-91. doi: 10.1016/j.spinee.2013.06.028. Epub 2013 Aug 22.

Abstract

BACKGROUND CONTEXT

Surgeon-industry conflict of interest (COI) has become a source of considerable interest. Professional medical societies, industry, and policy makers have attempted to regulate potential COI without consideration for public opinion.

PURPOSE

The objective of this study was to report on the opinions of individuals representing the general public regarding surgeon-industry consulting relationships.

STUDY DESIGN/SETTING: Web-based survey.

METHODS

Survey was administered using a "spine Web site," and opinions are collected on surgeon-industry consulting and regulation. Associations among responses to similar questions were assessed to ensure validity and subgroup analysis performed for respondent age, sex, education, insurance, employment, and patient status.

RESULTS

Six hundred ten of 642 surveys had complete data. The sample population comprised more females and was older and more educated than the American population. About 80% of respondents felt it was ethical and either beneficial or of no influence to the quality of health care if surgeons were consultants for surgical device companies. Most felt disclosure of an industry relationship was important and paying surgeons royalties for devices, other than those they directly implant, would not affect quality of care. Respondents support multidisciplinary surgeon-industry COI regulation and trust doctors and their professional societies to head this effort.

CONCLUSIONS

Despite the known potential negative impact of surgeon-industry COI on patient care, this study revealed that this does not seem to be reflected in the opinion of the general public. The respondents felt that disclosure is deemed one of the most important means of self-regulation and COI management, which is in agreement with current trends of most spine societies and journals that are increasing the stringency of disclosure policies.

摘要

背景

外科医生与行业的利益冲突已成为备受关注的一个源头。专业医学协会、行业及政策制定者试图对潜在的利益冲突进行监管,却未考虑公众意见。

目的

本研究的目的是报告代表普通公众的个人对外科医生与行业咨询关系的看法。

研究设计/地点:基于网络的调查。

方法

通过一个“脊柱网站”进行调查,收集对外科医生与行业咨询及监管的看法。评估对相似问题回答之间的关联以确保有效性,并针对受访者的年龄、性别、教育程度、保险情况、就业状况及患者身份进行亚组分析。

结果

642份调查问卷中有610份有完整数据。样本人群中女性更多,且比美国总体人群年龄更大、受教育程度更高。约80%的受访者认为,如果外科医生担任手术器械公司的顾问,在道德上是可以接受的,且对医疗质量要么有好处要么没有影响。大多数人认为披露行业关系很重要,而且除了外科医生直接植入的器械外,就其他器械向他们支付版税不会影响医疗质量。受访者支持多学科对外科医生与行业利益冲突的监管,并信任医生及其专业协会来牵头这项工作。

结论

尽管已知外科医生与行业的利益冲突对患者护理有潜在负面影响,但本研究表明这似乎并未在普通公众的看法中得到体现。受访者认为披露被视为自我监管和利益冲突管理的最重要手段之一,这与大多数脊柱协会和期刊目前加强披露政策严格性的趋势一致。

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