Dr Pies responds
I am sure both of [our organizations] strongly support the ideals of full disclosure of conflict of interest and “transparency” in scientific journals. This, indeed, was the intention behind our recent disclosure policy at Psychiatric Times.
It is one thing for a journal like JAMA to “cast a wide net” and require disclosure information from authors extending back 5 years. It is quite another for an organization such as yours to single out specific editors-in-chief and their publications for what amounts to the not-very-subtle implication that we are somehow involved in undisclosed or inappropriate conflicts of interest that might bias the scientific content of our publications—and all this, without seeing fit to contact or distinguish the particular editors, with respect to their specific disclosures or potential conflicts of interest, if any.
Section II D of the International Committee of Medical Journal Editors (ICMJE) “Uniform Requirements for Manuscripts Submitted to Biomedical Journals” includes a statement on conflict of interest (COI): “Conflict of interest exists when an author (or the author’s institution), reviewer, or editor has financial or personal relationships that inappropriately influence (bias) his or her actions (such relationships are also known as dual commitments, competing interests, or competing loyalties). These relationships vary from those with negligible potential to those with great potential to influence judgment, and not all relationships represent true conflict of interest.”
Section II D 3 notes that “editors should publish regular disclosure statements about potential conflicts of interests related to the commitments of journal staff. . . .”
Knowing from our August 2008 Editorial (which you cited) that Psychiatric Times was in the process of posting updated disclosure information about its editorial board, the responsible action—rather than publishing innuendoes—would have been to check with me, and with the identified psychiatrists individually, to see if we were at present reporting potential or actual conflicts of interest; and then, making a professional determination as to whether any such conflicts represented ones with “negligible potential” or “greater potential” to influence our editorial judgment, consistent with ICMJE standards.
Otherwise, you are essentially arguing that there is no substantive difference, with respect to safeguarding the public interest, between, say, a physician who accepted two or three $500 speaking honoraria 3 years ago and none since; and a physician who, to this day, belongs to a drug company’s speakers bureau, receives regular stipends from that company, and holds substantial stock in it.
This sort of broad-brush approach to disclosure only tars reputations and does not serve the public interest, in my view. Furthermore, in my opinion, your failure to investigate these particulars does not reflect well on the “integrity” of your organization. Indeed, the conclusion reached in your article re: Psychiatric Times’ new disclosure policy strikes me as both misleading and cynical; ie, “the move only raises further questions about who is calling the shots at leading psychiatric journals.”
Surely, our policy does not “only” raise further questions—it also answers some, as regards our Board members and writers. Indeed, I would argue that our policy represents a significant step in the direction of “transparency,” and stands as an example of responsible practice for other professional journals. I would have thought that your conclusion that PT’s new disclosure policy “[elevates] your own publication’s standards . . .” and that “. . . it will pay dividends in the form of increased credibility in the years ahead” might have been reflected in the original announcement you ran. It puzzles and disturbs me that it was not.
I hope you will see fit to contact the other psychiatrists whose reputations you have impugned—esteemed colleagues and thoroughly decent professionals, all—to see if they wish to respond to your organization’s article. . . .
We support Dr Pies’s view that it is not appropriate to make statements about conflicts of interest based on incomplete and out-of-date information. One well-respected medical ethicist who reflected on the matter commented, “It is misleading to speak in the present tense about events that happened in the past, especially without a footnote explaining their process of attributing conflicts of interest.” As Dr Pies puts it, “misuse of the ‘look-back’ period is blatantly misleading to the general public—a curious position to be in an organization that casts itself in the role of guardian of the public interest and a paragon of ‘integrity.’”
Please e-mail us your comments at PTEdit@cmpmedica.com.
[*The link to one of the named editors (R.F.) brings up information about another person with a similar name.]