Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Mass.
Department of Biostatistics, Boston University School of Public Health, Boston, Mass.
J Vasc Surg. 2021 Feb;73(2):675-681. doi: 10.1016/j.jvs.2020.04.527. Epub 2020 Jun 11.
Financial relationships between vascular surgeons and industry are essential to the development and adoption of innovative technology. However, these relationships may establish competing interests. Our objective was to describe publicly available financial transactions between industry and academic vascular surgeons.
Academic vascular surgeons were identified and characterized on the basis of publicly available data correlated with Accreditation Council for Graduate Medical Education and Association of American Medical Colleges data to identify academic practice settings. Vascular surgeons were linked to Open Payments data for 2017 as reported by the Centers for Medicare & Medicaid Services. Univariate and nonparametric tests were used for analysis.
Of 1158 academic vascular surgeons identified, 997 (86%) received industry payments totaling $8,548,034. Overall, the median of total payments received was $814 (interquartile range [IQR], $124-$2863). The top paid decile of vascular surgeons received $29,645 (IQR, $16,128-$61,701). Payments to the top decile accounted for 81% of all payments. Payments did not vary by academic rank but did vary by sex, with male vascular surgeons (n = 954) receiving $889 (IQR, $146-$3217) vs female vascular surgeons (n = 204) receiving $467 (IQR, $87-$1533; P = .002). By leadership role, division chiefs received the highest median payment amount ($1571; IQR, $368-$11,281) compared with department chairs ($424; IQR, $56-$2698) and vascular surgeons without leadership role ($769; IQR, $117-$2592; P = .002). Differences in payments were also seen on the basis of U.S. census region: Northeast, $571 (IQR, $90-2462); Midwest, $590 (IQR, $75-$2364); South, $1085 (IQR, $241-$3405); and West, $1044 (IQR, $161-$4887; P = .001). The most common categories of payments were food and beverage (paid to 85% of all vascular surgeons), travel and lodging (35%), and consulting fees (13%). Among the top decile of vascular surgeons, median payments exceeded $10,000 for three categories: consulting fees, compensation, and honoraria. Payments were made by 178 distinct entities with median total payments of $286 (IQR, $70-$6285). The three top entities paid a total of $5,004,061, which accounted for 59% of all payments. Payments from at least one of the top three entities reached 76% of vascular surgeons.
Most academic vascular surgeons receive publicly reported industry payments that are paid by a limited number of entities, typically for food and beverage or travel and lodging. The top 10% of vascular surgeons received higher median payment amounts, totaling 81% of all industry payments. Vascular surgeons should be aware of publicly reported payment information and the potential for conflicts of interest.
血管外科医生与行业之间的财务关系对创新技术的发展和采用至关重要。然而,这些关系可能会产生利益冲突。我们的目的是描述行业与学术血管外科医生之间公开可用的财务交易。
根据与研究生医学教育认证委员会和美国医学协会数据相关的公开数据,确定和描述学术血管外科医生,以确定学术实践环境。血管外科医生与医疗保险和医疗补助服务中心报告的 2017 年开放支付数据相关联。使用单变量和非参数检验进行分析。
在确定的 1158 名学术血管外科医生中,997 名(86%)接受了总计 8548034 美元的行业支付。总体而言,中位数总支付额为 814 美元(四分位距[IQR],124-2863 美元)。排名前十分之一的血管外科医生收到了 29645 美元(IQR,16128-61701 美元)。排名前十分之一的支付占所有支付的 81%。支付与学术等级无关,但与性别有关,男性血管外科医生(n=954)收到 889 美元(IQR,146-3217 美元),而女性血管外科医生(n=204)收到 467 美元(IQR,87-1533 美元;P=.002)。按领导角色划分,科室主任的支付金额中位数最高(1571 美元;IQR,368-11281 美元),与系主任(424 美元;IQR,56-2698 美元)和没有领导角色的血管外科医生(769 美元;IQR,117-2592 美元;P=.002)相比。根据美国人口普查区域也存在支付差异:东北部,571 美元(IQR,90-2462 美元);中西部,590 美元(IQR,75-2364 美元);南部,1085 美元(IQR,241-3405 美元);西部,1044 美元(IQR,161-4887 美元;P=.001)。最常见的支付类别是食品和饮料(支付给所有血管外科医生的 85%)、差旅和住宿(35%)和咨询费(13%)。在排名前十分之一的血管外科医生中,有三种类别的中位数支付超过 10000 美元:咨询费、薪酬和酬金。有 178 个不同的实体支付了款项,中位数总额为 286 美元(IQR,70-6285 美元)。排名前三的实体支付总额为 5004061 美元,占所有支付的 59%。至少有一个前三名实体的支付达到了 76%的血管外科医生。
大多数学术血管外科医生接受了公开报告的行业支付,这些支付来自数量有限的实体,通常用于食品和饮料或差旅和住宿。排名前 10%的血管外科医生收到的中位数支付金额更高,总计占所有行业支付的 81%。血管外科医生应该了解公开报告的支付信息和潜在的利益冲突。