http://bmj.com/cgi/content/full/323/7307/263
BMJ 2001;323:263-264 ( 4 August )
Papers
Declaring financial competing interests: survey of five general medical
journals
Amina Hussain
BMJ,
London WC1H 9JR
Correspondence to: A Hussain, Raigmore
Hospital, Inverness IV2 3UJ hussainamina@hotmail.com
Krimsky et al investigated the financial interests of over 1000 authors
whose articles appeared in 14 scientific and medical journals
in 1992.3
Although 15% of authors had financial ties relevant to one of their
publications, no voluntary disclosures were published. In
1998, Stelfox et al showed that 23/24 authors (96%) defending
the safety of calcium channel antagonists had financial ties with
manufacturers of these drugs compared with 11/30 (37%) who were
critical of their use.1
Only 2/70 articles disclosed the authors' potential conflicts of
interest. These findings confirmed that little had been achieved
since initial concerns had been raised over a decade earlier.
Recently, however, editors have been paying more attention to the
issue and urging authors to declare competing interests. This study
aimed to find out whether more authors have been doing this.
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Methods
and results |
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Using random number tables, we selected six sample issues of five leading
medical journals (Annals of Internal Medicine, BMJ, JAMA, Lancet,
and New England Journal of Medicine) from each of four years:
1989, 1994, 1996, and 1999. All editorials, papers reporting
original research, and letters were examined to see if they
contained a statement declaring authors' potential financial competing
interests (this did not include statements that only mentioned the
funding source). We also examined each journal's written policy on
financial competing interests (see the BMJ 's website).
We studied 3642 articles, 52 (1.4%) of which declared authors'
competing interests: two articles in 1989, eight in 1994, four in
1996, and 38 in 1999. The papers section had the greatest
proportion of declarations (23/656; 3.5%), followed by editorials
(7/412; 1.7%), then letters (22/2574; 0.9%) (table).
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Comment |
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After much delay, there are now signs of a small, but increasing, proportion
of articles declaring competing interests in some journals.
Variations in policy requirements may account for the disparity
among journals. For instance, the lack of declarations in New
England Journal of Medicine editorials is not surprising as the
journal (not always successfully2) prohibits
them being written by authors with financial ties. The Lancet's
in-house editorial team always writes the first editorial of each
issue, signing it "The Lancet," a style that makes it
impossible to know whether contributing authors have competing
interests. But subsequent editorials conform to the more common
format of naming individual authors at the end of the article,
making it possible to request, and thus publish, details of each
author's competing interests. The greater proportion of declarations
in JAMA editorials may reflect the journal's longstanding
policy of requiring authors to sign documents declaring any
financial competing interests. The proportion of declarations in BMJ
papers was much greater in 1999 than 1996. This may
reflect the journal's adoption, in 1998, of Stelfox's
recommendations requiring authors to answer a series of short
questions on their financial ties.5
Data in this study have been drawn from information published in journals,
and not directly from what authors revealed to editors. There is
potential for disparity here, but it is difficult to see why editors
would decide against revealing competing interests that were
disclosed to them, given what is clearly stated in their policies.
Editors can learn much from examining the policies of other journals and
adopting the features that seem conducive to disclosure. Research is
needed to verify whether some of the authors who had not made a
declaration did in fact have undeclared financial competing interests
when they wrote their articles. It would also be useful to know the
impact, if any, of competing interest statements on readers.
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Acknowledgments |
We thank Julie Morris for statistical advice.
Contributors: AH designed the study, collected the data, and wrote the
paper. RS proposed the idea for the study, discussed the interpretation with
AH, and corrected the manuscript. AH is guarantor.
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Footnotes |
Funding: No additional funding.
Competing interests: RS is the editor of the BMJ and responsible for
devising its policy on competing interests. He is paid a fixed
salary and will not be affected financially by the success or
failure of the policy on competing interests.
This study was peer reviewed in the normal way, except that RS played no
part in the process.
Written policies on each of the five
journals are available on the BMJ's website
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References |
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1. |
Stelfox HT, Chua G, O'Rourke K, Detsky AS. Conflict of
interest in the debate over calcium channel antagonists. N Engl J Med
1998; 338: 101-105 |
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2. |
Monmaney T. Medical journals may have flouted own
ethics 8 times. Los Angeles Times 1999 October 21. |
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3. |
Krimsky S, Rothenberg LS, Stott P, Kyle G. Scientific
journals and their authors' financial interests: a pilot study. Sci Eng
Ethics 1996; 2: 395-410 |
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4. |
International Committee of Medical Journal Editors.
Conflict of interest. Lancet 1993; 341: 742-743 |
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5. |
Smith R. Beyond conflict of interest. BMJ 1998;
317: 291-292 |
(Accepted 26 March 2001)
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