September 15, 2010 - The financial ties between a group of orthopedic specialists who serve as highly paid consultants and the medical device companies that pay them frequently went unmentioned in the medical journal articles they published, according to a paper in the Archives of Internal Medicine this week. Failure to reveal financial links to drug and device companies in research papers is one of several medical conflicts of interest tackled in an IOM report Conflict of Interest in Medical Research, Education, and Practice. The report emphasizes both the value of collaborations between medical professionals and industry -- particularly in biomedical research -- and the need to ensure that such partnerships do not create conflicts of interest that could influence professional judgments. Noting the wide variance in policies across institutions, the report calls on journals as well as academic medical centers, health professional societies, and others to establish or strengthen conflict-of-interest policies and ensure that physicians and researchers adhere to them.
The study published in the Archives did not suggest that the orthopedic specialists’ consulting relationships with the device companies had resulted in undue influence over the physicians’ work. Concerns about other cases of perceived or actual conflicts resulting from consulting work led to the IOM report’s recommendation that consulting arrangements should be limited to legitimate expert services spelled out in formal contracts and paid for at a fair market rate. It also called on researchers, medical school faculty, and private-practice doctors to forgo gifts of any amount from medical companies and to decline to publish or present material that was ghostwritten or otherwise controlled by industry.
To help academic medical centers and journals verify disclosures by individuals and institutions, the report recommended the creation of a web-based program through which companies would be required to publicly report payments to medical professionals and institutions. With the passage of the Physician Payments Sunshine provisions in the health care reform law earlier this year, companies are required to begin recording any payments worth more than $10 in 2012 and to report them in an Internet database starting Sept. 30, 2013.