Steven Vlad

In going through the NY Times this evening (July 23, 2006) I ran across the following editorial: ‘Our Conflicted Medical Journals‘.

Now, I completely agree that conflicts of interest between article authors and drug/device manufacturers may be a big problem. I certainly agree that the example they cite of a journal editor publishing one of his studies in his own journal and failing to mention that 8 if 9 articles had received fees from the device manufacturer was pretty egregious and should be unacceptable.

But hold on a minute:

If they cannot stop printing articles by scientists with close ties to these businesses, they should at least force the authors to disclose their conflicts of interest publicly so that doctors and patients are forewarned that the interpretations may be biased.

Exactly how is a medical journal supposed to do that? The Times suggests that journals simply refuse to publish an author again if he/she fails to disclose relevant conflicts of interest. This is a nice idea, but probably not practical.

There are too many journals. One can’t expect each journal to keep track of every author every other journal has banned. If an author gets banned at one he’ll simply go elsewhere.

Conflicts of interest are a problem. They should not be ignored, and authors should agree to disclose any and all conflicts, whether they feel they are relevant to the article at hand or not.

But I think the Times does medical journals and their editors a disservice in suggesting that they are somehow to blame, as a group, for the unethical behavior of some authors. And that’s certainly how this editorial comes off. Medical journals are trying to address this problem and it will get better in the future. But it does not have an easy solution and the Times should not pretend it does