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  Vol. 296 No. 2, July 12, 2006 TABLE OF CONTENTS
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Update on JAMA's Conflict of Interest Policy

Annette Flanagin, RN, MA; Phil B. Fontanarosa, MD, MBA; Catherine D. DeAngelis, MD, MPH

JAMA. 2006;296:220-221.

Since the mid-1980s, JAMA and other medical journals have encouraged authors to disclose conflicts of interest that they may have in the subject matter of their manuscripts.1 In 1989, JAMA began requiring authors to sign a statement declaring all potential financial conflicts of interest and began including all such disclosures in published articles.2 Since that time, the journal's conflict of interest policy has continued to evolve with the goal of improving disclosures and transparency for all involved.3-4 For example, the policy applies to all types of manuscripts, including letters and book reviews, and to all individuals involved in the review, editorial evaluation, and publication process, including peer reviewers, editorial board members, and editors. Most recently, JAMA began requiring authors to specifically indicate if they have no conflicts of interest in the subject matter of their manuscript.4 The International Committee of Medical Journal Editors (ICMJE),5 the Council of Science Editors (CSE),6 and the World Association of Medical Editors (WAME)7 have similar policies.

However, biomedical journals have a wide range of conflict of interest policies (eg, some request disclosures, some require disclosures, and some publish disclosures and some do not).8-9 Journals also define relevant conflicts of interest in different terms to include financial and nonfinancial conflicts or only financial interests, and for financial interests, may define relevance in different monetary amounts or lengths of time. Perhaps because of these different policies, some authors may not fully understand JAMA's requirements for reporting potential conflicts of interest and might not fully disclose their conflicts of interest to JAMA at the time they submit their manuscripts. For example, some authors completely disclose all relevant conflicts of interest in the submitted manuscript, whereas other authors disclose relevant interests in a cover letter or only in the authorship form. The result is an inconsistent approach whereby for some authors, the disclosure is completely transparent to all involved in the manuscript evaluation process, including peer reviewers; but for other authors, the disclosure is made public only at the time of publication. In addition, some authors continue to misunderstand what is expected and provide inaccurate or incomplete disclosures that are discovered after publication and result in a published correction or letter of explanation.10-14

To further improve the transparency of reporting of potential conflicts of interest and to encourage more accurate and complete disclosures, an important new policy is that JAMA will begin requiring all authors to disclose all potential conflicts of interest in the Acknowledgment section of the manuscript at the time of submission. This includes specific financial interests and relationships and affiliations relevant to the subject of the manuscript. Between now and the end of 2006, JAMA will permit submissions of manuscripts in which authors' conflict of interest information is not yet included in the manuscript, but with the understanding that this information will be obtained and submitted promptly—and definitely before any revisions are considered. Beginning January 2007, JAMA will require that complete disclosures of conflicts of interest from all authors, including declaration of no conflicts of interest, are included in the Acknowledgment section of the manuscript. JAMA's Web-based manuscript submission system will require the corresponding author to indicate that this information is included in the manuscript at the time of submission. Authors will continue to complete and sign an authorship responsibility form that includes statements on conflict of interest as well as funding and support.

Conflicts of interest in biomedical science continue to be under intense and increasing scrutiny. To help ensure transparency and complete reporting of this information, JAMA's policies on conflicts of interest have been updated (as noted below).15 All authors are encouraged to read these policies carefully and to follow them completely. By doing so, peer reviewers and editors can expect full disclosure of potential conflicts of interest in manuscripts submitted to JAMA, and physicians, other health care professionals, and the public can expect complete reporting of conflict of interest information in articles published in JAMA.

JAMA Conflict of Interest Policy

"A conflict of interest may exist when an author (or the author's institution or employer) has financial or personal relationships or affiliations that could influence (or bias) the author's decisions, work, or manuscript. All authors are required to disclose all potential conflicts of interest, including specific financial interests and relationships and affiliations (other than those affiliations listed in the title page of the manuscript) relevant to the subject of their manuscript. Authors should err on the side of full disclosure and should contact the editorial office if they have questions or concerns.

All such disclosures should be listed in the Acknowledgment section at the end of the manuscript. Authors without conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject of their manuscript, should include a statement of no such interests in the Acknowledgment section of the manuscript. Failure to include this information in the manuscript may delay evaluation and review of the manuscript.

