OTA 2003 Posters

Increasingly Conflicted: An Analysis of Conflicts of Interest

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

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

Purpose: We identified trends in industry sponsorship of orthopaedic trauma research presented at the annual meetings of the Orthopaedic Trauma Association since the establishment of conflict-of-interest reporting policies in 1993. Industry has played an ever increasing role in the funding of orthopaedic research. The purpose of this study was to analyze the role of industrial support in orthopaedic research as documented in the final programs of the annual meetings of the Orthopedic Trauma Association (OTA), to determine the incidence and nature of conflicts of interest in the papers and posters accepted for OTA presentation, and to report any changes in the frequency of reporting since disclosure policies were enacted in 1993.

Methods: We analyzed conflicts of interest for all years since the adoption of the reporting policies: 1993 to 2002. From 1993 to 1998, presenters of posters and papers presented at the OTA annual meetings were required to disclose conflicts of interest of a financial value of more than $500; the type of monetary distribution was not recorded. From 1999 to 2002, presenters of posters and papers were required to acknowledge the type of support: 1) research grant, 2) miscellaneous non-income support, 3) royalties, 4) stock, and 5) consultant fees. All conflicts of interest and type were recorded for each year. Frequency of conflict of interest was calculated for each category. A multiple regression analysis was performed on the data. Level of significance was set at P<0.05.

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

Discussion: Industry is playing an increasing role in the funding of orthopaedic research. The majority of industrial support is in the form of research grants. The degree to which industrial support compromises the ethical pursuit of knowledge to further the improvement of patient care remains in large part hidden. The increasing industrial support of scientific research in the public sector is to be applauded as long as it does not lead to the sequestering and suppression of information that may be disadvantageous to the industrial sponsor.