Medical journals fail to reveal conflicts of interest

Critics demand consequences

Medical journals nationwide are taking a harder look at their conflict-of-interest — or financial disclosure — policies, as publications acknowledge a spate of embarrassing examples of journals failing to cite ties between authors and the companies producing the treatments they write about.

In July, the journal Neuropsychopharmacology announced it would publish a correction after it was disclosed that an article lead-written by the journal's editor in chief, nationally respected psychiatrist Charles Nemeroff, favorably reviewed a controversial treatment for depression without citing that he and seven co-authors had financial ties to the company that makes the treatment.

Complaints ranged from letters charging the article was merely a public relations campaign disguised as a scientific review, to concerns that a treatment that has been questioned by medical and regulatory bodies was presented in a positive light without adequate disclosure of the authors' interest in seeing the treatment be successful.

The Neuropsychopharmacology controversy arose as the Journal of the American Medical Association (JAMA) took its third hit of 2006 when articles in consecutive issues were found to have been published without acknowledgement of the authors' ties to the companies they wrote about.

In its July 12 issue, Chicago-based JAMA published a statement saying that a February paper on depression in pregnancy failed to include information about the authors' financial ties to a company that sells treating medications.

The correction appeared in the same issue that JAMA's editor in chief, Catherine D. DeAngelis, MD, MPH, published an editorial spelling out how the journal plans to enhance and clarify its conflict-of-interest policy.

"Beginning January 2007, JAMA will require that complete disclosures of conflicts of interest from all authors, including declaration of no conflicts of interest, are included in the acknowledgment section of the manuscript," the policy states.

The next issue, July 19, carried another article — this one on migraines and the risk of cardiovascular disease in women — that later had to be corrected because, again, the journal did not include disclosure information.

Ethicists and media analysts are urging journals to take their policies on disclosure a step further, and impose sanctions on authors who violate the rules. JAMA's conflict-of-interest policy, both before and after the update, does not mention penalties for violators.

According to the New York-based Alliance for Human Research Protection, thus far only two journals — Environmental Health Perspectives and Journal of Thoracic and Cardiovascular Surgery— have announced they would ban authors, either for a period of years or permanently, for failing to comply with policies on disclosing financial conflicts of interest.