Papers

Declaring financial competing interests: survey of five general medical journals

Amina Hussain, Clegg scholar, Richard Smith, editor. 

BMJ, London WC1H 9JR

Correspondence to: A Hussain, Raigmore Hospital, Inverness IV2 3UJ hussainamina{at}hotmail.com

Although many authors of biomedical journal articles have financial competing interests, they often fail to disclose them.^1-3 Editors have been concerned about this for a long time. In 1985, the International Committee of Medical Journal Editors produced a statement on conflicts of interest, and journal editors adopted individual policies.⁴ But how effective have their policies been in practice?

Krimsky et al investigated the financial interests of over 1000 authors whose articles appeared in 14 scientific and medical journals in 1992.³ Although 15% of authors had financial ties relevant to one of their publications, no voluntary disclosures were published. In 1998, Stelfox et al showed that 23/24 authors (96%) defending the safety of calcium channel antagonists had financial ties with manufacturers of these drugs compared with 11/30 (37%) who were critical of their use.¹ Only 2/70 articles disclosed the authors' potential conflicts of interest. These findings confirmed that little had been achieved since initial concerns had been raised over a decade earlier. Recently, however, editors have been paying more attention to the issue and urging authors to declare competing interests. This study aimed to find out whether more authors have been doing this.

	Methods and results

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Using random number tables, we selected six sample issues of five leading medical journals (Annals of Internal Medicine, BMJ, JAMA, Lancet, and New England Journal of Medicine) from each of four years: 1989, 1994, 1996, and 1999. All editorials, papers reporting original research, and letters were examined to see if they contained a statement declaring authors' potential financial competing interests (this did not include statements that only mentioned the funding source). We also examined each journal's written policy on financial competing interests (see the BMJ 's website).

We studied 3642 articles, 52 (1.4%) of which declared authors' competing interests: two articles in 1989, eight in 1994, four in 1996, and 38 in 1999. The papers section had the greatest proportion of declarations (23/656; 3.5%), followed by editorials (7/412; 1.7%), then letters (22/2574; 0.9%) (table).

	Comment

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After much delay, there are now signs of a small, but increasing, proportion of articles declaring competing interests in some journals. Variations in policy requirements may account for the disparity among journals. For instance, the lack of declarations in New England Journal of Medicine editorials is not surprising as the journal (not always successfully²) prohibits them being written by authors with financial ties. The Lancet's in-house editorial team always writes the first editorial of each issue, signing it "The Lancet," a style that makes it impossible to know whether contributing authors have competing interests. But subsequent editorials conform to the more common format of naming individual authors at the end of the article, making it possible to request, and thus publish, details of each author's competing interests. The greater proportion of declarations in JAMA editorials may reflect the journal's longstanding policy of requiring authors to sign documents declaring any financial competing interests. The proportion of declarations in BMJ papers was much greater in 1999 than 1996. This may reflect the journal's adoption, in 1998, of Stelfox's recommendations requiring authors to answer a series of short questions on their financial ties.⁵

Data in this study have been drawn from information published in journals, and not directly from what authors revealed to editors. There is potential for disparity here, but it is difficult to see why editors would decide against revealing competing interests that were disclosed to them, given what is clearly stated in their policies.

Editors can learn much from examining the policies of other journals and adopting the features that seem conducive to disclosure. Research is needed to verify whether some of the authors who had not made a declaration did in fact have undeclared financial competing interests when they wrote their articles. It would also be useful to know the impact, if any, of competing interest statements on readers.

	Acknowledgments

We thank Julie Morris for statistical advice.

Contributors: AH designed the study, collected the data, and wrote the paper. RS proposed the idea for the study, discussed the interpretation with AH, and corrected the manuscript. AH is guarantor.

	Footnotes

Funding: No additional funding.

Competing interests: RS is the editor of the BMJ and responsible for devising its policy on competing interests. He is paid a fixed salary and will not be affected financially by the success or failure of the policy on competing interests.

This study was peer reviewed in the normal way, except that RS played no part in the process.

Written policies on each of the five journals are available on the BMJ's website

	References

Top Methods and results Comment References

1.	Stelfox HT, Chua G, O'Rourke K, Detsky AS. Conflict of interest in the debate over calcium channel antagonists. N Engl J Med 1998; 338: 101-105[Abstract/Free Full Text].
2.	Monmaney T. Medical journals may have flouted own ethics 8 times. Los Angeles Times 1999 October 21.
3.	Krimsky S, Rothenberg LS, Stott P, Kyle G. Scientific journals and their authors' financial interests: a pilot study. Sci Eng Ethics 1996; 2: 395-410[Medline].
4.	International Committee of Medical Journal Editors. Conflict of interest. Lancet 1993; 341: 742-743[CrossRef][Medline].
5.	Smith R. Beyond conflict of interest. BMJ 1998; 317: 291-292[Free Full Text].

(Accepted 26 March 2001)