What We've Still Got Here: Orthopods' Failure to Disclose

Orthopedic surgeons don't seem to be particularly forthcoming when revealing their financial ties to industry. Last year, Okike et al showed that about 30% of orthopods presenting at the annual meeting of the American Academy of Orthopedic Surgeons (AAOS) failed to disclose payments—some in excess of $1 million—from medical-device makers.

Now another analysis, by Chimonas et al in the Archives of Internal Medicine, indicates that the disclosure rate is worse among ridiculously compensated orthopods who write journal articles. Among 32 published surgeons who received $1 million or more from device companies,* only 44 (46%) of their 95 articles disclosed a financial relationship. And only 7 articles, all published in The Journal of Bone and Joint Surgery, printed any information about the amount of money received; however, in this case, the disclosure merely revealed that payments were "in excess of $10,000." The investigators, from Columbia University, found that authors were also inconsistent in their disclosure, but that disclosure was significantly more likely if authorship position was prominent—meaning a first, second, or anchor position.

Chimonas et al used the same information as Okike, the OIG-mandated disclosure of physician payments from 5 orthopedic-device companies* in 2007, to assess whether the highest-paid docs are fessing up when disclosure is requested. The authors ultimately assessed the disclosure behavior of 32 physicians who received $1 million or more by cross checking data from the online payment information and 95 printed articles (clinical studies, reviews, meta-analyses, and device evaluations). 

OIG = Office of the Inspector General.

** Biomet, DePuy, Smith & Nephew, Stryker, and Zimmer.

Strother Martin in Cool Hand Luke.