A recent article in the Journal of the American Medical Association (JAMA), titled “Requirements and Definitions in Conflict of Interest Policies of Medical Journals,” examined the COI policies of medical journals to determine the prevalence and variability of COI disclosure requirements and definitions.
The article noted that “recent studies examining the content of COI policies among journals with a clinical focus are limited,” and there is “variation between journals in handling information about COI.”
According to the report; an overwhelming majority (89%) of medical journals have readily available on-line COI policies and require submission of COI statements. Those remaining 11% without online COI statements in all likelihood have COI policies, just not readily available for review.
This represents a major change in collecting and disclosing COI by medical journals. A 1997 study found only 16% of medical journals had COI policies in place as compared to 89%+ today.
All high impact journals have COI policies and procedures in place.
Research Findings
The study identified 2117 medical journals across 35 subject categories, with 262 journals from these 35 subject categories being used.
Of 262 journals, 256 (98%) provided a URL linking to Instructions for Authors, manuscript submission forms, or both.
Within the Instructions for Authors, 25% of journals included online links to policy statements or articles on COI.
The study found that 228 of 256 sampled journals (89%) had language requesting author COI disclosure, and 89% of medical journals also had COI policies available for public review. Of the 89%, eighty five percent of journals requested COI disclosure in the Instructions for Authors, and an additional 4% requested COI disclosure only in manuscript submission documents. Of 256 journals, 138 (54%) required authors to submit signed disclosure statements.
77% of the journals defined or gave examples of possible COIs for submitting authors, and most of these journals included direct financial relationships such as “equities interest or stock ownership” (89%) or “consultancies” (84%). A minority included other potential conflicts such as personal relationships (42%), paid expert testimony (42%), relationships with organizations (26%), or travel grants (12%).
All internal medicine, respiratory medicine, and toxicology journals studied had comprehensive COI definitions, with 19 of these 24 journals requiring signed disclosure attestations.
6 of the 19 highest-impact journals in geriatrics and gerontology; radiology, nuclear medicine, and medical imaging; and rehabilitation requested that submitting authors disclose COIs.
Another survey (published in 2006) of the editors of 91medical journals found that 93% of medical journal editors reported having a COI policy.
Conclusion
In 2008, most medical journals with relatively high impact factors had author COI policies available for public review, although there was substantial variation in journal policies for solicitation of author COIs and in definitions of COI.
The study was limited because the authors did not survey the journal editors, and relied on review of journal policies available on the Internet. As a result, the authors noted that their “methodology could lead to underestimation of the prevalence of COI policies if COIs were only requested by editors in communication with authors after submission.”
Additionally, the research found a lack of uniformity among journal editors on what constitutes COI, highlighting the difficulty authors encounter as they submit to different journals may limit the intended goal of COI policies. As a result, the article mentions the recent work of the ICMJE and editors of leading medical journals who have implemented increasingly comprehensive policies regarding disclosure of authors’ financial interests and other potential conflicts. Consequently, they even asserted that “conflict of interest policies and their implementation have evolved over time,” which led the study to conclude that journals have experienced “a substantial increase in the prevalence of COI policies over the past decade,” an “encouraging finding.”
Another factor that has led to this increase in COI policies in journals is that ICMJE member journals have recently published a uniform vehicle for recording and submitting COI disclosures. Although this new uniform disclosure form has standard definitions and disclosure requirements and enables authors to save online copies of the forms that can be updated as needed, ICMJE member journals are still testing this form and the universal disclosure process and are asking for feedback until April 2010.
Once journals and ICMJE members are able to gather enough information about the effectiveness and drawbacks of this form, journals will hopefully be able to eliminate the need to reformat disclosure information for each submission to ICMJE member journals and other journals that would eventually accept this universal disclosure form.
Ultimately, this JAMA study is an encouraging piece or research revealing the recent trends in journals, editors and articles habits of disclosing information and reporting potential COIs. The future transparency among companies, researchers and physicians in the coming months will only continue this trend to help certain media sources and officials realize that authors and editors of journals maintain high levels of integrity when disseminating research breakthroughs to the public.