title: Disclosure of financial conflicts of interest: an evaluation of orthopaedic surgery patients' understanding.
abstract: BACKGROUND
  Industry and orthopaedic surgeons often partner to develop new technology, which can lead to orthopaedic surgeons having financial conflicts of interest (FCOI). It is essential these FCOI be conveyed clearly to patients. It is unclear, however, whether and to what degree patients understand the ramifications of physician FCOI.
  
  
  OBJECTIVE
  We evaluated (1) patients' concerns regarding their surgeon having FCOI or the presence of institutional FCOI, (2) the effect of surgeon FCOI on patients' willingness to have surgery, and (3) patients' understanding of FCOI.
  
  
  METHODS
  We asked 101 patients (66% female) receiving total joint arthroplasty from the orthopaedic practices of two surgeons at an academic health center to complete a descriptive, correlational designed survey at their 6-week followup appointment. The data collected included patient demographics, knowledge of FCOI, and the influence of FCOI on patient attitudes toward surgery and their surgeon.
  
  
  RESULTS
  A minority of patients (13%) reported discussing FCOI with prior physicians and only 55% agreed or strongly agreed a surgeon should disclose FCOI. Only 15% of patients believed such conflicts would make them less likely to have their surgeon operate on them. Level of education was weakly correlated (Spearman's rho = 0.29) with patient understanding of FCOI.
  
  
  CONCLUSIONS
  Overall, patients had a poor understanding of FCOI. Both level of education and previous discussions of FCOI predicted better understanding. This study emphasizes communication of FCOI with patients needs to be enhanced.
authors.affiliation: Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA. jlieberman@uchc.edu
authors.forename: Jay R
authors.initials: JR
authors.lastname: Lieberman
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Pensak
authors.forename: Michael S
authors.initials: MS
authors.lastname: Kelleher
authors.forename: Robin R
authors.initials: RR
authors.lastname: Leger
authors.forename: Gregory G
authors.initials: GG
authors.lastname: Polkowski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000191:economics*; D003142:Communication; D032882:Comprehension; D016265:Conflict of Interest; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000191:economics*; D010817:Physician-Patient Relations; D010820:Physicians; D011795:Surveys and Questionnaires; D014342:Truth Disclosure