Discrepancies in Self-Reported and Actual Conflicts of Interest in Pediatric Urology Robotic Surgery

In assessing publications that address the benefits of robotic surgery over traditional laparoscopic and open approaches, transparency of conflicts of interest (COI) is essential. We sought to assess discrepancies between self-reported and actual COI, and whether or not COI is associated with favorable endorsement of robotic surgery.

Articles on robotic surgery within pediatric urology were searched in the EMBASE and MEDLINE databases. English-language articles published since 2013 (start of Open Payments database) were included. For all U.S.-based authors, Open Payments was used to identify the total amount of financial payment received from Intuitive Surgical. Chi-square test was used to assess the association between COI and favorable endorsement of robotic surgery.

191 articles were initially identified. After exclusion criteria were applied, 107 articles remained (267 distinct authors). 86 articles (80.4%) had at least one author with history of payment from Intuitive Surgical; of these, 79 (91.9%) had at least one author who did not declare a COI despite history of payment. 44 authors (16.5%) had a history of payment from Intuitive Surgical. Average payment was $3,594.15. Articles with a first and/or last author with history of payment were more likely to have favorable endorsement of robotic surgery compared to articles without (85.1% vs. 63.6%, p = 0.0124).

Nondisclosure of COI with Intuitive Surgical is extremely common within pediatric urology. Steps to ensure accurate reporting of COI are essential. There appears to be an association between a history of payment and favorable endorsement of robotic surgery.

The Journal of urology. 2018 Jul 24 [Epub ahead of print]

Masaya Jimbo, Candace F Granberg, Tijani S Osumah, Jathin Bandari, Glenn M Cannon, Jonathan C Routh, Patricio C Gargollo

Mayo Clinic, Department of Urology, Rochester, MN., University of Pittsburgh Medical Center, Department of Urology, Pittsburgh, PA., Duke University Medical Center, Department of Surgery, Division of Urology, Durham, NC.