Conflict of Interest Policies Should Be Better Reported in Dental Journals

May 1, 2012

The relationship among industry, scientific investigators and academic institutions is complex and conflicts of interest may arise. A conflict of interest is a set of conditions in which professional judgment about a primary interest (such as a patient's welfare or the validity of research) is unduly influenced by a secondary interest (such as financial gain).1 In other words, a conflict of interest occurs when financial gain or prestige2 may affect research results. For example, studies3-5 suggest that industry-sponsored research tends to yield pro-industry conclusions. Other studies suggest that negative results of trials supported by profit-based organizations may not be published or their publication may be delayed.3 For these reasons, scientific journals should have clear conflict of interest policies and readers should be allowed full and complete access to this information. This way, interested readers can better understand the relationship of all parties involved in the project and make their own judgment about the effect of a potential conflict of interest on the study results.

The Need for a Detailed and Standard Conflict of Interest Form

The International Committee of Medical Journal Editors (ICMJE) recently introduced a uniform format for the disclosure of competing interests.6,7 Use of a detailed, standard form can make the disclosure of competing interests consistent, easy, and more informative for authors and readers.7 Nevertheless, a detailed survey of the instructions for authors (or author guidelines) on the homepages of a representative sample of dental journals revealed that only one journal requires the submission of this form with the manuscript. Although most dental journals require conflict of interest statements when authors submit a paper for peer review, these statements are not standardized and usually do not provide a detailed assessment of potential conflicts of interest.

High standards and uniform reporting are crucial to developing an informed opinion about whether a journal's conflict of interest policy is appropriate or which aspects of that policy need further scrutiny.8 For example, in clinical research, guidelines9-11 created to improve the quality of reporting scientific studies are pivotal to the assessment and comparison of these studies. In the same way, interested readers among the general public should have clear information about the conflict of interest policies of journals publishing scientific research without having to access the article's submission system or contact the editor to obtain detailed information. Low standards for reporting guidelines or instructions may hinder the ability of a reader to adequately judge the merits of an article.

Dental journals should seriously consider adopting the ICMJE form for 2 reasons. First, the form gives readers a clear, detailed picture of the potential effect of conflicts of interest on published results. Second, the standardized form enables comparison of the conflict of interest policies of all journals and may also enable editors and reviewers of the journals to better, more objectively assess the conflict of interest information authors provide. Like the guidelines for reporting scientific studies,12 efforts should focus on translating the ICMJE form into the original languages of journals that support ICMJE guidelines around the world to inform readers about each journal's conflict of interest policy.

More Transparency in the Peer Review Process

Having a conflict of interest policy for editors and reviewers would improve the peer-review process. The potential conflicts of interest of editors and reviewers should also be disclosed to the general public. For example, any relationship a reviewer has with either the authors of the study or any entity supporting the research project should be clearly reported. Controlling all the variables related to the peer-review process would, however, be a demanding task. To increase public trust in research, journals should provide detailed information about reviewers' conflicts of interest and other ethical issues in their instructions to authors.13 Controversial topics, for example the requirement to submit with the manuscript the raw data from clinical trials14,15 and strategies to report the role of each author in the study and drafting of the paper,16 are other measures that should be extensively discussed.

Good standards for reporting conflict of interest policies in dental journals are necessary to improve transparency in dental research.

THE AUTHOR

Dr. Faggion Jr. is a senior lecturer in the department of oral sciences, school of dentistry, University of Otago, Dunedin, New Zealand.

Correspondence to: Dr. Clovis Mariano Faggion Jr., Department of oral sciences, School of dentistry, University of Otago, PO Box 647, Dunedin 9054, New Zealand. Email: clovisfaggion@yahoo.com

The views expressed are those of the author and do not necessarily reflect the opinions or official policies of the Canadian Dental Association.

This article has been peer reviewed.

References

  1. Thompson DF. Understanding financial conflicts of interest. N Engl J Med. 1993;329(8):573-6.
  2. Lemmens T, Singer PA. Bioethics for clinicians: 17. Conflict of interest in research, education and patient care. CMAJ. 1998;159(8):960-5.
  3. Bekelman JE, Li Y, Gross CP. Scope and impact of financial conflicts of interest in biomedical research: a systematic review. JAMA. 2003;289(4):454-65.
  4. Bhandari M, Busse JW, Jackowski D, Montori VM, Schünemann H, Sprague S, et al. Association between industry funding and statistically significant pro-industry findings in medical and surgical randomized trials. CMAJ. 2004;170(4):477-80.
  5. Montgomery JH, Byerly M, Carmody T, Li B, Miller DR, Varghese F, et al. An analysis of the effect of funding source in randomized clinical trials of second generation antipsychotics for the treatment of schizophrenia. Control Clin Trials. 2004;25(6):598-612.
  6. Blum JA, Freeman K, Dart RC, Cooper RJ. Requirements and definitions in conflict of interest policies of medical journals. JAMA. 2009;302(20):2230-4.
  7. Drazen JM, de Leeuw PW, Laine C, Mulrow C, DeAngelis CD, Frizelle FA, et al. Toward more uniform conflict disclosures: the updated ICMJE conflict of interest reporting form. JAMA. 2010;304(2):212-3. Epub 2010 Jul 1.
  8. Egger M, Altman DG, Vandenbroucke JP; of the STROBE group. Commentary: strengthening the reporting of observational epidemiology the STROBE statement. Int J Epidemiol. 2007;36:948-50. Epub 2007 Oct 2.
  9. Moher D, Schulz KF, Altman DG. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials. Lancet. 2001;357(9263):1191-4.
  10. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ. 2007;335(7624):806-8.
  11. Needleman I, Moher D, Altman DG, Schulz KF, Moles DR, Worthington H. Improving the clarity and transparency of reporting health research: a shared obligation and responsibility. J Dent Res. 2008;87(10):894-5.
  12. Consolidated Standards of Reporting Trials. Available at: http://www.consort-statement.org (Accessed March 22, 2012).
  13. Atlas MC. Emerging ethical issues in instructions to authors of high-impact biomedical journals. J Med Libr Assoc. 2003;91(4):442-9.
  14. Vickers AJ. Whose data set is it anyway? Sharing raw data from randomized trials. Trials. 2006;7:15.
  15. Faggion CM Jr. Improving transparency in dental research by making the raw data available. J Can Dent Assoc. 2011;77:b122.
  16. Whellan DJ, Ellis SJ, Kraus WE, Hawthorne K, Piña IL, Keteyian SJ, et al. Method for establishing authorship in a multicenter clinical trial. Ann Intern Med. 2009;151(6):414-20.

Add new comment