EDITORIAL

http://dx.doi.org/10.5546/aap.2018.eng.3

Editors of biomedical journals and the disclosure of their own conflicts of interest

Continuing with the topic of conflicts of interest related to scientific publications, recently, an article by Liu et al.¹ was published in the British Medical Journal (BMJ) regarding the financial relations of medical journal editors. According to this investigation, in the USA, approximately half of the editors of 52 prestigious medical journals received financial payments from the pharmaceutical industry and medical device manufacturers in 2014.

Recently, in a special article² published in Argentine Archives of Pediatrics (Archivos Argentinos de Pediatría) with regard to a publication supplement in the Journal of the American Medical Association (JAMA) devoted to conflicts of interest, the complex topic of conflicts of interest was extensively approached in different scenarios: real conflicts or perceived by physicians, investigators, professional associations, scientific societies, biomedical journals among other stakeholders.

The objective of the observational and retrospective study by Liu et al.,¹ was to estimate the financial payments from industry to US journal editors. Two medical editors (editors in chief or associate editors) were selected from 52 journals drawn from 26 specialties, with a high impact factor for their specialty. General and research payments received from pharmaceutical companies and medical device manufacturers were collected and examined in 2014, through the Open Payments databases. Additionally, the magnitude of such payments was compared across journals and by specialty, and journal websites were also reviewed to determine if conflict of interest policies for editors were readily and publicly accessible.

Out of the 713 eligible editors, 361 (50.6%) received research payments in 2014. The highest general payments received by journal editors were from endocrinology, cardiology, gastroenterology, rheumatology and urology. Payments were higher for those specialties that rely on expensive devices (cardiology, orthopaedics). Conflict of interest policies were easily accessible (within the first five minutes of search) for 17 out of the 52 (32.7%) journals.

Authors conclude that "Industry payments to journal editors are common and often large, particularly for certain subspecialties. Journal editors should consider again conflict of interest policies and the impact that the editor's relations with industry might have on public trust in published research".

Authors of the article, by means of a very accurate methodology, performed a detailed analysis of the situation of medical editors of influential scientific publications regarding payments and commercial interests with the industry. This paper, according to the authors, is the first one examining industry payments to physicians that pharmaceutical companies should disclose in the publicly available database Open Payments.

Open Payments is a US federal program required by the Affordable Care Act, that collects information about general payments that pharmaceutical and device companies make to physicians and teaching hospitals for issues like travel, meals, gifts, speaking fees and research. It also includes ownership interests (shares or others) that physicians or their immediate family members have in these companies. This information is made available to the public each year on the website.³

Payments to editors ranged from low amounts or none to figures as high as 10 million dollars. Besides, it was found that only 30% of the journals included in the study had published editorial policies for conflicts of interest readily accessible in their website. Moreover, even when policies were available they were variable. It was also noted that one journal (Anesthesiology) had a conflict of interest policy which was so detailed and accessible that could serve as an example.¹

Among publication policies or regulations of most of biomedical journals, authors of studies published should disclose their sources of funding and other conflict of interests related to their study. Likewise, reviewers are requested to declare if they have conflicts of interest for each particular article. However, and only recently, the subject of disclosing conflicts of interest of editors (in chief, associate/assistant) of scientific publications is being examined.

It is recognized that there might be the possibility of bias during the process of review and/or publication. Certain predisposition in favor or against about a manuscript publication might be influenced by commercial and/or personal interests.

The adequate procedure would be to avoid any situation that might lead to a conflict of interest, even an apparent and/or potential conflict. But nobody is exempt from a potential conflict. One should not prejudge. Weschler (several years ago) in an editorial on this topic mentioned a conclusive statement by Richard Smith, former editor of the BMJ who said that "Conflict of interest is a condition, not a behavior".⁴

Hence, having conflicts of interest is not a harmful or detrimental act. The problem is not to have conflicts; the problem is concealment.

The International Committee of Medical Journal Editors (ICMJE) states that the final determination about the publication of an article should not be influenced by any type of conflicts.⁵ However, this is not standardized. Each journal should formulate and implement policies for the disclosure of conflicts of interest necessary to ensure, as far as possible, editorial transparency. At present, honesty of all parties involved seems to be the most adequate policy.

Adriana Aguilar, M.D.

Assistant Editor

REFERENCES

1. Liu JJ, Bell CM, Matelski JJ, et al. Payments by US pharmaceutical and medical device manufacturers to US medical journal editors: retrospective observational study. BMJ 2017;359:j4619.         [ Links ]

2. Serra ME. Conflictos de interés: claroscuros entre los principios y el fin. Arch Argent Pediatr 2017;115(5):501-4.         [ Links ]

3. Centers for Medicare and Medicaid Services. Open payments. Baltimore: CMS; 2017. [Acceso: 20 de noviembre de 2017]. Disponible en: https://www.cms.gov/openpayments/

4. Wechsler AS. Conflict of interest: What's a journal to do? J Thorac Cardiovasc Surg 2006;131(4):771-2.         [ Links ]