A High Rate of Inaccuracies Exists When Looking at Reported Conflicts of Interest in the Transcarotid Artery Revascularization Literature

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INTRODUCTION: To systematically review the accuracy of self-reported conflicts of interest (COI) among trans-carotid artery revascularization (TCAR) studies and evaluate factors associated with increased discrepancies. METHODS: A literature search identified all TCAR-related studies with at least one American author published between January 2017 - December 2020. Industry payments from Silk Road Medical, Inc. were collected using the Centers for Medicare & Medicaid (CMS) Open Payments database. COI discrepancies were identified by comparing author disclosure statements with payments found for the year of publication and year prior (24-month period). Risk factors for COI discrepancy were evaluated at the study and author level. RESULTS: A total of 79 studies (472 authors) were identified. Sixty-four studies (81%) had at least one author receive Silk Road Medical payments. Fifty-eight (73%) studies had at least one author receive an undeclared payment. Consulting fees represented the majority of payment sub-type (85%). Authors who accurately disclosed payments received significantly higher median payments compared to authors who did not accurately disclose payments ($37,222 [IQR: $28,203 - $132,589] vs $1,748 [IQR $257 - $35,041], p < 0.0001). Senior authors were significantly more likely to have a COI discrepancy compared to first authors (p = 0.0219). CONCLUSION: The majority of TCAR-related did not accurately declare COI. Authors with accurate disclosures received higher payments. Senior authors were more likely to have inaccuracies compared to first authors. This study highlights the need for increased efforts to improve the transparency of industry sponsorship, especially when consulting authors are reporting results on patient outcomes.

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