A JAMA journal has quickly issued a correction for a 2016 paper after the author failed to mention several relevant conflicts of interest. Normally, we’d see this as a run-of-the-mill correction notice, but since we reported last week that a journal retracted a paper for omitting pharma funding, we got to wondering: Is failure to disclose a conflict of interest a retractable offense?
Guidelines from the Committee on Publication Ethics (COPE) do say that retractions are used for “failure to disclose a major competing interest likely to influence interpretations or recommendations.” But most of the time when we see corrections to the literature for such omissions, they’re corrections, not retractions.
On Friday, JAMA Ophthalmology issued a correction notice for an invited commentary published in April, which addressed two papers in the journal about melanoma of the eye (uveal melanoma). However, the original commentary failed to note that author Arun D. Singh at the Cleveland Clinic had some relevant conflicts to mention, as the notice explains:
To the Editor I am writing to report that I had failed to declare several conflicts of interest relevant to the subject of my Invited Commentary1 on 2 studies on gene expression profiles for uveal melanoma.2,3 In January 2016, I participated in a uveal melanoma meeting hosted by Castle Biosciences as a member of the Castle Biosciences Advisory Board, for which I received compensation. I also have received compensation for my role as an advisory board member of Aura Biosciences and Iconic Therapeutics related to investigations of novel therapies for primary uveal melanoma. I also have a pending patent application for a risk calculator of vision loss following brachytherapy.
Although “Prognostication of Uveal Melanoma: A Work in Progress” was corrected, another journal recently retracted a paper about a crow’s feet filler after learning the authors did not disclose that it was funded by a pharmaceutical company that produces the cosmetic.
Granted, the melanoma commentary was not an original research paper, and the retracted crow’s feet paper was a phase 3 trial of the cosmetic — but both papers had potential health implications. So when is retraction necessary? Tell us what you think in the poll, below.
[polldaddy poll=9466292]
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I do not think this survey question is adequately primed for this particular issue, as the question itself and the spectrum of potential answers are too narrow.
Regarding the question itself: If I’m correct, we are supposed to interpret it as a no-if-ands-or-buts scenario. That is, a journal must (or must not) retract if any author omits any relevant conflict of interest. While all authors are supposed to have equal input in a published piece, some authors (notably the first and senior authors) have greater sway over the manuscript, how the findings are framed, etc., etc. Does an omission of a conflict of interest from a first or senior author weigh as much as an omission from someone who is more secondary? I would say “no,” but your survey question assumes otherwise, and there’s not room to express that disagreement.
Onto the answer set: We have three options, and “yes” (that any omission of conflict of interest should yield a retraction) is the only unambiguous option. But what does “no” mean? Does that the omission should have no role in deciding to retract a piece? Does that mean it can be grounds for retraction and requires further deliberation? Or, does it mean that it can be a reason to retract but only if another separate concern is raised (such as adding authors who contributed very little to the manuscript)? And then we have the bizarre answer of yes, but only if there are potential health impacts. I know that this entry focuses on a biomedical piece, but what about papers that may have educational, political, or economic impacts? Is this question only concerned with biomedical/public health scholarship?
If you’re curious, I would say that omission of a conflict of interest is deserving of investigation and that a one-size-fits-all rule should not be applied. Not all omissions are of equal significance (depending on the author and/or the conflicting relationship), and the findings may still be valuable. Plus, we can’t immediately conclude that all omissions are malicious.
I agree with the above. Well written.
I also agree. I found the ambiguity to be anxiety-provoking.
Why wouldn’t conflicts of interest be weighed more heavily for first and senior authors? Malicious or not, omissions neglect to give the reader all the information that may have influenced the work, and consequently, the interpretation of the work by the reader. You may not have malicious intent when you run the red light but you still get the ticket.
CoIs affect the review of a paper by editors and reviewers alike. Many papers that are accepted might have been rejected had the CoI been disclosed.
CoIs alert the reviewers/editors to potential bias.
If an undisclosed CoI is noted the editors MUST carefully RE-evaluate every line in the paper for bias that may have influenced the writing, conclusions or review of the manuscript.
If there is a whiff of bias the paper MUST be retracted.
In this day not disclosing CoI is as bad as many forms of misconduct (self-plagiarism [lazy], p-hacking, selective use of data, creative throwing out of outliers) that should get your paper retracted.
Yes, yank it—what was the author trying to hide??!!!
I can’t answer “yes” or “no” to your survey because I think it doesn’t ask the right question. I think the question should be, “Should the phrase ‘Conflicts of Interest’ disclosures be replaced with the phrase ‘Areas of Financial Interest” disclosures?
I’ve co-authored medical journal publications with physicians and researchers. When it came time to gather the COI statements, there were things that I thought should have been disclosed, but weren’t. (example: I generate a substantial income as an expert witness on this subject and publishing this paper is likely to bring me more clients!)
It wasn’t an intentional unethical act that my co-authors balked at certain financial disclosures. It was that the term “Conflicts of Interest” is offense to authors. It infers that if publication authors have received any income from the subject of which they are writing, it presents a conflict that makes their writing questionable — which is not true in most cases.
Most researchers and physicians are experts in a subject directly because it is part of their work by which they generate their income. They don’t always see this as a “conflict” and thus don’t always disclose financial interest in the subject, as they possibly should.
If the phrase “Conflicts of Interest” disclosures was replaced with “Areas of Financial Interest” disclosures, I think it would encourage more disclosures of author-funding, without the author being made to feel that what he or she is disclosing is an unethical “conflict”.
We have seen too many instances where the author or authors of medical articles are either being paid directly, or that a part of their income derives from the subject matter they are writing about. More often than not the authors are paid 100’s of thousands of dollars by industry to pen articles that put a certain industry in a positive light. How can this type of science be trusted, if the authors do not reveal their potential conflict of interests on the front end thereby letting the reader know whether or not the author has a potential bias? Moreover, many times these “so-called” unbiased articles are used in the legal setting. If lawyers have to reveal any potential conflicts of interest they may have, then why shouldn’t the scientists who are writing these articles be held to the same standard ?
1) Remember that even ‘academic’ researchers are not exempt from ‘bias’ if they receive any kind of research support whether it is funding/infrastructure/equipment/students etc. Everybody may have something to gain and it does not have to be just money.
2) All research should be reviewed carefully and scrutinized to an equal extent. Limit your reviews to 10-20 high-quality reviews per year and treat them equally.
3). In the end, if the data checks out and later reproduced, the ‘bias’ may not matter. Nowadays, registration of clinical trials (clinicaltrial.gov) and data repositories are often mandated.
So – it appears that retracting important work for bias when the science checks out may be a knee jerk reaction. It appears that reviewing NIH-funded papers with less scrutiny than industry-sponsored papers is naive (and inappropriate?).