Only 46 percent of surgeons who received at least $1 million from orthopedic device makers disclosed their relationships in their published scientific articles, according to a study by theInstitute on Medicine as a Profession, a think tank based at the Columbia University College of Physicians & Surgeons.
IMAP examined the 2007 physician payment info from five device makers - Biomet, Smith & Nephew, Stryker, Zimmer and Johnson & Johnson's DePuy - that made 1,654 payments totaling $248 million consulting, honoraria or other activities, according to an analysis of publicly available data. Such info is increasingly posted by drug and device makers due to large settlements with federal prosecutors (look here), negative publicity over conflicts of interest and a new federal law that requires disclosure by 2013 (see this).
The study found that payments to 41 orthopedic surgeon researchers ranged from more than $1 million to a high of $8.8 million, and these payments represented 62 percent of all such expenditures. However, only 7 percent of 95 articles reviewed had disclosed any financial ties between device makers and journal authors. And all of these appeared in one particular journal that asked authors to disclose whether the company in question had paid them in excess of $10,000.
Moreover, none of the articles revealed the extent of the payments, even though almost all of the articles were related directly related to a device made by the device maker. Those who were paid $1 million or more appeared as first or sole authors in 26 percent of the studies, as middle authors in 36 percent of the studies and as senior authors in 38 percent of the studies. The study appears in the Archives of Internal Medicine (read it here).
“The findings raise troubling questions about undisclosed payments or royalties and other fees from medical device companies that could lead to biased scientific conclusions,” senior author and IMAP president David Rothman says in a statement, who argues that journal readers are not adequately informed of conflicts even when payments to authors are significant and that medical journals must become more aggressive in monitoring such financial relationships. Specifically, he suggests journal editors modify their forms to do a better job of gathering such info and the publicizing that the relationships in published articles.