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外科和医疗器械行业向医生支付报酬与自我宣称的利益冲突的关联。

Association of Compensation From the Surgical and Medical Device Industry to Physicians and Self-declared Conflict of Interest.

机构信息

Department of Surgery, University of California, Irvine, School of Medicine, Orange.

出版信息

JAMA Surg. 2018 Nov 1;153(11):997-1002. doi: 10.1001/jamasurg.2018.2576.

Abstract

IMPORTANCE

Surgical and medical device manufacturers have a cooperative relationship with clinicians. When evaluating published works, one should assess the integrity and academic credentials of the authors, who serve as putative experts. A relationship with a relevant manufacturer may increase the potential risk for bias in relevant studies.

OBJECTIVE

To characterize the association of industrial payments by device manufacturers, self-declared conflict of interest (COI), and relevance of publications among physicians receiving the highest compensation.

DESIGN, SETTING, AND PARTICIPANTS: This population-based bibliometric analysis identified 10 surgical and medical device manufacturing companies and the 10 physicians receiving the highest compensation from each company using the 2015 Open Payments Database (OPD) general payments data. For each of the 100 physicians, the total amount of general payments, number of payments, institution type, and academic rank were recorded. Royalty or license payments were excluded. A search of PubMed identified articles published by each physician from January 1 through December 31, 2016, and their associated COI declaration. Scopus was used to identify bibliometric data reported as the h index (number of papers by a researcher with at least h citations each).

MAIN OUTCOMES AND MEASURES

Discrepancy between self-declared COI and industry payments.

RESULTS

The 100 physicians included in the sample population (88% men) were paid a total of $12 446 969, with a median payment of $95 993. Fifty physicians (50.0%) were faculty at academic institutions. The mean (SD) h index was 18 (18; range, 0-75) for the authors. In 2016, 412 articles were published by these physicians, with a mean (SD) of 4 (6) publications (range, 0-25) and median of 1 (36 physicians had no publications). Of these articles, 225 (54.6%) were relevant to the general payments received by the authors. Only in 84 of the 225 relevant publications (37.3%) was the potential COI declared by the authors.

CONCLUSIONS AND RELEVANCE

A high level of inconsistency was found between self-declared COI and the OPD among the physicians receiving the highest industry payments. Therefore, a policy of full disclosure for all publications, regardless of relevance, is proposed. No statistically significant association was demonstrated between academic rank or productivity and industrial payments.

摘要

重要性

外科和医疗器械制造商与临床医生之间存在合作关系。在评估已发表的作品时,应评估作为假定专家的作者的完整性和学术背景。与相关制造商的关系可能会增加相关研究中出现偏见的潜在风险。

目的

描述医疗器械制造商的工业支付、自我宣称的利益冲突 (COI) 以及收到最高补偿的医生出版物的相关性。

设计、环境和参与者:这项基于人群的文献计量分析确定了 10 家外科和医疗器械制造公司以及每家公司收到的最高补偿的 10 名医生,使用 2015 年公开支付数据库 (OPD) 的一般支付数据。对于每位医生,记录了总支付金额、支付次数、机构类型和学术级别。排除了版税或许可证支付。从 PubMed 检索每位医生在 2016 年 1 月 1 日至 12 月 31 日期间发表的文章,并记录他们的相关 COI 声明。Scopus 用于识别报告为 h 指数(研究人员至少有 h 个引用的论文数量)的文献计量数据。

主要结果和措施

自我宣称的 COI 与行业支付之间的差异。

结果

样本人群中的 100 名医生(88%为男性)共获得 12446969 美元的报酬,中位数为 95993 美元。50 名医生(50.0%)在学术机构担任教职。作者的平均(SD)h 指数为 18(18;范围,0-75)。2016 年,这些医生共发表了 412 篇文章,平均(SD)有 4 篇(6)出版物(范围,0-25),中位数为 1 篇(36 名医生没有出版物)。在这些文章中,有 225 篇(54.6%)与作者收到的一般报酬有关。只有在 225 篇相关出版物中的 84 篇(37.3%)中,作者声明了潜在的 COI。

结论和相关性

在收到最高行业报酬的医生中,自我宣称的 COI 和 OPD 之间存在高度不一致。因此,建议对所有出版物(无论相关性如何)实行全面披露政策。没有发现学术级别或生产力与工业支付之间存在统计学上显著的关联。

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