Conflict of Interest

[ICMJE Recommendations]

Public trust in the scientific process and the credibility of published articles depend, in part, on how transparently conflicts of interest are managed during the planning, implementation, writing, peer review, editing, and publication of scientific work. A conflict of interest exists when professional judgment concerning a primary interest (such as patient welfare or the validity of research) may be influenced by a secondary interest (such as financial gain). Perceptions of conflicts of interest are as important as actual conflicts.

Financial relationships (such as employment, consultancies, stock ownership or options, honoraria, patents, and paid expert testimony) are the most easily identifiable conflicts of interest and are most likely to undermine the credibility of the journal, the authors, and science itself. However, conflicts can also arise from other sources, such as personal relationships or rivalries, academic competition, and strong intellectual beliefs.

Authors should avoid entering into agreements with study sponsors—whether for-profit or nonprofit—that restrict their access to all of the study’s data or interfere with their ability to analyze and interpret the data, and to prepare and publish manuscripts independently, at a time and place of their choosing.

Participants

All participants in the peer-review and publication process—including authors, peer reviewers, editors, and editorial board members—must consider any potential conflicts of interest when fulfilling their roles. They are required to disclose all relationships that could be perceived as potential conflicts of interest.

Authors

When authors submit a manuscript of any type or format, they are responsible for disclosing all financial and personal relationships that could bias—or be perceived to bias—their work. The ICMJE has developed a Disclosure of Conflicts of Interest Form to facilitate and standardize authors’ disclosures. ICMJE member journals require authors to use this form, and ICMJE encourages other journals to adopt it as well.

Peer Reviewers

Reviewers should be asked, at the time they are invited to review a manuscript, whether they have any conflicts of interest that could affect their impartiality. Reviewers must disclose to the editors any conflicts that could bias their evaluation and should recuse themselves from reviewing specific manuscripts if a potential for bias exists. Additionally, reviewers must not use any knowledge gained through the review process—prior to the manuscript’s publication—for their own personal or professional advantage.

Editors and Journal Staff

Editors who make final decisions on manuscripts should recuse themselves from editorial decisions if they have conflicts of interest or relationships that present potential conflicts related to the articles under consideration. Other editorial staff involved in decision-making must provide the editors with an up-to-date disclosure of their financial interests or other conflicts that may influence their editorial judgment and must recuse themselves from decisions where such conflicts exist. Editorial staff must not use information obtained through handling manuscripts for personal gain. Editors should publish regular disclosure statements regarding any potential conflicts of interest related to the journal staff's responsibilities. Guest editors are expected to adhere to these same procedures.

Reporting Conflicts of Interest

Articles should be published with accompanying statements or supporting documents—such as the ICMJE Conflict of Interest form—declaring the following:

• Any conflicts of interest of the authors;
• All sources of support for the work, including the names of sponsors, along with a description of their role, if any, in the study design; data collection, analysis, and interpretation; writing of the report; and decision to submit the report for publication. Alternatively, a statement should be included declaring that the supporting source had no such involvement.
• Whether the authors had access to the study data, with details on the nature and extent of that access, including whether such access is ongoing.

To support these declarations, editors may require authors of studies sponsored by entities with a proprietary or financial interest in the outcome to sign a statement such as: “I had full access to all of the data in this study and take complete responsibility for the integrity of the data and the accuracy of the data analysis.”