Discrepancies in Financial Conflicts of Interest in Robotic Cardiothoracic Surgery Studies
Manish Karamchandani1, Tina Tian1, Ryan Hall1, Ian Nickel1, Jeffrey Aalberg4, Antonio Lassaletta2, Abhishek Chatterjee3, Dustin Walters2
1Surgery, Tufts Medical Center, Boston, Massachusetts, United States, 2Surgery, Thoracic Surgery, Tufts Medical Center, Boston, Massachusetts, United States, 3Surgery, Plastic and Reconstructive Surgery, Tufts Medical Center, Boston, Massachusetts, United States, 4Tufts University School of Medicine, Boston, Massachusetts, United States
Objective: To review the accuracy of Conflict of Interest (COI) disclosures among studies related to the use of robotic technology in cardiothoracic surgery and evaluate factors associated with increased discrepancies.
Design: Literature review
Setting: Our study reviews published literature across the broad spectrum of practice settings within cardiothoracic surgery. All patients were inpatients at academic medical centers.
Patients: All of the reviewed studies were derived from three major American cardiothoracic surgery journals (Journal of Thoracic and Cardiovascular Surgery, Annals of Thoracic Surgery, and Annals of Cardiothoracic Surgery). The reviewed studies evaluated adult patients who underwent robotic-assisted cardiac or thoracic surgery.
Interventions: No specific intervention was made. We evaluated the prevalence of inaccurate reporting of COI as well as the factors that were associated with increased risk of inaccurate COI reporting.
Main Outcome Measure: Accuracy of COI reporting. A literature search identified robotic surgery-related studies with at least one American author published between January 2015 - December 2020 from three major American cardiothoracic surgery journals (Journal of Thoracic and Cardiovascular Surgery, Annals of Thoracic Surgery, and Annals of Cardiothoracic Surgery). Industry payments from Intuitive SurgicalTM (IntuitiveTM) were collected using the Centers for Medicare & Medicaid 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 144 studies (764 authors) were identified. One-hundred-twelve studies (78%) had at least one author receive payments from IntuitiveTM. Ninety-eight (68%) studies had at least one author receive an undeclared payment from IntuitiveTM. Authors who accurately disclosed payments received significantly higher median payments compared to authors who did not ($16,511 [IQR: $6,389 - $159,035] vs $1,762 [IQR: $338 - $7,500], p<0.0001). Last authors were significantly more likely to have a COI discrepancy compared to middle and first authors (p = 0.018; p = 0.0015).
Conclusions: The majority of studies investigating the use of robotic technology in cardiothoracic surgery did not accurately declare COI with IntuitiveTM. This study highlights the need for improved accuracy of reporting industry sponsorship by publishing authors.
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