Is There an Association between Industry Payments and the Reported Results after Nerve Repair Using Conduits or...

Nerve conduits and allografts are increasingly used for peripheral nerve repairs. Most studies are industry-funded and of limited quality, which leaves surgeons potentially vulnerable to commercial influences.

The authors searched for studies published from 2012 until 2024 reporting on outcomes (Medical Research Council classification, static 2-point discrimination [s2PD], or Semmes-Weinstein monofilament outcomes) of nerve repairs using conduits or allografts, with at least 1 author holding a National Provider Identifier. After screening 2677 titles and abstracts and 156 full texts, we included 41 studies. Most studies were retrospective (85%) and noncomparative (73%). Overall study quality was low to moderate. Nerve-related payments were extracted from the Open Payments Database from 2013 to 2022, with a median of $36,948 (range, $0 to $410,486) per author per article. Only 1 study had no nerve-related payments.

Among studies reporting less than 70% meaningful recovery (Medical Research Council classification ≥S3/M3), 89% (8 of 9) received less than $20,000 in funding, compared with 28% of studies (8 of 29) reporting 70% or greater meaningful recovery. Similarly, among studies reporting at least 13 mm s2PD, 100% (4 of 4) received less than $20,000 in funding, compared with 27% of studies (3 of 11) reporting s2PD less than 13 mm. Due to limited studies reporting Semmes-Weinstein monofilament outcomes ( n = 7), we could not assess their association with nerve-related payments. No association was found between payments and adverse events.

Authors receiving greater industry funding are more likely to report more favorable meaningful recovery and s2PD. Awareness of this potential publication bias can help surgeons and patients dispassionately evaluate the rationale for using autografts, allografts, and conduits, although the evidence remains inconclusive.