Non-financial Conflicts Of Interest Research Articles

Atopic Dermatitis (Eczema) Guidelines 2023: Highlights

Atopic Dermatitis (AD) is one of the most common chronic inflammatory skin disorders with a complex pathogenesis. AD is characterized by eczematous skin lesions, pruritus, and recurrent skin infections; with negative impact on patients (and caregivers) quality of life.The American Academy of Allergy, Asthma and Immunology (AAAAI)/American College of Allergy, Asthma and Immunology (ACAAI) Joint Task Force (JTF) Atopic Dermatitis Guideline Panel recently released updated AD guidelines. This guideline focuses on addressing clinical questions using trustworthy guideline development standards, including mitigating the potential influence of financial and non-financial conflicts of interest, and GRADE methodology. A multidisciplinary panel used systematic reviews and meta-analyses to inform specific recommendations addressing optimal use of (1) topical treatments, (2) dilute bleach bath, (3) dietary avoidance/elimination, (4) allergen immunotherapy and (5) systemic treatments. The comprehensive recommendations, emphasizing the third principle of evidence-based medicine - that evidence alone is never enough; that patient values and preferences must be carefully considered when determining optimal treatments for patients and populations - provide a framework to support clinicians in selecting an optimal treatment plan for each patient.This review provides an overview of the guideline and discusses how those recommendations relate to current practice.

Perspectives on non-financial conflicts of interest in health-related journals: A scoping review

ABSTRACT The objective of this scoping review was to systematically review the literature on how non-financial conflicts of interest (nfCOI) are defined and evaluated, and the strategies suggested for their management in health-related and biomedical journals. PubMed, Embase, Scopus and Web of Science were searched for peer reviewed studies published in English between 1970 and December 2023 that addressed at least one of the following: the definition, evaluation, or management of non-financial conflicts of interest. From 658 studies, 190 studies were included in the review. nfCOI were discussed most commonly in empirical (22%; 42/190), theoretical (15%; 29/190) and “other” studies (18%; 34/190) – including commentary, perspective, and opinion articles. nfCOI were addressed frequently in the research domain (36%; 68/190), publication domain (29%; 55/190) and clinical practice domain (17%; 32/190). Attitudes toward nfCOI and their management were divided into two distinct groups. The first larger group claimed that nfCOI were problematic and required some form of management, whereas the second group argued that nfCOI were not problematic, and therefore, did not require management. Despite ongoing debates about the nature, definition, and management of nfCOI, many articles included in this review agreed that serious consideration needs to be given to the prevalence, impact and optimal mitigation of non-financial COI.

Conflicts of Interest in Radiology Publishing

Lack of disclosure of Conflicts of Interest (COI) in radiology research can undermine trust in medical recommendations and patient care. A recent study found significant discrepancies between disclosed COIs and those listed in the Open Payments Database (OPD). This commentary discusses the importance of transparency in financial and nonfinancial COIs, the implications of undisclosed COIs on research integrity and clinical decision-making, and the challenges and controversies surrounding current disclosure practices. The field of radiology should discuss and update COI management and ethical standards, for more practical accountability in radiology publishing.

Surviving Sepsis Campaign.

Surviving Sepsis Campaign.

Evaluation of Financial and Nonfinancial Conflicts of Interest and Quality of Evidence Underlying Psoriatic Arthritis Clinical Practice Guidelines: Analysis of Personal Payments From Pharmaceutical Companies and Authors' Self-Citation Rate in Japan and the United States.

To assess financial conflicts of interest (COI) and nonfinancial COI among psoriatic arthritis (PsA) clinical practice guideline (CPG) authors in Japan and the US, and to evaluate the quality of evidence and strength of recommendations of PsA CPGs. We performed a retrospective analysis using payment data from major Japanese pharmaceutical companies and the US Open Payments Database from 2016 to 2018. All authors of PsA CPGs issued by the Japanese Dermatological Association (JDA) and American College of Rheumatology (ACR) were included. Of 23 CPG authors in Japan, 21 (91.3%) received at least 1 payment, with a combined total of $3,335,413 between 2016 and 2018. Regarding 25 US authors, 21 (84.0%) received at least 1 payment, with a combined total of $4,081,629 during the same period. The 3-year combined mean± SD payment per author was $145,018 ± $114,302 in Japan and $162,825 ± $259,670 in the US. A total of 18 authors (78.3%) of the JDA PsA CPG and 12 authors (48.0%) of the ACR PsA CPG had undisclosed financial COI worth $474,663 and $218,501, respectively. The percentage of citations with at least 1 CPG author relative to total citations was 3.4% in Japan and 33.6% in the US. In sum, 71.4% and 88.8% of recommendations for PsA in the JDA and ACR were supported by low or very low quality of evidence. More rigorous cross-checking of information disclosed by pharmaceutical companies and self-reported by physicians and more stringent and transparent COI policies are necessary.

