D27. Examining the Potential Influence of Industry Payments on Allograft and Conduit Nerve Repair Outcomes

PURPOSE: Industry-supported research helped advance peripheral nerve surgery but raises concerns about conflict of interest. We asked: is there an association between industry payment to study authors and the reported outcomes after nerve grafts and conduits? METHODS: A systematic literature review was conducted between Jan-2005 and Sep-2023. Studies reporting 2-point discrimination, monofilament testing and medical research counsel scales for muscle strength after nerve repair with allograft or conduit were extracted. Study details was extracted independently by two reviewers, resulting in 20relevant studies. Payments made prior and following the study can introduce potential bias. Therefore, we pooled total value received per study by summing the amount each author received from allograft and conduit companies as reported in the Open Payments Database. Study quality was low, mostly due to high reported lost-to-follow-up. RESULTS: Every study was conducted by one or more authors who before or after the study received some form of payment. Specifically 83% (114/146) of all authors received industry payments. The mean payment to authors was 314, 472 (range 103-1, 086, 215). Since all studies received some payment, it was not feasible to compare outcomes between potentially biased and unbiased studies. CONCLUSION: The quality of studies assessing outcomes after nerve repair with allograft and conduits is low. The fact that one or more authors of each study received some form of industry payment before or after the study is concerning. Due to the substantial cost of allografts and conduits to the healthcare system and patients, unbiased high level evidence is necessary to justify their use.