Conflicts of interest Helping you get published
Conflicts of interestA cornerstone of science is that it should be objective andunbiased. Suppose a researcher could gain financially or career-wise if he or she gets a particular result from a study. Although thisby itself is acceptable, some people might doubt whether suchconsiderations had compromised the study design, conduct, orpublication of the study findings, especially if the researcher hadnot disclosed the potential gain.1 This situation is termed“Conflicts of interest” (COI).
What is conflict of interest?A conflict of interest arises whenever there is any potential bias that could affect aresearcher’s work.Conflicts of interest can include both financial and non-financial gains.2,3 For example,consider a peer reviewer who is evaluating a study that decreases the importance of thereviewer’s own research. This could lead the reviewer to recommend rejection of thestudy even if the study itself is original and robust, which gives rise to a conflict of interest.Conflict of interest due to financial gain is the most common one that authors face andmust disclose. It includes sources of funding, ownership of stocks in companies that maygain financially from the research, and acceptance of consulting fees or salary from acompany that may benefit from the research, among others. For example, a review on thepublication of research findings revealed that research sponsorship contributes topublication bias because the sponsors often own the data, making the data susceptible tomanipulation and suppression.4The World Association of Medical Editors (WAME) has a very good description of conflictsof interest that may arise in various scenarios.
The six PsConflicts of interest are inevitable in an academic career, and it is the responsibility ofresearchers to identify potential or actual conflicts. The Integrity Coordinating Group hasoutlined an excellent list – known as the six Ps - that researchers can use to determinewhether a conflict of interest exists:5Public duty versus private interest: Do I or the research sponsor have personal orfinancial interests that may conflict or be perceived to conflict with the interests andwelfare of the general public?Potentialities: Could there be financial or other intellectual benefits for me, myorganization, or research sponsor that could cast doubts on my research and data?
The six PsPerception: How will my or my research sponsor’s involvement in study conception,study supervision, study design, research conduct, and manuscript writing be perceived byothers? Would any bias in research design, sample selection, data reporting, datamodification, and manuscript preparation be perceived as a conflict of interest associatedwith me, my organization, or research sponsor? Are there any risks associated with me, myorganization, or research sponsor?Proportionality: Does my or my research sponsor’s involvement in all decisions regardingthe research appear to be fair and reasonable?Presence of mind: What consequences will I face if I ignore or do not disclose a conflictof interest? Can I give a reasonable answer if editors, reviewers, or readers question my ormy research sponsor’s involvement?Promises: Have I, my organization, or research sponsor made any promises orcommitment in relation to conducting or publishing the research? Do I stand to gain orlose from the promised action/decision?
Why authors must disclose conflicts of interestAlmost all scientific and non-technical journals require authors to disclose potential oractual conflicts of interest related to their study. Some journals, like JAMA, require authorsto submit signed financial disclosure statements. Other journals, like BMC Cancer, insist intheir guidelines that a separate section on conflict of interest be included in themanuscript and that any details be provided in the covering letter.When declaring conflicts of interest, researchers are expected to provide detailedinformation about relevant financial interests; grants, financial support, and fundingreceived from industry; and other intellectual benefits like filed or pending patents thatrepresent future financial gains. Researchers are also required to specify the role of thefunding organization or sponsor in the study design and conduct; data collection, analysis,and interpretation; and manuscript drafting, review, and final approval.
Why authors must disclose conflicts of interestIt is very important to inform journals about conflicts of interest. Journals may not alwayspublicly disclose conflicts of interest at the time of publishing the paper. However, if anyone questions the study or raises doubt that a conflict of interest exists, the journal willpublish the authors’ conflict of interest disclosure and mention that the authors hadalready informed the journal; this makes the authors’ conduct seem less suspicious.However, if the authors had not informed the journal and it is discovered that conflicts ofinterest did indeed exist, the consequences can be serious, including retraction of thepaper and investigation by the authors’ affiliated institutes.Journals do not usually police conflicts of interest issues themselves. Rather, it is theauthors’ affiliation (university or research institute) that creates, implements, andmonitors conflicts of interest policies for their faculty. Thus, authors are usually able toavoid conflict of interest scenarios before their research is complete and their paper issubmitted for publication. When in doubt, researchers are advised to consult theirinstitution before approaching the journal.
ConclusionWhen the potential for bias is disclosed, readers are aware of the situation and willjudge the research on its merits. On the other hand, failure to disclose relevantfinancial/intellectual interests violates the public’s trust, and if such information isrevealed subsequently, the credibility of the researchers and the journal that publishesthe work may be seriously damaged.6
Conflicts of interestReferences1. Financial conflicts of interest and research objectivity: issues for investigators and institutional review boards. Release Date: June 5, 2000. http://grants.nih.gov/grants/guide/notice-files/not-od- 00-040.html2. Conflicts of interest in research, University of Southern California. Date issued: November 1, 2007.http://www.usc.edu/research/private/docs/policies/conflictresearch110107.pdf3. Columbia University. Conflicts of Interest: Responsible Conduct of Research. Available at: http://ccnmtl.columbia.edu/projects/rcr/rcr_conflicts/foundation/index.html#2. Last accessed: December 26, 2011.4. Song F, Parekh S, Hooper L, Loke YK, Ryder J, Sutton AJ, et al. Dissemination and publication of research findings: an update review of related biases. Health Technol Assess 2010;14(8).5. Integrity in the WA public sector; Integrity Coordinating Group. http://www.opssc.wa.gov.au/ICG/Integrity_in_the_WA_public_sector/Conflict_of_interest/ Date accessed: May 21, 20116. DeAngelis CD, Fontanarosa PB, Flanagin A. Reporting financial conflicts of interest and relationships between investigators and research sponsors. JAMA 2001;286:89-91
Conflicts of interestReferences7. Shalala, D. (2000). Protecting research subjects—what must be done. New England Journal of Medicine, 343(11) 808–810.8. Akst, J. (2009). Consent issues nix blood samples. The Scientist. Available at http://classic.the- scientist.com/blog/display/56230/%20and%20http://www.texascivilrightsproject.org/?p=10969. International Committee of Medical Journal Editors. Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Ethical Considerations in the Conduct and Reporting of Research: Privacy and Confidentiality. Available at http://www.icmje.org/ethical_5privacy.html10. The American Journal of Psychiatry. Guidelines For Authors On Preparing Manuscripts. Available athttp://ajp.psychiatryonline.org/misc/ifora.dtl11. Journal of the American Medical Association. Instructions for Authors. Available at http://jama.ama- assn.org/site/misc/ifora.xhtml#EthicalApprovalofStudiesandInformedConsent12. Levine, S. B., & Stagno, S. J. (2001). Informed consent for case reports: The ethical dilemma of right to privacy versus pedagogical freedom. Journal of Psychotherapy Practice and Research, 10. 193– 201. Available at http://jppr.psychiatryonline.org/cgi/content/full/10/3/193