Mahanti, Hannah

Background: Conflicts of interest pose a risk to the integrity of clinical research. As part of the Sunshine Act, the Open Payments Program was established to provide transparency in financial relationships between commercial entities and physicians. Previous research indicates disparities between industry payments self-reported by plastic surgeon authors and those disclosed by commercial entities. This study sought to revisit the accuracy of conflict-of-interest disclosures, comparing current trends with previously published data, and introduce a novel automated search tool designed to facilitate future reviews of self-disclosures. Methods: Articles from the Aesthetic Surgery Journal and Plastic and Reconstructive Surgery published between 2017 and 2022 were reviewed. Self-reported disclosures for plastic surgeon authors were aggregated and compared against the Open Payments database using Python. Results: A total of 8040 articles were reviewed. After filtering and applying inclusion criteria, 961 unique authors and 4226 authorships were identified. A total of 5802 discrepancies were found, with 78.6% of eligible authors having at least 1 discrepancy. Four percent of the included publications were estimated to contain undisclosed relationships that qualified as conflicts of interest. The median total payments for authors with discrepancies were greater than for authors without discrepancies ($9600 vs. $2500; P <0.001). A discrepancy in self-reporting was more likely to be identified among senior authors ( P <0.001). Conclusions: Plastic surgeon authors continue to underreport their financial relationships. Automated screening may help identify disclosure discrepancies and support more complete author self-reporting.

As plastic surgery has grown, leaders within the field have advocated transforming plastic surgery divisions into independent departments. This shift raises critical questions regarding departmental identity, resource allocation, and potential administrative conflicts. The purpose of this study was to explore the potential implications of these institutional hierarchies from the perspective of plastic surgery program chairs. An anonymous online survey was distributed to chairs of accredited plastic surgery programs. Thirty-five of 103 (34.0%) individuals responded to the online questionnaire. Twenty-eight of 33 (84.8%) programs were classified as divisions of surgery, whereas 5 of 33 (15.2%) were independent departments. Nine of 28 (32.1%) respondents believed their division had lost patients to other surgical specialties because their program was not an independent department. Eighteen of 33 (54.5%) respondents believed that plastic surgery is negatively impacted when institutional programs are not independent departments. Respondents who indicated losing patients to other specialties, compared with those who did not, were 22.4 times more likely to be critical of institutional hierarchies ( P =0.004). Respondents from independent departments were 12.6 times more likely to also express a negative view ( P =0.049). Our findings provide a nuanced understanding of the institutional structures within plastic surgery programs. The extent to which institutional hierarchies negatively impact plastic surgery remains unclear. The significant association between patient loss and negative perceptions implies that direct clinical or financial repercussions strongly shape opinions. Moreover, chairs from independent departments may be more critical of institutional hierarchies because they have a deeper appreciation for the advantages that come with departmental status.