Failure to Disclose Authors’ Financing Tightens JAMA Policies

By Mark Hoerrner

Everyone wants to trust their doctor, but what if the doctor has self-interests at heart rather than the interests of patients? That’s what the editors of the respected Journal of the American Medical Association, a peer-reviewed scholarly publication, want to avoid. JAMA staff recently revised their financial disclosure policy regarding pharmaceutical companies after receiving letters in response to a story published by a host of authors advocating the use of antidepressants for pregnant women. The authors all had financial ties to manufacturers of antidepressant medication; the lead author had more than eight ties to such firms.

"Because we've had some experience where it may not as clear to authors as it should be, we have tightened our conflict-of-interest statement," said Dr. Catherine D. DeAngelis, editor-in-chief of JAMA, in an interview with Forbes Magazine. "We want utmost transparency."

The new policy now requires that all authors reveal all financial connections, even if those connections do not directly deal with the subject discussed, with any company. Those financial concerns are to be discussed within the article and listed at the end of any article. For example, researchers looking at pain effects for geriatric patients must disclose any corporate connection to companies that manufacture products for pain or for geriatric individuals and must also indicate that they also receive money from alzheimer’s research and pregnancy-prevention companies, despite the unrelated nature.

Dr. Mark Fendrick is a professor of internal medicine at the University of Michigan School of Medicine in Ann Arbor.

"The earlier policies left some discretion for individuals to determine what was a 'relevant' conflict of interest," Fendrick told Forbes. "Given the multitude of examples where investigators and authors could not police themselves, I believe the new JAMA conflict-of-interest policy is unfortunately required."

The authors, however, took exception to the accusations that their research may have been skewed in favor of any particular drug company. They claimed that they held a high degree of impartiality because the study was funded by the National Institute of Mental Health and did not study any specific drug. However, they noted that they would abide by the Journal’s policy revision

"[G]iven the implications of these findings relating to potential antidepressant use during pregnancy," the authors wrote, "we regret that we failed to include disclosures of the financial associations of all of the authors. Such disclosures would have provided utmost transparency with respect to potential conflict of interest, and we wholeheartedly support such a practice.