Study links financial conflicts of interest to favorable robotic bariatric surgery research

Editor's Note

A study presented at the 2024 Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) annual meeting has revealed a significant correlation between financial conflicts of interest and favorable research outcomes in robotic bariatric surgery, General Surgery News January 18 reports. The article noted this concerning trend: authors who publish research favorable to robotic bariatric surgery are significantly more likely to have financial conflicts of interest and receive industry compensation compared to those who publish neutral or unfavorable findings.

The research analyzed 52 peer-reviewed manuscripts on robotic bariatric surgery published between 2018 and 2022. All studies involved US-based authors and focused on robotic platforms manufactured by Intuitive Surgical, which dominates 80% of the global robotic surgery market. The investigators cross-referenced authors’ disclosed conflicts of interest with payments reported on the Centers for Medicare & Medicaid Services (CMS) Open Payments database and categorized each study as favorable, neutral, or unfavorable toward robotic surgery.

Key findings include:

• Over 75% of authors who published favorable robotic surgery studies had financial conflicts of interest—significantly more than those with neutral or unfavorable conclusions (P=0.013).
• Only 32% of favorable-study authors accurately disclosed their financial ties, compared to 70% of authors who published unfavorable or neutral studies (P=0.045).
• Authors of favorable studies were more likely to receive substantial payments, with 41% receiving over $20,000 in the year prior to publication (P<0.001).
• Favorable-study authors were more likely to receive additional payments from Intuitive Surgical—the dominant company in the robotic surgery market—in the year after publication, raising concerns about a potential “quid pro quo” dynamic (P=0.003).

Senior investigator Anthony Petrick, MD, a specialist in esophageal and bariatric surgery, emphasized the ethical implications, noting the financial relationships between researchers and industry vendors could undermine public trust in scientific research. Session co-moderator Christopher Schlachta, MD, of Western University’s Schulich School of Medicine, acknowledged the study’s significance but cautioned that authors of unfavorable studies may also harbor biases against robotic surgery. However, he agreed that transparency is essential to maintaining the credibility of surgical research.

In response to these findings, the researchers urged medical journals and professional societies to enforce stricter conflict-of-interest transparency and disclosure requirements. They recommended that authors include the most recent Open Payments data with their submissions and disclose any financial ties up to the date of publication. They also called for standardized sanctions for non-disclosure, excluding minor expenses like food and travel.