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Conflict of interest disclosures


Many biomedical journals request that authors provide information about competing financial interests to help readers to understand the relationship the authors may have between various commercial organizations and the information reported in their article. Despite this common practice, there is currently no uniform way for authors to disclose financial associations when publishing articles in biomedical journals. Nor is their any evidence that such disclosures actually work to deter conflicts. No doubt, most of you would have seen the editorial published in 5 November 2009 issue of the New England Journal of Medicine. The editorial discusses a new expanded form introduced on behalf of the International Committee of Medical Journal Editors (ICMJE), of which the New England Journal of Medicine is a member. This new form is intended to provide a uniform format and broader disclosure for authors to disclose their competing financial interests. This initiative has been adopted by all journals that are members of the ICMJE.

While we applaud the initiative of the ICMJE, this does not avoid the specific problem of authors not disclosing information (either willing or unwillingly) that they know is relevant to the article. So, is all this necessary? Is it really another example of the general solution for the specific problem—the specific problem being the individual who didn't disclose information because he or she didn't want to disclose? The most glaring examples of conflict have been instances where any intelligent individual should have known they had a conflict and reported it, and no form would have corrected it—like owning a patent on the drug under discussion and not reporting it. Does disclosing a wider variety of interests actually sanction biased opinions instead? Moreover, what's wrong with having commercial ties anyhow? Many of the greatest advances in medicine have been made by a partnership between a pharmaceutical company and academia, such as the development of the remarkably effective drug imatinib for the treatment of chronic myelogenous leukemia. Some have proposed actually discouraging commercial ties as a way of preventing conflicts. Do we really want to do that at this exciting time in cancer medicine? Are universities and medical journals going to develop new drugs instead?

“This is probably the most powerful deterrent of commercial conflict and scientific fraud yet devised”

The Clinical Nature Reviews journals (formerly Nature Clinical Practice) have always had a robust competing interest's policy. We stipulate that all authors declare relationships, during the past 2 years, currently or pending, with any organization that might have a financial gain or loss from publication of the paper. Examples include research support or employment such as salaries, equipment, supplies, reimbursement for attending symposia, stocks or shares, or other interests such as consultation fees or other remuneration. In the printed journal we list all companies or organizations the authors have declared associations with, whereas the specific details of these associations are published in the online version of the article. We request all authors provide this information at the submission stage and any article that does not include a signed competing interest form is not published. We also ask invited referees to inform us of any competing interest that they think may be relevant that might preclude them from refereeing an article. We also will not publish ghost written articles. But, like all other journals, we have no way of policing all of this.

Financial disclosure forms also do not prevent scientific fraud. The best deterrent to fraud is the scientific process itself; the knowing that any interesting result will force the repetition of the experiments by other scientists to confirm or disprove it. Nature journals that publish original research either require, or strongly suggest, that the data be in a public domain so readers can analyze it themselves. Instead of condemning a study because of commercial ties, the reader can then analyze the data and come to their own conclusions. This is probably the most powerful deterrent of commercial conflict and scientific fraud yet devised.

Despite expanding questionnaires and using unified forms, all journals rely on the integrity and honesty of all authors that they have not omitted to disclose information that may be perceived as relevant to their article. Clinical researchers and journals can experience harsh criticism if an author is discovered not to have disclosed competing financial interests that are relevant to their article. A one-size-fits-all policy on disclosure of competing interests may not be the way forward.

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Hutchinson, L., DeVita, V. Conflict of interest disclosures. Nat Rev Clin Oncol 7, 1 (2010).

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