Academic Influence and Industry Funding in Nerve Allograft Research: A Coauthorship Network Analysis

Background: Clinical use of acellular nerve allografts is rapidly increasing despite limited high-quality, comparative evidence of superiority. Simultaneously, nonresearch payments to clinicians by the nerve allograft industry exceed $14 million over the past decade. In this study, the authors hypothesized that nerve allograft–related academic influence would correlate with industry funding. Methods: PubMed studies on nerve allografts in plastic and reconstructive surgery journals were reviewed. Using author lists from extracted studies, a coauthorship network was generated and degree centralities—quantitative measurements of influence within a network—were calculated. Open Payments data from the nerve allograft industry was summated for each author. Finally, Pearson correlation and linear regression were used to analyze the relationship between centrality and payments received. Results: A total of 185 studies were included, with 581 unique authors (nodes) and 2406 coauthorships (ties) between them. Among authors with exceptional network influence (centrality >10, 75th percentile; n = 113), 56 were clinicians with valid National Provider Identifiers and therefore eligible for inclusion in the Open Payments database. Forty-four (79%) of these authors received at least 1 payment from the industry. Pearson correlation revealed a moderate (0.4 < r < 0.6) positive correlation between centrality and payments received (r = 0.51; P < 0.001). Linear regression demonstrated an estimated 16% increase in total pay per additional unit of centrality (P < 0.001; 95% CI, 8% to 25%). Conclusions: There is a significant connection between academic influence and financial support from the nerve allograft industry. Such results warrant discussion concerning conflicts of interest in clinical research and best practices for mitigating potential bias related to commercially backed treatments.