Undisclosed conflict of interest is “prevalent” in spine journals

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Jeremy D Shaw

Many studies published in major spinal surgery journals do not include the full disclosure of researchers’ financial conflicts of interest (COIs), according to a study published in Spine. Authors of the study have called for a standardisation of definitions and financial thresholds for significant COI, and to shift the reporting burden to review potential conflicts of interest, rather than relying on self-reporting by researchers.

The study, authored by Jeremy D Shaw (University of Pittsburgh Medical Center, Pittsburgh, USA) and colleagues, reviewed financial COIs reported by authors of studies published in Spine, The Spine Journal, and the Journal of Neurosurgery: Spine between 2014 and 2017, including nearly 40,000 authors and around 6,800 research articles. The disclosures for each author were compared to those reported in the Center for Medicare and Medicaid Services’ (CMS) Open Payments Database (OPD). In total they found that 15.8% of spinal surgery authors had payments reported in the OPD.

The study team compared the OPD reported payments with the authors’ financial disclosures in the published studies, finding that of the total US$1.90 billion received by authors, approximately US$1.48 billion—78% of the total—was accurately disclosed. Of undisclosed payments, 68.7% were under US$1,000 and only 7.2% were greater than US$10,000, and included US$180 million in researcher funding and US$188 million in royalties, Shaw and colleagues found, noting that charitable contributions and payments from royalties/licenses were most likely to be accurately reported, while funds for research and entertainment were least likely to be disclosed.

The authors emphasise that their study is not aimed at making accusations of misconduct, and that under-disclosure likely does not involve conscious effort to hide financial interactions. For example, the study found that less-experienced authors were more likely to have inaccurate disclosures than more-experienced authors—suggesting that junior researchers may need mentoring on the importance of accurately reporting COIs.

Shaw and colleagues suggest a system to improve financial transparency: searching public databases such as the OPD to actively verify relationships between authors and industry, before studies are published. The researchers conclude: “There is a need to standardise COI reporting and actively query the publicly available databases of payments to increase rates of correct financial COI disclosure in the spine literature.”

Discussing the study’s findings with Spinal News International, Shaw said: “ I would like to emphasise that the study was not aimed at making accusations of misconduct, and that under-disclosure does not indicate a conscious effort to hide financial interactions. Most importantly, there is a need to standardise COI reporting across journals in spine and other disciplines.

“As the OPD exists and is available to everyone, we believe that journals should actively query the publicly available data to increase rates of correct disclosure. Academic publishing is a for profit enterprise, as such the journals share a responsibility with authors for helping to create a simple and transparent system for accurate disclosure.”


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