The Associated Press

June 12 —

The distinguished New England Journal of Medicine is relaxing its strict conflict-of-interest rules for authors of certain articles because it cannot find enough experts without financial ties to drug companies.

The change, announced in Thursday's issue, applies to experts who write either editorials or review articles, which are overviews of research on a particular drug or treatment, rather than original studies.

Dr. Jeffrey M. Drazen, the journal's editor in chief, said the policy reflects the way drugs are developed nowadays.

"New treatments are brought out by investigators whose research is in part supported by industry. They're the ones who know about new stuff," he said.

The change brings the journal's policy into line with that of other medical publications such as the Journal of the American Medical Association.

Original studies in the New England Journal of Medicine will continue to include a note saying who sponsored the research and disclosing any financial stake the author might have.

Since 1990, the journal's rule was that nobody who wrote a review article or editorial could have any financial interest in a company that made a product discussed in the article, or in any competitor of such a product.

Now, instead of forbidding any financial interest, the journal will forbid any "significant" stake. Its definition of significant is that agreed on by the National Institutes of Health and the Association of American Medical Colleges: payments of up to $10,000 a year are insignificant.

However, stock, stock options or patent positions of any value are deemed significant, because their value can rise and there is no limit on their potential for profits.

In addition, authors of such articles cannot have had "major research support or a major proportion of their funding from relevant companies" within two years of the article's publication.

The change comes at a time when the credibility of medical journals is under fire. Just last week, the Journal of the American Medical Association published research criticizing itself and its rivals for running studies that are misleading or riddled with conflicts of interest.

In 2000, the New England Journal of Medicine acknowledged that it had violated its conflict-of-interest policy 19 times over the previous three years when choosing doctors to review new drug treatments. But Drazen said that in the two years he has been editor, he has been able to commission and publish only one review article about a new drug.

"The New England Journal of Medicine sort of joined the rest of us" by adding the word "significant," said Dr. Catherine DeAngelis, editor of the Journal of the American Medical Association.

"It's extremely difficult to get the best people to write the editorials on a topic if you say they can have no association or potential conflict of interest," she said, noting that the top people in any field usually consult for companies or receive payments as visiting professors.

On the Net:

http://www.nejm.org

http://jama.ama-assn.org

Copyright 2002 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.