Conflicts of Interest in Neurosurgical Innovation

Conflicts of interest (COI) are formed from competing interests or motivations held by an individual or group. They are ubiquitous in the setting of innovation and collaboration, as these same collaborative ventures are imperative for the advancement of any field. While neurosurgical innovation benefits from the vast collaboration, industry funding, and incentives for innovation, it is important that COI are managed ethically. Financial COI between the medical device industry and physicians is perhaps the most evident example of how COI can affect clinical decisions and innovative practice. Additionally, in the realm of the scientific literature, there have been examples of abuse from the medical device industry, in which COI may have led to poor trial design and incomplete reporting of adverse events. Aside from the influence of industry, even more subtle forms of COI can have a lasting effect. For example, all physicians are subjected to more subtle forms of coercion that could affect judgment, and the effect of these is perhaps amplified given the subjective nature of many clinical decisions and the lack of oversight in innovation of thought. Thus, it is important to promote ethical innovation in order to preserve the quality of the literature and clinical practice and to protect patients.