Less than half of orthopedic sports medicine surgeons use disclosure information to interpret study results

CHICAGO — A majority of sports medicine physicians believe disclosure data is important in interpreting data in a study, however, nearly half of those surgeons surveyed will use these data, according to a presenter here.

“So our conclusions really are the majority of respondents believe that disclosure of conflict is important,” Fotios P. Tjoumakaris, MD, from the Rothman Institute in Egg Harbor Township, N.J., stated in his presentation at the American Orthopaedic Society for Sports Medicine Annual Meeting. “Unfortunately, less than half of us use this information when interpreting orthopedic literature, at least based on this survey.”

Fotios P. Tjoumakaris

Tjoumakaris and colleagues sent 750 orthopedic surgeons a survey about using disclosure information to interpret study results. They received 522 responses with the majority of respondents being male orthopedic surgeons who worked in the northeastern United States and were in single specialty private practice groups. A small group of respondents were non-sports medicine physicians and they also received responses from physicians practicing in the Midwest at hospitals and from physicians who practiced in multiple specialty models.

In the study, 80% of respondents strongly agreed that conflict of interest statements are important, but 20% of respondents disagreed. In the study, 60% of respondents read the disclosure slides, while 38% did not; further, nearly half of the respondents “sometimes or always” felt a disclosure slide helped them interpret the study, Tjoumakaris said.

The researchers then presented the respondents with a mock study about a prescription drug used to treat knee osteoarthritis. They named the type of institution, level of evidence and study results and asked them to decide whether the study had merit or bias.

In a case series at an academic medical center that showed positive results, 75% of respondents thought the study was biased.

“Reporting negative or no different results had the largest effect, meaning that it improved our perception of reliability of the study when there is a perceived conflict of interest,” Tjoumakaris said.

Changing the study to an academic center conducting a randomized, prospective design with blinded authors, patients, reviewers, a placebo-controlled trial and positive results, the researchers found 78% of respondents thought the study had merit. A change to a community practice increased the number of respondents to 95% who thought the study had merit, he said.

“When the authors reported negative results at an academic center, we found they felt 95% of the time that it was with merit and likely devoid of conflict,” he said.

Reference:

Tjoumakaris FP. Paper #43. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 11-14, 2013; Chicago.

Disclosure: Tjoumakaris has no relevant financial disclosures.