Financial conflicts, industry funding associated with favorable conclusions in TJA studies
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Key takeaways:
- Financial conflicts of interest and industry funding in arthroplasty research was associated with favorable conclusions for new technologies.
- Readers should be aware of the potential for bias in these studies.
According to published results, the presence of financial conflicts of interest and industry funding in lower extremity arthroplasty research was associated with favorable conclusions for new technologies.
Researchers from the University of Virginia performed a review of 43 articles published between 2010 to 2022 that analyzed cost-effectiveness or economic implementation claims on patient-specific instrumentation, robotics or implants used in total hip and knee arthroplasty.
After reviewing disclosures and statements, researchers found 76.7% of articles (n = 33) had a financial conflict of interest and 37.2% of articles (n = 16) had industry funding. They found 67.4% of all articles (n = 29) had conclusions favorable to a technology.
Among articles with favorable conclusions to a technology, 89.7% (n = 26) had at least one author with a financial conflict of interest, whereas 48.3% (n = 14) had industry funding. Researchers also noted 78.8% of articles with financial conflict of interests (n = 26) had favorable conclusions to a technology, whereas 87.5% of articles with industry funding (n= 16) had favorable conclusions.
Overall, researchers found a statistically significant association between favorable conclusions for a technology and the presence of financial conflict of interest or industry funding (OR = 13.5).
“Considering the variation in how these studies are conducted and the assumptions that often need to be made, caution should be exercised in interpreting the conclusions of these studies, given the potential for bias,” the researchers wrote in the study.
Perspective
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In the recent article “Financial conflicts of industry and industry fundings are associated with conclusions favorable to new technologies,” James A. Brown, MD, and colleagues document that 79.1% of hip and knee arthroplasty research on the economic benefits of new technologies are favorable when the authors have a conflict of interest with the company manufacturing the device. This article highlights the critical importance of not only disclosing bias, but also managing bias and conflicts of interest in published research. While a partnership between orthopedic surgeons and researchers with implant and technology manufacturers is of critical importance, there must also be independent, objective and unbiased research performed to verify and authenticate the results of the research performed by the authors with conflicts.
Given the cost of new technologies in hip and knee replacement and the emergence of value-based care with the recent announcement of mandatory bundled episode of care government programs, it is essential that any new technology have a proven benefit to patients at the appropriate economic value.
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