These authors point out that orthopaedic surgeons receive a disproportionately small share of funding from the National Institutes of Health, but they receive the largest amount of funding from industry sources. They sought to examine the association between payments from industry partners and research productivity among orthopaedic research authors, as well as to identify predictors of high research productivity.
United States-based physicians who published an article in 2016 in The Journal of Bone & Joint Surgery or The American Journal of Sports Medicine were included in this study. These authors were queried in the Centers for Medicare & Medicaid Services Open Payments database (OPD) to determine the amount of industry payments received, and on Scopus, a bibliometric web site, to assess the quantity (total publication count) and quality (Hirsch index [h-index]) of each author’s research.
Of the 766 included authors, 494 (64.5%) received <$10,000 per year, 162 (21.1%) received between $10,000 and $100,000, and 110 (14.4%) received >$100,000 in total payments. The h-index increased significantly from a mean (and standard deviation) of 13.1 ± 12.9 to 20.9 ± 14.4, and to 32.3 ± 16.7, from the lowest to highest payment cohorts, as did total publication count.
When authors were stratified by academic position (assistant professor, associate professor, full professor, and nonacademic), those who received more industry payments (>$100,000) had a higher h-index and total publication count at all academic levels relative to lower-earning (<$10,000) authors.
Independent predictors of a high h-index included industry payments of between $10,000 and $100,000 (odds ratio [OR], 1.63; p = 0.048), payments of >$100,000 (OR, 5.87), associate professorship (OR, 6.53), full professorship (OR, 33.38), and last authorship (OR, 2.22) (p < 0.001 for all comparisons unless otherwise noted).
The authors point out that in addition to direct research funding, industry payments to orthopaedic surgeons include nonresearch financial payments for fellowship funding, consulting, speaking engagements, product development, and royalties. 1.7% of the number of payments directed toward orthopaedic surgeons were for royalties (i.e. not for research support), but these payments accounted for 69.5% of the total monetary value that orthopaedic surgeons received.
Comment: This article indicates that orthopaedic companies support publications by "thought leaders". It does not discuss why industry might do this and what effect this research support may have on the type of research or the conclusions of this research conducted by these investigators. For example, is industry more likely to support (a) investigation of a non-operative approach to managing chronic cuff tears or (b) investigation of a new cuff repair technique using multiple suture anchors made by the supporting company? As another example, is industry likely to continue much desired research and personal support for a surgeon (a) if the surgeon's research reveals a relatively high complication rate for a new prosthesis or (b) if the surgeon's research reveals that osseous ingrowth by CT scan is better for this new component? What effect might this have on the direction of the surgeon's research?
We recognize the value of industrial support for orthopaedic research. We also recognize that
We're talking real money here (see this link): data from 2016
and see this link (link), where two of the top three recipients are orthopaedic surgeons
As discussed in Demographics of Disclosure of Conflicts of Interest at the AAOS, industrial payments to physicians may also affect the work presented at national meetings.
This article might well have included a discussion of these important aspects of the industry-investigator relationship.
This article might well have included a discussion of these important aspects of the industry-investigator relationship.
=====
The reader may also be interested in these posts:
Use the "Search" box to the right to find other topics of interest to you.
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
