Medical journals and industry ties.

The BMJ was one of the first medical journals to seek declarations of competing interests from authors. Our focus is on financial competing interests as we believe these to be the most identifiable. We do, however, understand that competing interests come in many forms and we also routinely ask authors to declare relevant non-financial competing interests. The governing principle has been that transparency is a panacea. We placed faith in this principle, but mounting experience and evidence tell us that we were only half right. Transparency remains essential, but it isn’t sufficient to eliminate bias or perception of bias. We believe this risk of bias is particularly important for clinical educational articles that are designed to guide patient care, when authors’ biases may be less visible to general medical readers. For some years we have sought to minimise as well as declare competing interests for these articles. Recently we introduced more active management of competing interests, requiring authors to complete a more detailed declaration and excluding authors with close ties. Now we have decided to go a step further, as heralded three years ago. From next year our clinical education articles will be authored by experts without financial ties to industry (box). By industry we mean companies producing drugs, devices, or tests; medical education companies; or other companies with an interest in the topic of the article. We are phasing in this policy to start with editorials, clinical reviews, and most practice series. We hope that by the end of 2016, this will have extended to the rest of our education section: our specialist state of the art reviews and diagnostics and therapeutics series. Shift in culture