Wednesday, May 1, 2013

Disclosure of conflict of interest - acknowledging influence

Podium Disclosures at the 2012 AAOS Meeting: An Exercise in Going Through the Motions

This article is a nice partner to our article from earlier this year, Demographics of Disclosure of Conflicts of Interest at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons in which we point out the high and increasing degree to which orthopaedic companies influence what is presented in orthopaedic educational venues, such as the AAOS. In our article, we advocated inclusion of disclosures in the section of presentation that discusses the limitations of the investigation, recognizing that conflicts of influence can influence the design, results and conclusions of an investigation.

In the new article, the authors studied slide-based disclosure of potential conflicts of interest prior to presentations during the 2012 American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting to determine if the process is accomplishing its primary goal.

The authors observed 139 disclosures were observed across a range of subspecialties including adult reconstruction, hand and wrist, pediatrics, shoulder and elbow, sports medicine, trauma, and oncology. While 90% of the presentations included the required disclosure slide, only half noted whether the author disclosures were related to the data presented and over half of the presenters failed to mention the relationship of the disclosure to the topic of the presentation. 

As you can see from prior posts on this blog, the process of disclosure is voluntary, irregular, often incomplete, and often inaccurate.

One of the goals upgrading the standards of disclosure is to assure that the investigators themselves recognize and acknowledge that, for example, receiving payment as a speaker on behalf of a product is likely to influence how the investigators study and present the results with that product.  This is not to be confused with a mea culpa statement, rather it is an expression of the candor that we owe ourselves, our colleagues, our students, and our patients.
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