Date of Award

January 2012

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Jonathan N. Grauer

Subject Area(s)

Ethics

Abstract

DISCLOSURE OF CONFLICTS OF INTEREST IN THE ORTHOPAEDIC FIELD AND IN MEDICAL EDUCATION. Brian L. Ju, Christopher P. Miller, Peter G. Whang, Jonathan N. Grauer. Department of Orthopaedics and Rehabilitation, Yale University, School of Medicine, New Haven, CT.

The purpose of this study was to determine the variability in disclosure information reported by authors at three annual orthopaedic conferences in the same year. Furthermore, we examined the number of medical schools with disclosure policies regarding educational activities and the acceptance of gifts from industry (law school policies were similarly analyzed for comparison). We hypothesize there will be significant variability in disclosure of conflicts of interest in both the professional and educational arena.

The author disclosure information published for the 2008 North American Spine Society (NASS), Cervical Spine Research Society (CSRS), and Scoliosis Research Society (SRS) conferences were compiled into a database and examined. Online disclosure policies for all 131 accredited medical schools and all 200 accredited law schools were evaluated during August/September 2009.

Disclosure records were available for 1,231 authors at NASS, 550 at CSRS, and 642 at SRS. Of the 153 authors who presented at the NASS and CSRS meetings, 51% exhibited discrepancies in their disclosure information. Of the 131 accredited medical schools, 98% (vs. 18% of law schools) had protocols in place requiring faculty to disclose their financial relationships to their institutions. Only a small percentage of both medical and law schools required lecturers to disclose these associations with students. 40% of medical schools (vs. 1% of law schools) had established policies limiting gifts from industry.

These findings emphasize the significant variability that currently exists in the reporting of financial conflicts of interest by authors who presented at three major spine conferences. We believe these discrepancies are likely due to confusion regarding what relationships should be acknowledged in certain situations and the clear lack of uniformity among the disclosure policies. Not only in the professional arena, but the widespread implementation of disclosure guidelines in medical schools emphasizes the acknowledged need to regulate physician-industry relationships. The varied policies addressing faculty disclosures and the acceptance of gifts demonstrate that the regulation to these relationships remains inconsistent.

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