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To the Editor: In their Special Communication, Dr Brennan and colleagues¹ have proposed policies to eliminate the conflicts of interest that create bias in medical decisions and threaten scientific integrity. However, incomplete safeguards that ignore important contributors to bias will never be effective.

This proposal focused solely on some conflicts of interest related to industry, ignoring other important factors that create bias. For example, scientific and educational meetings routinely require disclosure of conflicts related to industry but do not ask for disclosures related to clinical income or National Institutes of Health (NIH) grants, both of which are major factors for professional success and involve financial sums much greater than the small gifts that the authors strongly argue can influence the behavior of physicians and scientists. If small gifts can create bias, there may be an even greater effect from larger amounts of money from clinical income, NIH grants, advertisements in . . . [Full Text of this Article]

Kimford J. Meador, MD
kimford.meador@neurology.ufl.edu
McKnight Brain Institute
University of Florida
Gainesville

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