title: Discrepancies in spine surgeon conflict of interest disclosures between a national meeting and physician payment listings on device manufacturer web sites.
abstract: BACKGROUND
  Previous studies have identified inconsistencies in physician conflict-of-interest disclosures at academic meetings. The Physician Payment Sunshine Act (PPSA) will require industry to disclose anything of value given to physicians by 2014. In preparation, some spine device companies have begun reporting payments online.
  
  
  OBJECTIVE
  To evaluate potential inconsistencies between physician disclosures and payments reported by industry before the PPSA implementation.
  
  
  METHODS
  Comparison of publically available disclosure/payment data.
  
  
  METHODS
  Physicians participating in the 2011 North American Spine Society (NASS) annual meeting and physicians listed on the 2010 physician payment web sites of Medtronic and Depuy Spine.
  
  
  METHODS
  Disclosures of participants at NASS were compared with the published Medtronic and Depuy Spine physician payments. The periods reflected by the disclosures compared should have coincided (except the Depuy site, which was only listed for one quarter of the NASS disclosure period). Discrepancies were noted whenever participant disclosures and company listings did not match as well as whenever payment ranges did not overlap. Fisher's exact test was used to compare disclosure discrepancy rates based on Medtronic payment size. No funding was received for this work. The authors report no conflicts of interest directly related to this study; however, one of the authors does do consulting unrelated to this study.
  
  
  RESULTS
  Medtronic and Depuy Spine were disclosed by 12.1% and 8.75% of NASS participants, respectively. Based on NASS disclosures, 52.4% of NASS participants affiliated with Medtronic had their disclosures inaccurately reflected on the Medtronic web site. Based on Medtronic payment postings, 45.7% of NASS participants listed on Medtronic's webpage had discrepancies in their NASS disclosures. Those who received payments <$100,000 from Medtronic were more likely to have discrepancies in their disclosures than those who received payments >$100,000 (p=.009). Based on Depuy Spine payment postings, 30% of NASS participants listed on Depuy Spine's site had discrepancies in their NASS disclosures.
  
  
  CONCLUSIONS
  Discrepancy rates between what spine surgeons disclosed at NASS 2011 and what companies reported for their consultants were high. This is concerning given the passage of the PPSA as well as the increased public visibility of potential discrepancies. More uniform practices will certainly be necessary.
authors.affiliation: Department of Orthopaedics & Rehabilitation, Yale University School of Medicine, 800 Howard Ave, New Haven, CT 06510, USA.
authors.forename: Rafael A
authors.initials: RA
authors.lastname: Buerba
authors.forename: Michael C
authors.initials: MC
authors.lastname: Fu
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Grauer
mesh_terms: D016265:Conflict of Interest; D003226:Congresses as Topic; D030881:Disclosure / Q000941:ethics*; D004864:Equipment and Supplies / Q000941:ethics*; D006801:Humans; D007221:Industry / Q000941:ethics; D020407:Internet; D009985:Orthopedics / Q000941:ethics*; D010820:Physicians / Q000941:ethics*
keywords: Conflict of interest; Disclosure; Industry; Medical ethics; Spine