Reese McKay, Mehta Yash A, Haupt Michael R, Dennis Daniella, Becker Miriam, Clark Robert Craig, Reid Chris M
From the Division of Plastic Surgery.
University of California, Riverside, School of Medicine.
Plast Reconstr Surg. 2025 Mar 1;155(3):632e-641e. doi: 10.1097/PRS.0000000000011759. Epub 2024 Sep 17.
Clinical use of acellular nerve allografts is rapidly increasing despite limited high-quality, comparative evidence of superiority. Simultaneously, nonresearch payments to clinicians by the nerve allograft industry exceed $14 million over the past decade. In this study, the authors hypothesized that nerve allograft-related academic influence would correlate with industry funding.
PubMed studies on nerve allografts in plastic and reconstructive surgery journals were reviewed. Using author lists from extracted studies, a coauthorship network was generated and degree centralities-quantitative measurements of influence within a network-were calculated. Open Payments data from the nerve allograft industry was summated for each author. Finally, Pearson correlation and linear regression were used to analyze the relationship between centrality and payments received.
A total of 185 studies were included, with 581 unique authors (nodes) and 2406 coauthorships (ties) between them. Among authors with exceptional network influence (centrality >10, 75th percentile; n = 113), 56 were clinicians with valid National Provider Identifiers and therefore eligible for inclusion in the Open Payments database. Forty-four (79%) of these authors received at least 1 payment from the industry. Pearson correlation revealed a moderate (0.4 < r < 0.6) positive correlation between centrality and payments received ( r = 0.51; P < 0.001). Linear regression demonstrated an estimated 16% increase in total pay per additional unit of centrality ( P < 0.001; 95% CI, 8% to 25%).
There is a significant connection between academic influence and financial support from the nerve allograft industry. Such results warrant discussion concerning conflicts of interest in clinical research and best practices for mitigating potential bias related to commercially backed treatments.
尽管高质量的、具有比较优势的证据有限，但脱细胞神经同种异体移植物的临床应用正在迅速增加。同时，在过去十年中，神经移植物行业向临床医生支付的非研究费用超过了1400万美元。在本研究中，作者假设与神经移植物相关的学术影响力将与行业资金相关。
回顾了发表在整形和重建外科杂志上关于神经移植物的PubMed研究。利用提取研究的作者名单，生成了一个共同作者网络，并计算了度中心性——网络内影响力的定量测量。汇总了神经移植物行业的公开支付数据，统计每位作者的收入。最后，使用Pearson相关性分析和线性回归分析来研究中心性与所获报酬之间的关系。
共纳入185项研究，涉及581位独立作者（节点），他们之间有2406个共同作者关系（边）。在具有卓越网络影响力的作者（中心性>10，第75百分位数；n = 113）中，56位是具有有效的国家提供者识别码的临床医生，因此有资格被纳入公开支付数据库。其中44位（79%）作者至少从该行业获得了一笔报酬。Pearson相关性分析显示，中心性与所获报酬之间存在中度（0.4 < r < 0.6）正相关（r = 0.51；P < 0.001）。线性回归分析表明，中心性每增加一个单位，估计总报酬增加16%（P < 0.001；95% CI，8%至25%）。
神经移植物行业的学术影响力与资金支持之间存在显著联系。这些结果值得讨论临床研究中的利益冲突以及减轻与商业支持治疗相关潜在偏倚的最佳实践。
