Dear All,
When pressed for their conflict of interest statement, authors of one of our manuscripts sent a letter stating honoraria and support from the pharmaceutical company of the medication dealt with in their manuscript. However, they also declared that "there is no conflict of interest in the sense of the ICMJE requirements for manuscripts". Apparently, the authors felt justified by section II.D.1 (second sentence) of the ICMJE Uniform requirements for manuscripts that reads: "To prevent ambiguity, authors must state explicitly whether potential conflicts do or do not exist." The authors argue that after having declared their financial relationship to the company this sentence allows a conclusion by the authors whether they think there is a conflict of interest or not.

Are the authors correct?

Does this practice contradict section II.D., paragraph 1, sentence 4: "The potential for conflict of interest can exist whether or not an individual believes that the relationship affects his or her scientific judgment"?

Thank you very much in advance for your time and effort.

Best regards,
Christopher Baethge
Editor, Deutsches Ärzteblat [German Medical Journal]

___________________________

The authors are wrong.

The POTENTIAL still exists, whether they think there was an actual conflict or not. And the judgement of whether there was actual conflict can never be best made by those involved—that's the whole point of revealing it. If human beings could accurately assess their own bias, we would not even need such policies. We have also observed that in almost every case in which actual conflict was felt or proved to exist (eg, former Surgeon General Koop) the conflicted party stoutly defended their own ability to keep these competing interests clear and separate in their minds. As we know from experience and social science, that is a fiction. We deceive ourselves daily and constantly.

Michael Callaham

___________________________

Dear Dr Baethge,
These authors misinterpreted the statement in the Uniform Requirements. The intent of the ICMJE statement is that authors should declare whether or not they have any relationships that could be a potential conflict of interest (For example: Yes, they received honoraria and support. OR No, they did not receive honoraria and support.) The ICMJE recommendations do NOT state that authors should state whether or not they think the relationship represents a true conflict.

Christine Laine (for the ICMJE)
Senior Deputy Editor, Annals of Internal Medicine

___________________________

I would argue that there is no such thing as a potential conflict of interest. Either there is a financial arrangement that could affect the impartiality of the author(s) of a manuscript or not. What I think we are talking about is whether an existing financial relationship (a conflict of interest) results in a potential bias in the article. The latter is for the editor(s) and reviewer(s) to decide. But a conflicting relationship either exists or it doesn't.

Bill Tierney

___________________________

Thanks to Dr Tierney for a rare breakout of lucidity.

Another example is the press's use of "alleged suspect." We even see "alleged victim."

This obscurity is an attempt to avoid being perceived as accusative, and at times to avoid emotional response that would result in a lawsuit. It is more than just redundant. Such usage now establishes euphemism as standard expression.

Wallace Sampson
Editor, Scientific Review of Alternative Medicine

___________________________

I thought WAME members might be interested in the following article from July's Wall Street Journal. See below.

Bill Tierney
Co-Editor-in-Chief, Journal of General Internal Medicine

**
Source: Wall St. Journal

URL: http://online.wsj.com/article/0,,SB108967337655561782,00.html

Date published: July 13th 2004

Study Says Medical Journals Don't Effectively Monitor Financial Ties of Authors

By ROBERT TOMSHO

___________________________