KEY TAKEAWAYS

• The accuracy of COI disclosures, including those in high-impact journals, remains questionable, despite adoption of the ICMJE disclosure form.
• Baraldi et al call for readers to compare COI disclosures in journals with payment data provided by the medical industry to prevent potential bias going unnoticed.

Conflict-of-interest (COI) disclosure is an important tool for identifying potential bias associated with medical research. Although efforts to improve COI disclosure have been made by various parties (including the US Government, The International Committee of Medical Journal Editors (ICMJE), and medical journals themselves), issues around transparent reporting remain.

To assess the scale of the problem in high-impact journals, Baraldi et al examined original clinical-trial research articles published in NEJM and JAMA in 2017, and compared physician-authors’ self-disclosures of general payments with their Open Payments data. The payments were categorised as ‘disclosed,’ ‘undisclosed,’ ‘indeterminate,’ or ‘unrelated’, per definitions based on the ICMJE form used by both journals:

• Disclosed: The author disclosed a payment from a company that matched the data from Open Payments.
• Undisclosed: The author received a payment during the relevant disclosure period that did not match any disclosures provided to the journal, AND the company offers, or offered at the time of the payment, a product that could broadly be considered related to the area of inquiry.
• Indeterminate: The author received a payment during the relevant disclosure period that did not match any disclosures provided to the journal, BUT the company was a subsidiary or parent company of a company listed on the disclosure, AND/OR it could not be determined whether that company offers, or offered at the time of the payment, a product that could broadly be considered related to the area of inquiry, AND/OR the payment has been disputed.
• Unrelated: The payment was not disclosed, AND the company from which the payment originated does not offer a product that could broadly be considered related to the area of inquiry.”

Thirty-one articles each from NEJM and JAMA met the study inclusion criteria, totalling 118 unique physician-authors. Of the 106 (90%) authors who received general payments, 86 (81%) received undisclosed payments, with 18 (21%) and 33 (38%) of those disclosing less than half and none of their payment amounts, respectively. No significant difference in COI disclosure rates was found between NEJM and JAMA authors.

Of the authors who received general payments, 86 (81%) received undisclosed payments, with 18 (21%) and 33 (38%) of those disclosing less than half and none of their payment amounts, respectively.

Baraldi et al concluded that self-disclosure of COIs is insufficient to ensure accurate reporting of potential bias, and call for readers to compare COI disclosures in journals with payment data provided by the medical industry.

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