Disclosure at the Medical Journals

Copyright 2003 The New York Times Company -- September 30, 2003

A troubling case of hidden financial conflicts has forced the publisher of some of the world's most influential scientific journals to expand its editorial disclosure policies. Last week the Nature Publishing Group, part of Macmillan Publishers, announced that it would henceforth require the authors of review articles to disclose any financial ties to the products they evaluate. It was a welcome if belated step to close a loophole in the journals' previous disclosure policies, which covered only research reports and not the review articles that evaluate progress in a particular field.

The new policy stems from a conflict of interest case last year involving a review article in Nature Neuroscience that evaluated experimental treatments for depression. As reported by Melody Petersen in The Times last month, the lead author of that article had significant financial stakes in three of the therapies he mentioned favorably. He held the patent on a lithium patch that he described as promising, owned 60,000 shares of stock in a small company whose drug he described as effective, and was a board member and recipient of stock options and consulting fees from another small company whose product he cited. Yet the journal had not asked him to disclose any conflicts of interest, and the scientist had not volunteered the information.

Requiring the authors of original research articles to disclose their financial conflicts has always made sense because industry financing is often associated with pro-industry findings. The case may be even stronger for requiring disclosure from the authors of review articles, which purport to weigh the value of one therapy against another and are, by their very nature, opinionated. Having come so far, the Nature journals may now want to extend their disclosure policy to cover letters as well, given their combative nature and potential influence.

Medical journals have made substantial efforts in recent years to reduce the potential for commercial bias. Full disclosure of financial ties is a powerful disinfectant, but when the conflicts loom too large, the journals should simply shop around for a less conflicted author.

Source: NY Times