Conflict of Interest Disclosures in Opinion-based Plastic Surgery Literature: A Comparison With Industry Payment Records on Open Payments.

Abstract

Industry relationships are common in plastic surgery but can introduce bias through conflicts of interest (COI). In 2010, the Physician Payment Sunshine Act mandated biomedical companies to disclose and publish physician payment records on the Open Payments database. Inconsistent author disclosures have been identified in peer-reviewed plastic surgery literature, but opinion-based plastic surgery literature (i.e., letters, commentaries, editorials) remain overlooked, despite a greater risk for bias and subjectivity. This study aimed to compare author disclosures in opinion-based plastic surgery articles with Open Payments records. COI disclosures amongst plastic surgeon authorships in all opinion-based articles published in Aesthetic Surgery Journal and Plastic and Reconstructive Surgery from 2021 to 2023 were systematically reviewed and cross-referenced with Open Payments. The primary outcome was discrepancies of COIs with Open Payments records and vice versa. Secondary outcomes included proportion of discrepancies over $250 and predictive factors for discrepancies. 1,108 authorship disclosures were compared with Open Payments data. 62% (n=689) of authorships had at least one discrepancy; 61% (n=678) received undisclosed payments, while 12% (n=128) disclosed relationships without corresponding Open Payments record. Authorships with payments over $250 were more likely to have a discrepancy (99.6% vs 62%, p <0.0001). Publication year and author position were predictive of discrepancies, but there was no significant difference between journals. COI is under-reported in opinion-based plastic surgery literature, leaving readers unaware of potential biases. Accurate COI disclosure is essential to maintain ethical and high-quality research, therefore collaboration between authors, editors, and regulatory bodies is needed to improve reporting standards.