Disclosing conflicts of interest to maintain ethical integrity.

Throughout the year, I receive questions from our Editorial Board members, reviewers, and authors about conflict of interest (COI) and disclosure—what it means, how comprehensive it should be, and how it impacts the validity of a study. Concerns arise on many fronts, from the impartiality (or lack thereof) of authors who submit a study about a product in which they are somehow invested to the role of industry sponsorship in the supplements we publish periodically as a companion to the main journal. This topic certainly warrants further discussion because the COI inherent in any kind of academic study can impact our ability to write, review, edit, and read the results without bias. However, if the potential predispositions are clearly outlined from the start, we can weigh their impact against the science itself and arrive at a fair conclusion about each article. What Exactly is a conflict of intErEst? First of all, allow me to define COI as it pertains to academic publishing. The World Association of Medical Editors (WAME), in its policy statement titled " Conflict of Interest in Peer Reviewed Medical Journals, " says the following: " In the context of medical publishing, COI exists when a participant in the publication process (author, peer reviewer, or editor) has a competing interest that could unduly influence (or be reasonably seen to do so) his or her responsibilities in the publication process. Among those responsibilities are academic honesty, unbiased conduct and reporting of research, and integrity of decisions or judgments. " 1 Although we most commonly think of COI as being financial, " competing interests " can also mean academic affiliations (ie, an editor is in the author's department and, despite the peer review process being blind, recognizes his or her colleague's work) or professional beliefs (ie, a reviewer passionately believes that his or her method of open rhinoplasty is superior to the author's description of a closed technique and therefore would not evaluate the results impartially). With respect to financial COI, the ties can be direct or indirect. If an author is a paid or unpaid investigator, a member of the speakers bureau, or a stockholder in the company whose product is being described in his or her article, there is a direct financial COI. Likewise, a reviewer or editor who is a beneficiary of the company (or, conversely , a competing company) would have a direct COI for that …