A Comparison of Self-Reported Conflict of Interest in the Surgical Infections Literature to the Centers of Medicare and Medicaid Services Open Payments Database

Deepa Cherla, University of Texas Health Science Center at Houston; Oscar Olavarria, University of Texas Health Science Center at Houston; Cristina Viso, University of Texas Health Science Center at Houston; Julie Holihan, University of Texas Health Science Center at Houston; Lillian Kao, University of Texas Health Science Center at Houston; Tien Ko, University of Texas Health Science Center at Houston; Mike Liang, University of Texas Health Science Center at Houston

Financial relationships are pervasive between healthcare providers and healthcare companies. In order to maintain transparency, investigators are expected to self-disclose their conflicts-of-interest (COI).  In 2010, the passage of the Physician Payments Sunshine Act led the Centers of Medicare and Medicaid Services (CMS) to establish an Open Payments Database (OPD) of COI reported by industry.

We hypothesize there is discordance between industry-reported and physician self-reported COI among publications pertaining to infections in surgical specialties.

A previously developed database of 400 manuscripts in four surgical specialties (cardiac, orthopedics, otolaryngology, and ventral hernia), 1986 authors, and the COI (self- and industry-reported) was searched for articles pertaining to surgical infections. COI were defined as payments received as honoraria, consulting fees, compensation for serving as faculty or as a speaker at a venue, research funding payments, or having ownerships/partnerships in companies. COI disclosed on the published manuscripts were compared to the financial relationships reported on the OPD.

A total of 40 studies were identified with 338 participating authors.  Of the 40 manuscripts, 5(12.5%) had complete concordance of self- and industry-reported COI, 20(50.0%) had differences between self- and industry-reported COI, and 15(37.5%) had no COI. Of the 338 authors, 98(28.9%) met the definition for COI. When comparing COI disclosed by authors and the COI disclosed in the OPD, 40 (11.8%) authors had at least 1 COI but did not declare any, and 34 (10.1%) declared a COI not listed in the OPD.  The overall discordance rate was 21.9% (Table).

Among the medical literature pertaining to surgical infections, there is substantial discordance between self-reported COI compared to those in the CMS OPD. Further studies are needed to determine the reasons for and impact of these differences, as COI may influence the validity of the design, conduct and results of a study.