Should Failure to Disclose Significant Financial Conflicts of Interest Be Considered Research Misconduct?

Accuracy of Financial Disclosures in Radiology Journals

PURPOSE

The accuracy and completeness of self-disclosures of the value of industry payments by authors publishing in radiology journals are not well known. The aim of this study was to assess the accuracy of financial disclosures by US authors in five prominent radiology journals.

METHODS

Financial disclosures provided by US-based authors in five prominent radiology journals from original research and review articles published in 2021 were reviewed. For each author, payment reports were extracted from the Open Payments Database (OPD) in the previous 36 months related to general, research, and ownership payments. Each author was analyzed individually to determine if the reported disclosures matched results from the OPD.

RESULTS

A total of 4,076 authorships, including 3,406 unique authors, were selected from 643 articles across the five journals; 1,388 (1,032 unique authors) received industry payments within the previous 36 months, with a median total amount received per authorship of $6,650 (interquartile range, $355-$87,725). Sixty-one authors (4.4%) disclosed all industry relationships, 205 (14.8%) disclosed some of the OPD-reported relationships, and 1,122 (80.8%) failed to disclose any relationships. Undisclosed payments totaled $186,578,350, representing 67.2% of all payments. Radiology had the highest proportion of authorships disclosing some or all OPD-reported relationships (32.3%), compared with the Journal of Vascular and Interventional Radiology (18.2%), the American Journal of Neuroradiology (17.3%), JACR (13.1%), and the American Journal of Roentgenology (10.3%).

CONCLUSIONS

Financial relationships with industry are common among US physician authors in prominent radiology journals, and nondisclosure rates are high.

Professional Relationships With Industry: ACOG Committee Statement No. 2

Developers and manufacturers of pharmaceutical agents and medical devices assist physicians in the pursuit of their educational goals and objectives through financial support of various medical, research, and educational programs. In general, industry seeks to optimize profit by providing useful goods and services. However, industry priorities may not always align with the ethical responsibilities of clinicians to promote the best interests of their patients, of educators to provide evidence-based instruction, and of researchers to ensure the scientific integrity of their investigations. To minimize both actual and perceived conflicts of interest, physicians and institutions should set guidelines for themselves and their employees regarding acceptable interaction with industry representatives. In this Committee Statement, the American College of Obstetricians and Gynecologists' Committee on Ethics provides recommendations for the management of professional relationships with industry, with an updated literature review and discussion of prevalence, regulations, and the effects of industry involvement in clinical care, education, and research.

Discrepancies in self-reported financial conflicts of interest disclosures by physicians: a systematic review

Background

There is a high prevalence of financial conflicts of interest (COI) between physicians and industry.

Objectives

To conduct a systematic review with meta-analysis examining the completeness of self-reported financial COI disclosures by physicians, and identify factors associated with non-disclosure.

Data sources

MEDLINE, Embase and PsycINFO were searched for eligible studies up to April 2020 and supplemented with material identified in the references and citing articles.

Data extraction and synthesis

Data were independently abstracted by two authors. Data synthesis was performed via systematic review of eligible studies and random-effects meta-analysis.

Main outcomes and measures

The proportion of discrepancies between physician self-reported disclosures and objective payment data was the main outcome. The proportion of discrepant funds and factors associated with non-disclosure were also examined.

Results

40 studies were included. The pooled proportion of COI discrepancies at the article level was 81% (range: 54%–98%; 95% CI 72% to 89%), 79% at the payment level (range: 71%–89%; 95% CI 67% to 89%), 93% at the authorship level (range: 71%–100%; 95% CI 79% to 100%) and 66% at the author level (range: 8%–99%; 95% CI 48% to 78%). The proportion of funds discrepant was 33% (range: 2%–77%; 95% CI 12% to 58%). There was high heterogeneity between studies across all five analyses (I²=94%–99%). Most undisclosed COI were related to food and beverage, or travel and lodging. While the most common explanation for failure to disclose was perceived irrelevance, a median of 45% of non-disclosed payments were directly or indirectly related to the work. A smaller monetary amount was the most common factor associated with nondisclosure.

Conclusions

Physician self-reports of financial COI are highly discrepant with objective data sources reporting payments from industry. Stronger policies are required to reduce reliance on physician self-reporting of financial COI and address non-compliance.

Toward Complete, Candid, and Unbiased International Consensus Statements on Concussion in Sport

Five international consensus statements on concussion in sports have been published. This commentary argues that there is a strong need for a new approach to them that foregrounds public health expertise and patient-centered guidance. Doing so will help players, parents and practitioners keep perspective about these potentially life-altering injuries especially when they recur.

Discrepancies in Financial Self-Disclosures and Open Payments Reporting Among Authors of Clinical Oncology Research Studies

PURPOSE

Company-reported payments from the Open Payments database (OP) have been compared with self-disclosed financial relationships made by physician authors. Discrepancies have been viewed as under-reporting of financial relationships. Our goal was to perform a systematic comparison to determine sources of discordance between company-reported and self-reported financial relationships.

METHODS

Financial disclosures reported by 163 authors and presenters who published in Journal of Clinical Oncology or who presented an abstract at the ASCO 2018 Annual Meeting were obtained and matched to payment data in OP. Categories included ownership, research, consulting/services, honoraria, expenses, royalty/patent/intellectual property, and other disclosures. Measures of concordance and discordance were calculated on the basis of matches on both company and category of disclosure and matches on company. Results are reported overall and within certain categories of disclosures.

RESULTS

Overall concordance between disclosures to ASCO and payments in OP was 16% for company and category matching and 24% for matching on the basis of company only. Authors tended to report more disclosures for research and consulting to ASCO than appear in OP. Expense disclosures were more frequently reported in OP than to ASCO. No payments were categorized as ownership in OP, but 35 authors/presenters disclosed ownership (including stock) to ASCO.

CONCLUSION

Our results reveal substantial discordance between self-reported and company-reported financial relationships for authors who report clinical oncology research. These findings support the calls for development of standardized disclosure policies across medicine.

Is it time to revise the definition of research misconduct?

U.S. federal policy defines research misconduct as fabrication of data, falsification of data, or plagiarism (FFP). In recent years, some have argued or suggested that the definition of research misconduct should also include sexual harassment, sabotage, deceptive use of statistics, and failure to disclose a significant conflict of interest (COI). While the arguments for revising the definition of misconduct used by federal agencies to include misbehaviors other than FFP are not convincing at this point in time, the arguments for revising definitions used by other organizations, such as professional societies, universities, or journals, may be. Since these other organizations play an important role in promoting integrity in science and deterring unethical behavior, they may consider adopting definitions of misconduct that extend beyond FFP. Debates about the definition of research misconduct are a normal and healthy part of broader discussions about integrity in science and how best to promote it. These debates should continue even if the federal definition of misconduct remains unchanged.