Conflict of interest
Case text (Anonymised)
After peer-review, a general medical journal published a household survey of violence following a coup against the country’s elected President. The survey revealed high levels of violence and human rights abuses, only a small minority of which were attributed to supporters of the deposed regime. The manuscript stated that none of the interviewers had political affiliations and the authors declared that they had no conflict of interest.
Within days of publication the Editor was contacted by an expatriate from the country and by a local aid worker who expressed incredulity over the fact that the findings attributed so little of the violence to supporters of the deposed President’s political party, It was also pointed out that one of the authors was acquainted with the deposed President and had previously published pieces under a different name which were supportive of him. Some of these pieces were cited in the manuscript.
The author admitted that she had done this and the co-author, her thesis supervisor, stated that he was aware of these facts and did not consider them a conflict of interest.
Not satisfied by the responses from the authors, the Editor asked the Dean of the authors’ institution to undertake an internal investigation to verify that the data had been coded accurately. Results are expected by the end of 2006.
This interesting case prompted much discussion. The committee felt that the conflict of interest should have been identified in the peer-review process and were surprised by the reviewers’ responses and their failure to pick up on the political bias. The committee agreed that the editor has a duty to his readers to inform them that an investigation is ongoing. He should tell his readers that there have been allegations made about the paper but that it is not possible to establish the truth as yet. Hence the advice was to issue a statement of concern in the journal or possibly write an editorial highlighting all sides of the issue.
Following discussion of the case, a statement was published in the journal, a summary of which is given below.
In response to credible allegations that one author’s former activities might constitute an undisclosed conflict of interest, the journal began an inquiry. The authors’ institution was asked to investigate the matter, and the issue was referred to the Committee on Publication Ethics (COPE).
The institution audited 100 questionnaires selected by computerised randomisation. Outcome details on the original handwritten records corresponded with the project’s computerised database. The overall distribution of rapes and murders were re-analysed according to alleged perpetrators, and the results agreed with the published findings. Outcomes were then compared by political affiliation of the interviewer and for the author’s own data (as an interviewer). Again, there was no evidence of systematic bias. On the basis of this investigation, the journal has confidence in the authors’ findings as published.
COPE recommended that readers should be made aware that the author had published as a reporter under another name, and that failure to disclose a separate name, under which relevant material had been published and cited in her paper, constitutes an undeclared conflict of interest. The journal’s position on transparent disclosure of potential conflicts of interest is in accordance with guidelines established by the International Committee of Medical Journal Editors. The journal has made this position prominently available to readers and to authors, and stated clearly that incomplete disclosures will be amended in a published statement in the Department of Error section, which will also be linked electronically to the publication in electronic databases. Such a correction for this study appears in today’s journal.
To realise their full potential to benefit populations, research findings must influence practice. Intelligent debate is part of that process. The journal encourages genuine debate, and will always consider seriously allegations of scientific misconduct. It is unfortunate, however, that in this case much of the debate was aimed at exploiting historical divisions in the country in question. That process has obscured the message of the authors’research and detracted from the real issue—the welfare of civilians in that country—to whom attention should now turn.