Conflicts of interest were not disclosed for 28.8% of the physicians participating in the American Academy of Orthopaedic Surgeons' 2008 annual meeting, according to a study in the New England Journal of Medicine.
In the report, published in the Oct. 8 issue, researchers compared 344 payments orthopedic-device makers made to AAOS directors, committee members and presenters at the annual conference held March 5-9, 2008 conference and found that only 71.2% of the payments had been disclosed under the AAOS' self-reporting program.
The authors—from Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School and other institutions—found the disclosure rate was 79.3% (165 out of 208 payments) if the payment was directly related to their presentation at the meeting, but only 50% (16 out of 32) if the payments were unrelated.
As part of a settlement with the U.S. Justice Department, the nation's largest hip and knee prostheses makers are required to disclose payments they made to physicians in 2007. Researchers compared those records with the conflict-of-interest disclosures made by physicians involved in the 2008 meeting.
Disclosure was more likely, the report said, if the payment was more than $10,000; if it was made directly to an individual (rather than a company or organization); or if it included an “in-kind” component such as lodging, meals, transportation or tuition. Thirty-six physicians cited for nondisclosure (39.6% of the total) responded to a survey asking for the reason why, with 38.9% saying the payment was unrelated to the topic of their presentation; 13.9% saying they misunderstood the disclosure requirement; and 11.1% said they made the disclosure but it was mistakenly omitted from the program, the report said.
A U.S. Senate investigation into possible academic and healthcare industry conflicts of interest led to the August resignation of David Polly Jr., M.D., from the AAOS board of directors.
In an e-mail, Joseph Zuckerman, M.D., AAOS board president, said the organization's policy is for meeting participants to disclose all potential conflicts of interests and it is committed to educating its members about the policy.
“The AAOS believes that, when transparent, relationships between physicians and medical industry can create innovative medical advances that benefit patients, and improve both healthcare and people's overall quality of life,” the e-mail stated. “These physician-industry relationships—and the responsible and complete reporting of these relationships—is a top priority, and a challenge across the U.S. healthcare system.”
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