Abstract
Conflict of interest in the medical literature remains an area of concern. Typically, the primary issues raised in various forums is that authors who have a financial interest in the product they are reporting upon will have a bias to report more favorable results. Recently, the Journal of Bone and Joint Surgery published an article entitled “Potential Conflict of Interest Among Physician Editorial Board Members of Orthopaedic Surgery Journals.” 1 In contrast to the author-related conflicts of interest, this article analyzed the amount of money reported to the Open Payments publicly searchable database (openpayments.cms.gov/search) of all physician editorial board members of 15 orthopedic journals. They found that 78% of the 908 identified editorial board members received something of value. With regard to our journal, they found that 18% reported receiving nothing of value, 9% received less than $10 000, 73% received >$10 000, 23% received >$250 000, and none received more than $950 000. They stated that these conflicts of interest have the potential to be more important than author conflicts of interest because the editorial board members control what is published.
Because this is a very important topic, our Editorial and Managerial Boards have discussed this topic and concluded that our current process is transparent and they did not perceive any bias occurring in our editorial process. As a result, while I have always tried to avoid assigning reviewers to articles where I know a potential conflict exists and have previously encouraged reviewers to decline invitations to review articles when they feel they have a conflict of interest, all reviewers are now specifically reminded with each solicitation to review an article to decline the invitation if they have a conflict. Also, all reviewers and Editorial Board members are required to maintain a current American Academy of Orthopaedic Surgeons (AAOS) disclosure. For our 2 basic science Board members who do not complete an AAOS disclosure, they complete an annual International Committee of Medical Journal Editors (ICMJE) disclosure form as required by all authors for each paper they publish. We will now start each meeting or conference call with each Editorial Board member having a chance to update any new disclosures, which is the current practice for the AOFAS Board. Ultimately, it was felt that the Editor in Chief was responsible for this process. Thus, to hold myself to a higher standard, I am publishing my current AAOS disclosure here (Figure 1). Also, upon reviewing the available data from the Open Payments database, one can see that I received $29 761 in 2015, $21 060 in 2014, and $14 883 in 2013 from the orthopedic industry. The website also has a breakdown of the amount of money received from each company and the purpose the money was spent, that is, consulting, royalties, travel/lodging, etc. The amount received by any other editorial board member is available from this website, also.
American Academy of Orthopaedic Surgeons Orthopaedic Disclosures.
With regard to author conflict of interest, each author completes an ICMJE disclosure form. We have included with each article published the conflicts of interest that the author felt may be related to the subject matter of an article. I now review the ICMJE disclosure form for each article that has been accepted to see if any of the other nonrelated disclosures may be relevant even if the author did not feel they were and include them with the reported disclosures when the article is published. We will also have a link so any reader can access the ICMJE form for any article. In addition, for articles involving implants or other topics that would have a high risk of conflict of interest, I now review the CMS open payments website to make sure that conflicts are being reported as accurately as possible.
Physician/industry collaboration is an essential relationship for the development of new devices, biological agents, techniques, and education. However, it is important that we are all aware of these relationships when evaluating research papers and educational material. We will continue to strive to report these relationships in as transparent a manner as possible.