The impact of disclosure of conflicts of interest in studies comparing robot-assisted and laparoscopic cholecystectomies-a persistent problem.

INTRODUCTION: Accurate disclosure of conflicts of interest (COI) is critical to interpretation of study results, especially when industry interests are involved. We reviewed published manuscripts comparing robot-assisted cholecystectomy (RAC) and laparoscopic cholecystectomy (LC) to evaluate the relationship between COI disclosures and conclusions drawn on the procedure benefits and safety profile. METHODS: Searching Pubmed and Embase using key words "cholecystectomy", laparoscopic" and "robotic"/"robot-assisted" retrieved 345 publications. Manuscripts that compared benefits and safety of RAC over LC, had at least one US author and were published between 2014 and 2020 enabling verification of disclosures with reported industry payments in CMS's Open Payments database (OPD) (up to 1 calendar year prior to publication) were included in the analysis (n = 37). RESULTS: Overall, 26 (70%) manuscripts concluded that RAC was equivalent or better than LC (RAC +) and 11 (30%) concluded that RAC was inferior to LC (RAC-). Six manuscripts (5 RAC + and 1 RAC-) did not have clearly stated COI disclosures. Among those that had disclosure statements, authors' disclosures matched OPD records among 17 (81%) of RAC + and 9 (90%) RAC- papers. All 11 RAC- and 17 RAC + (65%) manuscripts were based on retrospective cohort studies. The remaining RAC + papers were based on case studies/series (n = 4), literature review (n = 4) and clinical trial (n = 1). A higher proportion of RAC + (85% vs 45% RAC-) manuscripts used data from a single institution. Authors on RAC + papers received higher amounts of industry payments on average compared to RAC- papers. CONCLUSIONS: It is imperative for authors to understand and accurately disclose their COI while disseminating scientific output. Journals have the responsibility to use a publicly available resource like the OPD to verify authors' disclosures prior to publication to protect the process of scientific authorship which is the foundation of modern surgical care.

Accidental Physical Trauma in Children and Youth with Special Health Care Needs: A Scoping Review.

BACKGROUND: Children and youth with special health care needs (CYSHCN) may be at greater risk for accidental physical trauma. Interventions should be informed by the literature indicating incident characteristics and at-risk subpopulations. OBJECTIVE: To conduct a scoping review of accidental physical trauma in CYSHCN to characterize published literature and identify gaps. DATA SOURCES: Peer-reviewed literature within CINAHL, Embase, and PubMed, 1998 to February 2021. STUDY ELIGIBILITY CRITERIA: Studies that included individuals younger than 19 with special health care need(s) with accidental injuries classified as trauma. STUDY APPRAISAL AND SYNTHESIS METHODS: The study team extracted: research method, author field, special health care needs, geographic scope, author country, demographics, incident characteristics, and injury characteristics. RESULTS: We included 85 articles from an initial yield of 10,481. Pediatrics (32%) was the most-represented field among authors published on this topic. Publications most often considered developmental conditions (77.7%), including ADD/ADHD. Studies differed in how often they reported demographic characteristics: gender (96.5%); social determinants of health/socioeconomic status (41.2%) or race/ethnicity (25.9%). Few articles included injury time of day (10.6%) and day of week (2.4%); 40% did not include information about the place of injury. LIMITATIONS: Our search term development focused on diagnosis rather than need; we did not search reference lists or grey literature. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: This review reveals key gaps in the literature pertaining to incident characteristics and place of injury for CYSHCN. Those advising families and/or planning interventions focused on mitigating risk for CYSHCN have limited evidence upon which to rely for certain conditions. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO registration is not applicable to scoping reviews.