Post-publication evaluation and manufacturer information
Case text (Anonymised)
An online post-publication literature evaluation service, aiming to highlight the best papers in medicine, received an evaluation of a cost effectiveness study assessing a new therapy. The evaluator quoted estimated amounts of cost saved when using the new therapy compared with other therapies, naming the manufacturer of the new therapy. The evaluator declared in his/her competing interests that s/he had “received honoraria, financial support and […] been on several advisory boards” for the company that developed the therapy, mentioning the company name. Whether the evaluator was involved in the development of the therapy in question is unknown.
The editor presented the case in an editorial meeting, raising the following potential points of concern:
(1) Does inclusion of manufacturer information, a practice that is quite common in research articles to identify specific devices, become a form of advertising when appearing in a post-publication evaluation?
(2) Is it permissible to mention amounts of cost saved if quoting directly from the study or does that again amount to advertising?
(3) Can we accept this evaluation considering the evaluator’s involvement with the manufacturer?
The meeting made the following decisions:
In answer to (1), the meeting considered that it definitely felt awkward and clearly unnecessary to include the manufacturer’s information in the comments. It was therefore taken out.
In answer to (2), as the relevant statements merely paraphrased the study’s findings, they were considered acceptable.
In answer to (3), as competing interests were declared, the meeting felt that the evaluation should be accepted.
Questions we didn’t consider at the time but have since asked ourselves:
(4) Should we have asked if the evaluator was involved in the study itself and should this information have been included in the competing interests declaration?
(5) Does naming the manufacturer in the competing interests declaration amount to advertising? Should it therefore only have said “received honoraria from the therapy’s manufacturer”, not including the name?
Would COPE suggest a different course of action and how would COPE answer the subsequent two questions?
The committee agreed that it was best to find out the exact involvement of the author with the company and with the development of the therapy. The author’s involvement should be transparent. If there is a conflict of interest, it might be worth discovering whether it is a personal/specific or non-personal/non-specific conflict. If the latter, a conflict of interest statement should be published and the author allowed to publish the review. However, if the conflict of interest is personal/specific, the author should not be allowed to publish the review. The committee questioned the purpose of the review in the first instance as the reviewer is clearly not independent. The committee felt that it was imperative for the reviewer to publish the conflict of interest statement and so allow readers to make up their own minds.
After further investigation by the editor, it was discovered that the evaluator's conflicts of interest were too great, leading to rejection of the review on the basis of bias.