Debate: We need data infrastructure as well as data sharing - conflicts of interest in video game research.

Industry data sharing has the potential to revolutionise evidence on video gaming and mental health, as well as a host of other critical topics. However, collaborative data sharing agreements between academics and industry partners may also afford industry enormous power in steering the development of this evidence base. In this paper, we outline how nonfinancial conflicts of interest may emerge when industry share data with academics. We then go on to describe ways in which such conflicts may affect the quality of the evidence base. Finally, we suggest strategies for mitigating this impact and preserving research independence. We focus on the development of data infrastructure: technological, social, and educational architecture that facilitates unfettered and free access to the kinds of high-quality data that industry hold, but without industry involvement.

Education: Retinal racemose hemangioma arteriovenous malformation investigations, clinical course and management.

The authors report no financial or nonfinancial conflicts of interest that are directly or indirectly related to this manuscript.

Evaluation of Conflicts of Interest among Participants of the Japanese Nephrology Clinical Practice Guideline.

Rigorous and transparent management strategies for conflicts of interest and clinical practice guidelines with the best available evidence are necessary for the development of nephrology guidelines. However, there was no study assessing financial and nonfinancial conflicts of interest, quality of evidence underlying the Japanese guidelines for CKD, and conflict of interest policies for guideline development. This cross-sectional study examined financial and nonfinancial conflicts of interest among all 142 authors of CKD guidelines issued by the Japanese Society of Nephrology using a personal payment database from all 92 major Japanese pharmaceutical companies between 2016 and 2019 and self-citations by guideline authors. Also, the quality of evidence and strength of recommendations underlying the guidelines and conflicts of interest policies of Japanese, US, and European nephrology societies were evaluated. Among 142 authors, 125 authors (88%) received $6,742,889 in personal payments from 56 pharmaceutical companies between 2016 and 2019. Four-year combined median payment per author was $8258 (interquartile range, $2230‒$51,617). The amounts of payments and proportion of guideline authors with payments remained stable during and after guideline development. The chairperson, vice chairperson, and group leaders received higher personal payments than other guideline authors. Of 861 references in the guidelines, 69 (8%) references were self-cited by the guideline authors, and 76% of the recommendations were on the basis of low or very low quality of evidence. There were no fully rigorous and transparent conflicts of interest policies for nephrology guideline authors in the United States, Europe, and Japan. Most of the Japanese CKD guideline recommendations were on the basis of low quality of evidence by the guideline authors tied with pharmaceutical companies, suggesting the need for better financial conflicts of interest management.

PERSONAL CONFLICTS OF INTEREST IN THE PUBLISHING ENTERPRISE: FOCUS ON JOURNAL EDITORS

Editors play a central role and form an essential link in the publication process. Consequently, they hold considerable influence as to how the literature is molded, and what eventually gets published. In addition to their standard editorial responsibilities, holding that amount of power, editors have extremely high responsibilities to declare any conflicts of interest (COIs) internal to, and external to, the peer review process, particularly those involving personal relationships and networks. This is because they also exist in the peer community, can be high-profile public figures, and form a very unique and restricted – in terms of size, membership and exclusivity – set of individuals. Consequently, editors need to declare their COIs openly, transparently, and publicly on their editor board profiles, and as part of their curriculum vitae. Without such declarations, the greater risk is that editors might have unregulated freedom to enforce their own individual or group biases, through hidden relationships and networks, including the possibility of hiding instances of favoritism, cronyism and nepotism. In the worst-case scenario, this might reflect editorial corruption. Hidden COIs in authors, which tend to be the focus of the academic publishing establishment, including in codes of conduct and ethical guidelines such as those by COPE and the ICMJE, tend to down-play editorial COIs, or restrict them to scrutiny during the peer review process. This opinion piece examines whether there is a systemic problem with under-reported editorial COIs, particularly personal and non-financial COIs, that extend beyond the peer review process and their editorial positions. Greater awareness, debate, and education of this issue are needed.

