Medical Journals Rarely Disclose Researchers' Ties, Drawing Ire

By Ralph T. King
Copyright 1999 Wall Street Journal
February 2, 1999


Scientists are increasingly supported by for-profit companies, but a new study shows that critical fact is seldom revealed in published research.

To flag potential bias, researchers publishing studies are generally expected to disclose any financial conflicts of interest they have. But according to an analysis of 210 influential journals, mostly in the biomedical field, authors almost never do.

The finding, presented at a meeting of the American Association for the Advancement of Science last week, raises questions about the independence of researchers and the credibility of their results in an era of creeping commercialization in science. Industry plies scientists with grants, fees for speeches and consulting, or gifts including lab materials. In many fields, it's hard to find scientists who are conflict-free.

Yet in the study by Sheldon Krimsky of Tufts University and L.S. Rothenberg of the University of California at Los Angeles, a mere 0.5% of some 62,000 articles published in 1997 included information on the authors' research-related financial ties, such as stock ownership or patent rights. The data startled prominent medical editors, who said authors who don't disclose their business ties deprive readers of pertinent data in making health-care and other decisions.

Dr. Krimsky says that in a separate investigation of 800 scientific papers two years ago, he found that some 34% of authors had conflicts of interest, none of them disclosed.

Until the early 1990s, few journals insisted on the disclosure of a funding source for the author's research, Dr. Krimsky says. Now that practice is more established -- occurring with about 7% of all articles, Dr. Krimsky found -- yet disclosure of personal financial interests remains rare. In fact, all 210 journals in the survey have funding and personal-interest disclosure policies -- yet 142 of them carried no disclosures whatsoever.

'System Is Not Working'

"That suggests the system is not working," says Dr. Krimsky, adding that he is conducting a follow-up survey to find out why. Some editors may not enforce policies or fail to print facts disclosed to them. And some authors may not understand the rules or just choose to ignore them, he says.

"I think this shows a very bad state of affairs, if true," says Drummond Rennie, a deputy editor at the Journal of the American Medical Association. Jerome Kassirer, editor in chief of the New England Journal of Medicine, says, "The number sounds quite low, and it's something that could be worrisome."

Financial interests don't necessarily introduce bias into a scientist's work, and some scientists assert that they would never allow financial considerations to influence their interpretations. What's more, the disclosure of ties can sometimes unfairly taint studies that are scientifically solid, says Kenneth Rothman, editor of the journal Epidemiology. He refers to the campaign for more disclosure as "new McCarthyism."

Although the still-unpublished study doesn't indicate how many authors in the "nondisclose" camp actually had potentially conflicting ties, there is little question that dealings between researchers and corporations are legion. Last year, a New England Journal of Medicine study showed that virtually every researcher publicly supporting the use of new hypertensive drugs had financial ties to the drug manufacturers. And, significantly, none of their ties were disclosed.

"Many of these [scientists] don't perceive that these ties put them in a potential conflict of interest because they think they are incorruptible," says Allan Detsky, co-author of the study on hypertensive work. Even the New England Journal, a leader in setting disclosure standards, gives authors too much leeway in deciding what is disclosable, says Dr. Detsky, a member of the journal's editorial board.

The New England Journal's Dr. Kassirer disagrees, noting that authors already have to answer specific questions about their interests such as stock, stock options, consultancies and patent rights. "The problem is that going beyond that requires getting their income-tax forms," he says.

Detailed Questionnaires

Still, five journals in Dr. Krimsky's survey, including Investigative Ophthalmology and the Journal of Bone and Joint Surgery, that asked authors to fill out detailed questionnaires had far higher rates of disclosure. At one journal, the rate hit 23%, he said. Dr. Krimsky declined to name journals that disclosed no financial interests.

Recently, JAMA amended its list of disclosable financial interests to include expert testimony in court cases. "One person had given testimony 37 or so times, so that person couldn't really have had another job. He was doing it for money," says Dr. Rennie, the JAMA deputy editor.

"The important person is the reader, and if the financial conflict might alter their perception of the validity of results, then the reader should have those conflicts revealed," Dr. Rennie adds.

In Dr. Krimsky's view, financial-interest disclosure is no panacea but an overdue response to the growing commercial influences in science. "Now science has as a goal not only the pursuit of knowledge but the marketing of knowledge," he says. "We need to find new ethical norms to apply to the evolution of science in this new form."


Comments on this posting?

Click here to post a public comment on the Trash Talk Bulletin Board.

Click here to send a private comment to the Junkman.
 1