OTA 2003 Posters

Increasingly Conflicted: An Analysis of Conflicts ofInterest

Erik N. Kubiak, MD;Kenneth J. Egol, MD;. Kenneth J. Koval, MD; Joseph D. Zuckerman, MD;

Hospital for Joint Diseases, New York University, NewYork, New York, USA

Purpose: We identified trendsin industry sponsorship of orthopaedic trauma research presented at theannual meetings of the Orthopaedic Trauma Association since the establishmentof conflict-of-interest reporting policies in 1993. Industry has playedan ever increasing role in the funding of orthopaedic research. The purposeof this study was to analyze the role of industrial support in orthopaedicresearch as documented in the final programs of the annual meetings of theOrthopedic Trauma Association (OTA), to determine the incidence and natureof conflicts of interest in the papers and posters accepted for OTA presentation,and to report any changes in the frequency of reporting since disclosurepolicies were enacted in 1993.

Methods: We analyzedconflicts of interest for all years since the adoption of the reportingpolicies: 1993 to 2002. From 1993 to 1998, presenters of posters and paperspresented at the OTA annual meetings were required to disclose conflictsof interest of a financial value of more than $500; the type of monetarydistribution was not recorded. From 1999 to 2002, presenters of postersand papers were required to acknowledge the type of support: 1) researchgrant, 2) miscellaneous non-income support, 3) royalties, 4) stock, and5) consultant fees. All conflicts of interest and type were recorded foreach year. Frequency of conflict of interest was calculated for each category.A multiple regression analysis was performed on the data. Level of significancewas set at P<0.05.

Results: There was an increasein the percentage of papers and posters accepted and presented at the OTAannual meetings between 1993 and 2002 whose authors had conflicts of interest.The number of papers reporting a conflict of interest rose from 7.6% in1993 to 12.6% in 2002 (P = 0.0129). There was no significant increasein posters with conflict of interest over that same time period. There wereno observed changes in the nature of industrial involvement since the changein reporting enacted in 1999. Between 1999 and 2002, research distributionswere as follows: 84% research, 17% consultant fees, 12% miscellaneous funding,3% royalties, and 2% stocks/royalties. There was no observed trend in NIHor OTA grant distribution between 1993 and 2002.

Discussion: Industryis playing an increasing role in the funding of orthopaedic research. The majority of industrial support is in the form of researchgrants. The degree to which industrial support compromises the ethical pursuitof knowledge to further the improvement of patient care remains in largepart hidden. The increasing industrial support of scientific research inthe public sector is to be applauded as long as it does not lead to thesequestering and suppressionof information that may be disadvantageous to the industrial sponsor.