Watching the watchers: A report on the disclosure of potential conflicts of interest by editors and editorial board members of dental journals.

Reporting potential conflicts of interest (COIs) by all parties involved in the publication process is of pivotal importance to increase trust in research. The present study assessed the disclosure of potential COIs of editors and editorial board members of high-ranked dental journals. From 28 April 2021 to 05 May 2021, the websites of 91 dental journals classified by impact factor (IF) were scrutinized to obtain information on the reporting of COI forms of editors and board members, and whether these individuals reported their detailed curriculum vitae (CV). The COI forms were assessed to understand the potential financial and non-financial COIs of editors and board members. Only 11 (12.1%) journals reported COI forms of editors-in-chief (EICs) and associate editors (AEs). No journal reported a COI form of the editorial board members. Of the 100 editors (EICs plus AEs), 25 (25.%) declared connections to for-profit organisations, and seven (7%) to not-for-profit organisations. Five (5%) editors (all AEs) reported non-financial COIs, and 35 (35%) editors reported nothing to declare. Nine (9.9%) journals reported a short CV of editors, which were not informative regarding potential COIs. Editors and editorial board members of high-ranked dental journals should report in more detail their potential COIs.

Nonfinancial conflict of interest in peer-review: Some notes for discussion

ABSTRACT Strong beliefs can influence the way we deal with emotionally charged topics. Researchers, editors, and reviewers are not an exception. Declaring such nonfinancial conflict of interest when handling or reviewing submitted articles is often obligatory; however, the declaration is not a license to submit a biased review with personal insults or to break the journal’s guidelines. This kind of poor practice can be a clear sign of the seriousness of conflict of interest. In this article, I argue that hostile, unethical, and biased behavior of reviewers and editors often arises from a serious nonfinancial conflict of interest, which should not be ignored or undermined.

Expanding Conflicts of Interest in Public Health Research

Expanding Conflicts of Interest in Public Health Research

Adherence to conflicts of interest policy in Cochrane reviews where authors are also editorial board members: A cross-sectional analysis.

Cochrane devolves most editorial governance of the Cochrane Database of Systematic Reviews (CDSR), including title prioritization, protocol registration, peer-review, editorial oversight and subsequent review deposition, to specific Cochrane Review Group (CRG) editorial boards. Current Cochrane policy stipulates authors of reviews who are also members of the supporting CRG declare this non-financial conflict of interest and confirm no involvement in the review editorial process. The aim of this cross-sectional analysis was to assess adherence to Cochrane's editorial conflict of interest policy. All 260 published Cochrane reviews (CR) in issues 1 to 6 from 2019 of the CDSR were reviewed. A total of 133 (51.2%, 133/260) of CRs had at least one author that was also listed as an editor in the CRG. Of these, only five (3.8%, 5/133) appropriately declared the conflict according to Cochrane policy. In 6.5% (17/133) CRs, the contact author had a leading editorial position within the CRG and in only four of 17 was this declared according to Cochrane policy. No CR with the contact author who also had a leading editorial position described methods to prevent any potential issues related to this scenario during the editorial process in accordance with Cochrane policy. We propose a specific form to improve the transparency and reliability of editorial conflict of interest reporting in CRs. The suggested form can be adapted to other contexts.

Sales Representatives in the Operating Room: Conflict of Interest or Clinical Support?

The Physician Payment Sunshine Act, which became federal law in January 2012, mandated that medical device manufacturers must disclose any financial support provided to individual physicians on a publicly available Web site. The law reflects increasing concern about physician-industry relationships. The connection between surgeon and sales representative creates possibilities for both financial and non-financial conflicts of interest (COIs). Indeed, COIs may be inherent when a sales representative is motivated by profit while also serving a critical role in many surgeries. The potential benefits and risks for patients, who may not even be aware of the sales representative's presence in the operating room, must be considered. This paper adds to the national discussion about neurosurgical physician-industry conflicts of interests and the issues relative to sales representatives in the operating room.

