Correspondence

Accuracy of Financial Disclosures Reported by Physicians

N Engl J Med 2010; 362:470February 4, 2010

Article

To the Editor:

Okike et al. (Oct. 8 issue)1 found that the rate of conflict-of-interest disclosure reported by physicians who participated in the 2008 annual meeting of the American Academy of Orthopaedic Surgeons (AAOS) was 79% for directly related payments and 50% for indirectly related payments. I am writing to provide an update on the critical steps the AAOS has taken since the time this study was performed.

The AAOS has worked diligently for years and will continue to perfect, modify, and simplify the disclosure process that physicians use to identify their consulting and other arrangements with companies. Specifically, since 2008, we have made our mandatory disclosure process electronic; required disclosure of all potential conflicts and relationships, regardless of their relevance to the presentation; provided numerous educational programs and materials for our members that emphasize the importance of full disclosure and teach them how to fulfill this requirement; and formed a board project team to review our policies and recommend enhancements.

We believe that mandatory, complete disclosure and the appropriate management of conflicts of interest are essential. Our ongoing efforts to streamline the process and educate our members enable the physicians to focus on their real work — improving the quality of life for our patients with musculoskeletal conditions.

Joseph D. Zuckerman, M.D.
American Academy of Orthopaedic Surgeons, Rosemont, IL
joseph.zuckerman@nyumc.org

Dr. Zuckerman reports receiving royalties from Exactech for design of a shoulder-replacement system. No other potential conflict of interest relevant to this letter was reported.

1 References

1. 1

   Okike K, Kocher MS, Wei EX, Mehlman CT, Bhanderi M. Accuracy of conflict-of-interest disclosures reported by physicians. N Engl J Med 2009;361:1466-1474
   Full Text | Web of Science | Medline

Author/Editor Response

We thank Zuckerman for his response to our article. We agree that the AAOS has taken several important steps to improve the process for disclosing conflicts of interest since the time our study was conducted.

In addition to the steps taken by the AAOS, several recent changes regarding conflict of interest and its disclosure have been made by medical journals,1 healthcare organizations,2 universities,3 pharmaceutical companies,4 and state governments.5

We are optimistic that these changes will serve to promote full disclosure of conflicts of interest by all investigators; such disclosure is a minimum requirement for managing financial conflicts of interest in biomedical research.

Kanu Okike, M.D., M.P.H.
Brigham and Women's Hospital, Boston, MA
okike@post.harvard.edu

Mininder S. Kocher, M.D., M.P.H.
Children's Hospital, Boston, MA

Since publication of their article, the authors report no further potential conflict of interest.

5 References

1. 1

   Drazen JM, Van der Weyden MB, Sahni P, et al. Uniform format for disclosure of competing interests in ICMJE journals. N Engl J Med 2009;361:1896-1897
   Full Text | Web of Science | Medline

2. 2

   Partners HealthCare to implement new industry interaction recommendations. Press release of Partners HealthCare, Boston, April 10, 2009. (Accessed January 14, 2010, at http://www.partners.org/documents/CommissionPressRelease_PartnersHealthCare2009.pdf.)
   

3. 3

   New Johns Hopkins Medicine policies tighten rules on industry interactions. Press release of Johns Hopkins Medicine, Baltimore, April 8, 2009. (Accessed January 14, 2010, at http://www.hopkinsmedicine.org/Press_releases/2009/04_07_09.html.)
   

4. 4

   Lilly set to become first pharmaceutical research company to disclose physician payments. Press release of Eli Lilly and Company, Indianapolis, September 24, 2008. (Accessed January 14, 2010, at http://newsroom.lilly.com/releasedetail.cfm?ReleaseID=336444.)
   

5. 5

   Kowalczyk L. State bans drug firm gifts to doctors: disclosure of fees for consulting mandated. Boston Globe. March 12, 2009.
   

Citing Articles (1)

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1. 1

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