Assessment Of Self-Reported Financial Conflicts Of Interest In Vascular Surgery Studies
Tina Tian, MD, Anand Y. Shah, MD, Jeremy Darling, MS, Charlie Zaepfel, MS, Abhishek Chatterjee, MD, MBA, FACS, Mark Iafrati, MD, Payam Salehi, MD, PhD.
Tufts Medical Center, Boston, MA, USA.
Objective
With increased collaboration between surgeons and industry, there has been a push towards improving transparency of conflicts of interest (COI). This study aims to determine the accuracy of reporting of COIs among studies in major vascular surgery journals.
Methods
A literature search identified all comparative studies published from January 2018 - December 2018 from three major United States vascular surgery journals (Journal of Vascular Surgery, Vascular and Endovascular Surgery, and Annals of Vascular Surgery). Industry payments greater than >$100 were collected using the Centers for Medicare & Medicaid Services (CMS) Open Payments database. COI discrepancies were identified by comparing author declaration statements with payments found for the year of publication and year prior (24-month period).
Results
A total of 239 studies (1642 authors) were identified. Of these studies, 203 (86%) had a declaration statement regarding potential COIs. In 2018, 10,778 payments (totaling $22,174,578) were made to 510 unique authors by 145 companies. Food and beverage payments were the most commonly reported transaction (42%), but accounted for only 3% of total reported monetary values. Authors who accurately disclosed payments received significantly higher median general payments compared to authors who did not accurately disclose payments ($56,581 [IQR: $2441 - $100,551] vs $2,361 [IQR: $525 - $9,699], p < .001). When stratifying by dollar-amount discrepancy, the proportion of authors receiving undisclosed payments gradually decreased, from 88% of authors with undisclosed payments >$100 to 6% of authors with undisclosed payments >$50,000. Multivariate analysis demonstrated that first and senior authors were both significantly more likely to have undisclosed payments (OR 2.0, 95% CI 1.1-3.6 and OR 2.9, 95% CI 1.6-5.2, respectively).
Conclusions
There is a significant discordance between self-reported COI in vascular surgery studies compared to those listed in the CMS Open Payments database. This study highlights the need for increased efforts to improve the transparency of industry sponsorship for vascular surgery studies. 
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