A Politics of Objectivity: Biomedicine's Attempts to Grapple with "non-financial" Conflicts of Interest.

Increasingly, policymakers within biomedicine argue that "non-financial" interests should be given equal scrutiny to individuals' financial relationships with industry. Problematized as "non-financial conflicts of interest," interests, ranging from intellectual commitments to personal beliefs, are managed through disclosure, restrictions on participation, and recusal where necessary. "Non-financial" interests, though vaguely and variably defined, are characterized as important influences on judgment and thus, are considered risks to scientific objectivity. This article explores the ways that "non-financial interests" have been constructed as an ethical problem and the implications for research integrity. I conducted an interpretive, qualitative study, which triangulated two data sources: documents (including published accounts of identifying and managing "non-financial" interests and conflict of interest policies) and in-depth interviews with 16 leaders within evidence-based medicine, responsible for contributing to, directing, or overseeing conflict of interest policy development and implementation. This article outlines how evolutions in the definition of conflict of interest have opened the door to include myriad "non-financial" interests, resulting in the generalisation of a statistical concept-risk of bias-to social contexts. Consequently, biases appear equally pervasive among participants while in reality, a politics of objectivity is at play, with allegations of conflict of interest used as a means to undermine others' credibility, or even participation. Iterations of the concept of conflict of interest within biomedicine have thus consistently failed to articulate or address questions of accountability including whose interests are able to dominate or distort evidence-led processes and why. Consequently, current policy solutions meant to mitigate bias may instead serve exclusionary purposes under the guise of impartiality while remaining vulnerable to interference from powerful stakeholders.

Community and informal care providers at the heart of universal health coverage in sub-saharan africa: A position paper

Globally, increased demand on often scarce healthcare resources and those challenges incumbent in responding to the coexistence of infectious and non-communicable diseases warrant the need to address persistent health inequities. Understanding the complex intersectionality of vulnerability and reaching those in most critical need of healthcare lies at the heart of fostering and sustaining resilient healthcare systems. Harnessing the long-recognised value of Community and Informal Care Providers (CICPs) is instrumental to Universal Health Coverage (UHC). The present COVID-19 context serves as a poignant example of where access to formal healthcare services by many has become increasingly difficult. Here, the value of informal or volunteer-led health services has been a lifeline for many. For several decades, formal reportage has evidenced the established role of CICPs, particularly across Sub-Saharan Africa with quantifiable efficacy across a number of domains, such as, maternal and child health, neglected tropical disease prevention, tuberculosis care and malaria control. CICPs have been sustainable and effective as a conduit between the formal and informal health sectors, and between health facilities and the remotest of communities. Maximising the function of CICPs relies on socio-culturally, geographically sensitive, and bespoke support; psychosocial, practical, and logistical capacitation coupled with situationally and culturally appropriate monitoring and evaluation. The Astana Declaration highlights the centrality of building on existing knowledge, insight and resource. We therefore argue that CICPs are indispensable in Africa’s move towards UHC, and hold promise for acceptable, accessible, affordable, and quality healthcare to everyone who needs to get, be and stay healthy. Source of funding: The WHO African Regional Office and Hidayo Noguchi African Prize (HNAP) for Medical Services sponsored the processing fee for this article. Conflict of interest statement: The authors declare no financial or non-financial conflicts of interest. Acknowledgments: The authors acknowledge the mentorship of Professor Margaret Gyapong, Director of the Institute of Health Research, University of Health and Allied Sciences, Ghana. Authors’ contributions: EK contributed to the body of the essay and managed correspondences with the mentor and WHO African Regional Office; ELM wrote the outline, abstract and introduction of the essay; BOO made contributions to the body of the essay, wrote the conclusion and compiled the first complete draft; and MAK contributed to the body of the essay.

