From the Department of Plastic Surgery, University of Texas M. D. Anderson Cancer Center.
Hansjörg Wyss Department of Plastic Surgery, New York University Langone Health.
Plast Reconstr Surg. 2023 Sep 1;152(3):376e-384e. doi: 10.1097/PRS.0000000000010320. Epub 2023 Feb 27.
No study has assessed the impact of financial conflicts of interests (COIs) on the reporting of breast reconstruction outcomes with acellular dermal matrix (ADM) in peer-reviewed publications. The authors hypothesized that there is (1) an association between financial COIs and likelihood of studies reporting benefits in using ADM, and (2) inconsistent reporting of financial COIs.
The PubMed database was used to identify articles that reported on the use of ADM in breast surgery in four leading plastic surgery journals from January of 2014 to December of 2019. Financial COIs for authors were determined using the open payments database.
Fifty-five articles were included. Twenty-four articles (43.6%) supported use of ADM, 12 (21.8%) did not promote ADM use, and 19 (34.5%) were neutral. Fifty-one studies (92.7%) had either a first or senior author with a COI, and authors with a COI more commonly reported positive outcomes ( P = 0.02). Studies with positive outcomes featured first authors who received significantly larger financial payments ($95,955 versus $15,642; P = 0.029) compared with studies with negative or neutral outcomes. Receiver operating characteristic curve demonstrated that studies with first authors receiving over $376.28 were more likely to report positive results. Eight senior authors and three first authors received greater than $500 from ADM producers yet did not report any financial disclosure.
Financial COI is associated with higher likelihood of studies reporting benefit of using ADM in breast surgery. There remains inconsistent reporting of COIs, and better oversight is needed to ensure unbiased publication on the use of ADM in breast surgery.
目前尚无研究评估经济利益冲突（COI）对使用脱细胞真皮基质（ADM）进行乳房重建结果的同行评审文献报告的影响。作者假设存在以下两种情况：（1）经济 COI 与研究报告使用 ADM 获益的可能性之间存在关联；（2）经济 COI 的报告不一致。
作者使用 PubMed 数据库，从 2014 年 1 月至 2019 年 12 月期间，在四个领先的整形外科学杂志中，确定了报道 ADM 在乳房手术中应用的文章。使用公开支付数据库确定作者的经济 COI。
共纳入 55 篇文章。24 篇（43.6%）文章支持使用 ADM，12 篇（21.8%）文章不提倡使用 ADM，19 篇（34.5%）文章持中立态度。51 项研究（92.7%）的第一作者或资深作者存在 COI，有 COI 的作者更常报告阳性结果（P=0.02）。阳性结果研究的第一作者收到的经济报酬显著更高（95955 美元与 15642 美元；P=0.029），与阴性或中立结果研究相比。受试者工作特征曲线表明，第一作者收到超过 376.28 美元的研究更有可能报告阳性结果。8 位资深作者和 3 位第一作者从 ADM 生产商处获得的报酬超过 500 美元，但没有报告任何财务披露。
经济 COI 与报告使用 ADM 进行乳房手术获益的可能性更高相关。经济 COI 的报告仍不一致，需要加强监督，以确保 ADM 在乳房手术中应用的报道公正。
