Accuracy of declared conflicts of interest.

Growing evidence shows that the findings and conclusions of researchers with financial conflicts of interest are significantly more likely to favor the interests of their for-profit supporters (Bekelman et al. 2003; Swaen and Meijers 1988), as does evidence of the takeover of the institutions of science by for-profit corporations (Blumenthal et al. 1996; Willman 2003). However, many authors remain reluctant to declare the financial benefits they receive (Krimsky and Rothenberg 2001). In elucidating its new conflict of interest policy, the British Medical Journal theorized:

   We have two hypotheses to explain this. Firstly,
   authors think that an admission of a conflict of
   interest implies wickedness. We don't think so.
   Secondly, authors are confident that they have
   not been influenced by a conflict of interest and
   so don't tell us they have one. Our response is
   that bias works in subtle ways and that none of us
   is blessed with knowledge of our own motivations
   and mental mechanisms. (Smith 1998)

EHP too has strengthened its conflict of interest policy--to now require authors to provide a public declaration of competing interests that could constitute a real, potential, or apparent financial conflict, and require they certify their freedom from competing interests to conduct all aspects of research (Environmental Health Perspectives 2003).

Unfortunately, author reluctance is evident. For example, Starr (2003) (of TBS Associates) recently published a worthy commentary in EHP in which he analyzed the controversial and high-financial-stakes question of the cancer potency of dioxins; yet he states,

   Partial support for this work was provided by the
   Chlorine Chemistry Council [CCC]. The author
   declares he has no conflict of interest.

In the same issue, Gibson et al. (2003) reported on their investigation of the efficacy of therapies for multiple chemical sensitivity (MCS), as perceived by those taking them. They state,

   This research was supported in part by a grant
   from the Chemical Injury Information Network
   [CIIN] and a James Madison University Faculty.
   Summer Research grant. The authors declare
   they have no conflict of interest.

EHP's long-standing transparency of author affiliation and funding allows readers to judge both claims. The corporations that make up the CCC derive a huge financial benefit in seeing dioxins and other chlorinated chemicals declared safe to the biosphere. However, the CIIN, an influential support group for those with MCS, gains a small financial benefit from seeing MCS declared a prevalent hazard, even if the benefit is large relative to the CIIN's small size. Readers can factor in the CCC's dedication to the narrow interests of for-profit corporations (almost entirely financial gain) and the CIIN's bias toward the very public interest of health. University and government funders such as the National Institutes of Health also represent the broad public interest and are biased toward health issues.

Journal editors should require declarations (including for correspondence) to be more truthful. Editors should also declare their financial conflicts.

What about refusals to declare a financial conflict when the funding source does not indicate its presence? Journals should regularly publish a reminder about the importance of declaring all conflicts of interest, and they should solicit readers for notification of undisclosed conflicts and publish any that are received and verified.

Author bias is inevitable, but it contributes to scientific discourse--the only way for humanity to gain knowledge (e.g., when a journal publishes, without a conflict of interest declaration, the proceedings of symposia that include industry-affiliated authors). Full transparency is critical to the advancement of knowledge.

The author declares he has a competing financial interest because he received payment from a public-interest nonprofit agency (Women's Voices for the Earth) and a trial attorney, both of whom could profit from the service he provided. He did not receive funding for this letter.

Anthony Tweedale

Montana Coalition for Health, Economics, & Environmental Rights

Missoula, Montana

E-mail: [e-mail]

REFERENCES

Bekelman JE, Li Y, Gross CP. 2003. Scope and impact of financial conflicts of interest in biomedical research. JAMA 289(4):454-465.

Blumenthal D, Causino N, Campbell E, Louis KS. 1996. Relationships between academic institutions and industry in the life sciences--an industry survey. N Engl J Med 334(6):368-373.

Environmental Health Perspectives. 2003. Instructions to Authors. Available: http://ehpnet1.niehs.nih.gov/docs/ admin/edpolicy.html [accessed 10 September 2003].

Gibson PR, Elms AN-M, Ruding LA. 2003. Perceived treatment efficacy for conventional and alternative therapies reported by persons with multiple chemical sensitivity. Environ Health Perspect 111:1498-1504.

Krimsky S, Rothenberg LS. 2001. Conflict of interest policies in science and medical journals: editorial practices and author disclosures. Sci Eng Ethics 7(2):205-218.

Smith R. 1998. Beyond conflict of interest: transparency is the key

[Editorial]. Br Med J 317:291-292.

Starr T. 2003. Significant issues raised by meta-analyses of cancer mortality and dioxin exposure. Environ Health Perspect 111:1443-1447.

Swaen GM, Meijers JM. 1988. Influence of design characteristics on the outcome of retrospective cohort studies. Br J Ind Med 45(9):624-629.

Willman T. 2003. Stealth merger: drug companies and government medical research--some of the NIH's top scientists are also collecting paychecks and stock options from biomedical firms. Los Angeles Times (7 December), Available: http://www.latimes.com/news/nationworld/ nation/la-na-nih7dec07.story [accessed 16 January 2004].