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Is Methodologic Quality Influenced by Industry Support? An Analysis of the Plastic Surgery Literature
Brian H. Cho, MD1, Joseph Lopez, MD MBA1, Sandra Lopez, BS1, Jessica Means, BA2, Jacqueline Milton, PhD3, James W. May, MD4, Amir H. Dorafshar, MB.ChB1.
1Johns Hopkins School of Medicine, Baltimore, MD, USA, 2Columbia College of Physicians and Surgeons, New York, NY, USA, 3Boston University School of Public Health, Boston, MA, USA, 4Division of Plastic Surgery Massachusetts General Hospital, Boston, MA, USA.

PURPOSE:
Conflicts-of-interest (COI) are an emerging area of discussion within the field of plastic surgery. Recently, several studies have found that studies that disclose COI are associated with publication of positive outcomes. We hypothesize that this association is driven by industry’s funding of higher quality studies. This study aimed to investigate the association between industry-affiliation and study methodological quality.
METHODS:
We reviewed all entries in Plastic and Reconstructive Surgery, Annals of Plastic Surgery, and Journal of Plastic, Reconstructive, and Aesthetic Surgery within a one-year period encompassing 2013. All clinical original research articles were analyzed. Studies were evaluated blindly for study methodology quality based on a validated scoring system. A logistic regression model was used to examine the association between methodology score and COI.
RESULTS:
A total of 1,474 articles were reviewed, of which, 489 met our inclusion criterion. These underwent methodologic quality scoring. COI were reported in 29 articles (5.9%). Although the prevalence of higher study methodology scores differed in studies that disclosed COI when compared to those that did not (p-value = 0.0042), there was no significant association between articles with COI and higher methodologic score (p-value = 0.8139) after adjusting for article characteristics such as plastic surgery subspecialty.
CONCLUSION:
Plastic surgery clinical studies that disclose COI are not associated with higher methodologic quality when compared to studies that do not disclose COI. These findings suggest that although articles with COI are associated with the publication of positive findings, this association is not necessarily driven by higher quality studies.


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