Implications and Solutions
Clearly, a lack of transparency or honesty hurts all of us. It negatively affects the public’s trust in our profession and our trust in the veracity of the information provided in medical journals and textbooks and at medical meetings. If disclosures are not carefully considered, what else in the submission or presentation is less than truthful? We all lose if this problem is not addressed.
First, with respect to textbooks, all textbook publishers must adopt clear and unambiguous conflict-of-interest disclosure policies. In the meantime, readers beware!
Second, with respect to journals and medical meetings, we all have a role to play. Editors must carefully review and perhaps edit their standard disclosure language. Although I cannot for the life of me understand why receiving support of any kind is something to be dishonest about or why some authors apparently consider receiving samples or any kind of assistance as “no support” or “no financial support,” apparently some folks genuinely believe that if they did not receive a direct payment, they did not receive support (or something like that).6,7 Similarly, some authors appear to believe that serving on the board of a company involved in the development or marketing of a medical or medically related product or service is not considered a potential conflict of interest. Most of us would disagree. With that said, perhaps some disclosure forms should require more explanation of examples of potential conflicts of interest in order to reduce potential confusion.
Third, as a prospective author or speaker at a medical meeting, when in doubt it is always wise to err on the side of caution — that is, provide relevant information and leave it up to the editor and/or meeting organizers to decide what to do.
Finally, readers of medical journals and meeting attendees can help. We have to believe the vast majority of authors and speakers are honest and would not sign less-than-truthful statements. But if you read an article or attend a meeting and believe a potential conflict of interest has not been disclosed, you can help protect the integrity of our profession by asking the editor(s) and/or organizers to investigate. This may not be a responsibility we relish accepting but one we may have to assume at some point in our careers. We all have a role in protecting the veracity of the information we rely on to help guide patient care. What we may not know really can hurt us all. ν