Ethical Dilemmas in Nonprofit Governance: ARNOVA Governance Section Case Studies for Use in the Classroom and Practitioner Training

The three case studies presented in this issue continues the exploration of contemporary ethical dilemmas in nonprofit governance authored by members of the Governance Section of the Association for Research on Nonprofit Organizations and Voluntary Associations (ARNOVA). In the first two case studies in this series, published in recent issues of the Journal of Nonprofit Education and Leadership, Ruth Bernstein and Toni Aspin explore the challenges of governance when a nonprofit must consider compromising organizational values to provide services to a vulnerable population. In an examination of the collapse of a $40 million nonprofit agency, Yvonne Cafik Harrison considers a failure of board governance to protect critical constituencies and the very existence of the organization. The cases below expand the conversation regarding ethics and nonprofit governance. First, Jeff Aulgur considers the ethical challenges in contemporary presidential searches at public institutions of higher education. His exploration of the University of South Carolina System’s search for a new president in 2019 applies Karl Weick’s theory of sensemaking in organizations to nonprofit governance. Next, Dean Black, through the lens of a networked membership organization, discusses the ethical questions raised by non-financial conflicts of interest and how such disputes may damage a nonprofit’s reputation and legitimacy. In the last case, Louise Coventry explores the efficacy of the universal application of governance best practices and how scholars and practitioners must consider cultural boundaries and cultural appropriateness.

Reply to: Beyond Money: Conscientious Objection in Medicine as a Conflict of Interests.

Giubilini and Savulescu in their recent Journal of Bioethical Inquiry symposium article presented an account of conscientious objection that argues for its recognition as a non-financial conflict of interest. In this short commentary, I highlight some problems with their account. First, I discuss their solicitor analogy. Second, I discuss some problems surrounding their objectivity claim about standards of medical care. Next, I discuss some issues arising from consistently applying their approach. Finally, I highlight that conscientious objection should be viewed not as a conflict of interest but as something that society has an interest in preserving. I conclude by arguing that clinicians who have a conscientious objection can be treated in the same way as those who decide to subspecialize and do not need to give up work in their specialty. While Giubilini and Savulescu present an interesting argument about conscientious objection, theirs is not a compelling view. Indeed, the way we approach conscientious objection has more to teach us about conflicts of interest than the other way around.

Non-financial conflict of interest in social intervention trials and systematic reviews: An analysis of the issues with case studies and proposals for management

Research suggests that effect sizes are larger when program developers conduct studies compared to independent researchers. This is sometimes attributed to biases linked to conflicts of interest (CoI). While potential financial CoI is often acknowledged, non-financial CoI is more subtle, rarely reported and just as likely to lead to biased results. This paper highlights key arguments about non-financial CoI in the field of social and behavioral intervention research. It presents three cases studies of widely-disseminated child and family interventions which have been the subject of critical appraisals and debates related to potential non-financial CoI as a source of bias. The case studies illustrate how evidence appraisal can differ depending on the independence of the appraisers and how this may affect decisions around what is considered ‘good’ evidence. The case studies highlight the complex issues involved in trying to substantiate non-financial CoI, the unsatisfactory and fragmented ways that it is currently addressed, and the need for improved guidance to prevent and redress it.

The Policies for the Disclosure of Funding and Conflict of Interest in Surgery Journals: A Cross-Sectional Survey.

Industry through its funding of research and through its relationships with study authors can influence the results of research. Most journals have policies for reporting funding and disclosing conflict of interest (COI) to mitigate the influence of industry on research. The objective of this study is to assess the policies of surgery journals for the reporting of funding and the disclosure of COI. We described the prevalence and characteristics of funding and COI policies of journals indexed under "Surgery" in the Journal Citation Reports. We extracted data from publicly available information and through simulation of manuscript submission. Of the 186 eligible journals, 171 (92%) had policies for reporting of funding. None of the policies described procedures to deal with non-reporting or underreporting of funding. Of the 186 journals, 183 (99%) had a policy for disclosure of COI. All journals with a COI policy required disclosure of financial interest, while 96 (52%) required the disclosure of non-financial interests. Only 24 (13%) policies described how non-disclosure of COI affects the editorial process, and none described procedures to verify COI disclosure. Of the policies that required disclosing COI, 94 (51%) also required reporting the source of financial COI. Most journals have policies for reporting of funding and disclosure of financial COI. However, many do not have clear policies for disclosing non-financial COI. Major limitations in the policies include the lack of processes for the verification of disclosed interests and for dealing with underreporting of funding and of COI.