United we disclose
The relationship between pharmaceutical makers and physicians has come under close scrutiny lately. In recent weeks Congressional leaders have accused Harvard physicians of failing to properly disclose large payments from drug companies; meanwhile, other reports have highlighted the industry ties of certain experts who helped write the American Society of Pediatrics’ new recommendations for managing childhood cholesterol.
One way to facilitate greater transparency in biomedical research is to adopt a universal policy for reporting conflicts of interest in the scientific literature, according to the Center for Science in the Public Interest, a nonprofit health advocacy group based in Washington, DC.
The group has released a model disclosure policy, which requires authors to tell editors about all potentially relevant financial relationships from the past three years. This means all types of employment, consulting gigs, patents and patent applications for products related to the research, travel grants, speaking fees, writing fees, membership to science advisory boards, stock ownership (including investments by immediate family members) in funding by firms that have anything at stake in the research, and perhaps even strong personal, intellectual or political convictions relating to the study. The authors would also submit formal conflict-of-interest statements to be published along with the paper, which editors would evaluate against the scientists’ private declarations.
Transparency always seems to be the best policy, but will everyone agree upon what constitutes a potentially relevant conflict of interest? Some people are exceptionally good at convincing themselves that they are immune to bias, and since the policy relies on an honor system it will be hard to keep track of those who defy it. The other question is whether a uniform policy is better than having each journal frame its own policy, one that is tailored to the particular set of issues affecting its field. For example, patent issues seem to be particularly germane to biotechnology but not so much to geoscience, and pharmaceutical consulting fees are intensely to relevant to medicine but much less so to the physical sciences. Would a universal policy even be practical?

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Comments
"Transparency always seems to be the best policy, but will everyone agree upon what constitutes a potentially relevant conflict of interest?"
Is there always agreement on all issues and if there isn't, is it not possible to clarify issues and arrive at a consensus?
"Some people are exceptionally good at convincing themselves that they are immune to bias, and since the policy relies on an honor system it will be hard to keep track of those who defy it."
1) Everybody is prone to this particular conviction.
2) Just because laws are likely to be broken does not mean they should not be made in the first place or that some attempt should be made to implement and follow them.
3) Perhaps the way to go with ALL honor systems is for everybody to participate in maintaining an honorable image by keeping an eye on everybody else. Even if people are not likely to confess to their own transgressions, they will be happy to reveal others'.
"The other question is whether a uniform policy is better than having each journal frame its own policy, one that is tailored to the particular set of issues affecting its field."
The way the policy (to which a link has been provided above) reads seems to be a standard guideline FOR SCIENCE and MEDICAL journals. I am sure this doesn't prevent journals from adding their own requirements but it seems like a good place to start.
Posted by: Chris Muller | August 4, 2008 01:29 AM
Salomon docet: there is nothing new under the sun. I read the surprising question: "Transparency always seems to be the best policy, but will everyone agree upon what constitutes a potentially relevant conflict of interest?" Well! Who will decide what is relevant conflict of interest? In my opinion, there is a CLINICAL tool, highly efficacious in hindering drug companies to introduce useless products: Quantum Biophysical Semeiotics! See my website, and at least www.nature.com http://blogs.nature.com/news/thegreatbeyond/2008/02/confusion_after_diabetes_study.html#comments
Posted by: Sergio Stagnaro MD | August 3, 2008 04:35 AM