Authors are expected to provide detailed information about all relevant financial interests and relationships or financial conflicts within the past 5 years and for the foreseeable future (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), particularly those present at the time the research was conducted and through publication, as well as other financial interests (such as patent applications in preparation) that represent potential future financial gain. Although many universities and other institutions have established policies and thresholds for reporting financial interests and other conflicts of interest, JAMA requires complete disclosure of all relevant financial relationships and potential financial conflicts of interest, regardless of amount or value. For example, authors of a manuscript about hypertension should report all financial relationships they have with all manufacturers of products used in the management of hypertension, not only those relationships with companies whose specific products are mentioned in the manuscript. If authors are uncertain about what constitutes a relevant financial interest or relationship, they should contact the editorial office.

For all accepted manuscripts, each author's disclosures of conflicts of interest and relevant financial interests and affiliations and declarations of no such interests will be published. Decisions about whether such information provided by authors should be published, and thereby disclosed to readers, are usually straightforward. Although editors are willing to discuss disclosure of specific conflicts of interest with authors, JAMA's policy is one of complete disclosure of all potential conflicts of interest, including specific financial interests and relationships and affiliations (other than those affiliations listed in the title page of the manuscript) relevant to the subject of their manuscript. The policy requesting disclosure of conflicts of interest applies for all manuscript submissions, including letters to the editor and book reviews. If an author's disclosure of potential conflict of interest is determined to be inaccurate or incomplete after publication, a correction will be published to rectify the original published disclosure statement.

Authors also are required to report detailed information regarding all financial and material support for the research and work, including but not limited to grant support, funding sources, and provision of equipment and supplies in the Acknowledgment section of the manuscript.

All authors must also complete and sign a statement on financial disclosures, funding, and support that is part of the Authorship Form."


AUTHOR INFORMATION

Financial Disclosures: None reported.

Editorials represent the opinions of the authors and JAMA and not those of the American Medical Association.

Author Affiliations: Ms Flanagin (annette.flanagin{at}jama-archives.org) is Managing Deputy Editor, Dr Fontanarosa is Executive Deputy Editor, and Dr DeAngelis is Editor in Chief, JAMA.


REFERENCES

1. Lundberg GD, Flanagin A. New requirements for authors: signed statements of authorship responsibility and financial disclosure. JAMA. 1989;262:2003-2004. FULL TEXT | ISI | PUBMED
2. Rennie D, Flanagin A, Glass RM. Conflicts of interest in the publication of science. JAMA. 1991;266:266-267. FULL TEXT | PUBMED
3. DeAngelis CD, Fontanarosa PB, Flanagin A. Reporting financial conflicts of interest and relationships between investigators and research sponsors. JAMA. 2001;286:89-91. FREE FULL TEXT
4. Fontanarosa PB, Flanagin A, DeAngelis CD. Reporting conflicts of interest, financial aspects of research, and role of sponsors in funded studies. JAMA. 2005;294:110-111. FREE FULL TEXT
5. International Committee of Medical Journal Editors. Uniform requirements for manuscripts submitted to biomedical journals: updated October 2005. http://www.icmje.org. Accessibility verified June 15, 2006.
6. Council of Science Editors. Conflicts of interest and the peer review process. http://www.councilscienceeditors.org/services/draft_approved.cfm. Accessibility verified June 15, 2006.
7. World Association of Medical Editors. WAME recommendations on publication ethics policies for medical journals. http://www.wame.org/pubethicrecom.htm. Accessibility verified June 15, 2006.
8. Krimsky S, Rothenberg LS. Conflict of interest policies in science and medical journals: editorial practices and author disclosures. Sci Eng Ethics. 2001;7:205-218. ISI | PUBMED
9. Ancker J, Flanagin A. A comparison of conflict of interest policies at peer-reviewed journals in multiple scientific disciplines. Paper presented at: The Fifth International Congress on Peer Review and Biomedical Publication; September 17, 2005; Chicago, Ill. http://www.ama-assn.org/public/peer/program.html. Accessed June 13, 2006.
10. Incorrect statements on funding/support and role of the sponsors and incorrect and incomplete financial disclosures [published correction online May 16, 2006]. JAMA. 2006;295:2482. http://jama.ama-assn.org/cgi/content/full/295/21/2482-c. Accessed June 13, 2006.
11. Ridker PM. Incomplete financial disclosure for study of funding and outcomes in major cardiovascular trials [letter]. JAMA. 2006;295:2725-2726. FREE FULL TEXT
12. Incomplete financial disclosure [correction]. JAMA. 2006;295:2726. FREE FULL TEXT
13. Cohen LS, Nonacs R, Viguera AC, et al. Antidepressant treatment and relapse of depression during pregnancy [letter]. JAMA. 2006;296:165-167. FREE FULL TEXT
14. Incomplete financial disclosure [correction]. JAMA. 2006;296:170. FREE FULL TEXT
15. Instructions for authors. JAMA. 2006;296:107-116.


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