Conflict of Interest in Research and Publication: Has the Pendulum Swung Too Far?

Abstract

Traditionally scientists and industry have collaborated to contribute to the development of new drugs, biologics, and medical devices. Conflicts of interest (COI) may develop among surgeons and academic researchers, especially during the process of refinement of techniques and the marketing and sale of devices. Dramatic examples of COI occurred over the last 50 years, leading to strict regulations designed to reduce COI at research institutions. The International Committee of Medical Journal Editors created COI guidelines to help authors and editors ensure clear, reproducible, and unbiased medical articles. The Physician Payments Sunshine Act was designed to increase transparency of financial relationships between physicians and industry. However, in some cases authors and scientists are not obligated to fully disclose their COI. Only direct payments are required to be reported, not indirect payments to faculty at large academic institutions, allowing some to take advantage of the exceptions to the disclosure requirements whereas others must disclose payment for their work effort. Based on prominent scandals, regulations aimed at reducing industry influence in research and publication may fail to recognize the potential benefits of collaboration and produce a narrow-minded view of trust. Where should an editorial board or an academic institution draw the line?