Pharmonitor: Reality-Checking and Journalistic Integrity

Regular readers of Psychiatric Timesknow that we have been engaged in a comprehensive review of our “conflict of interest” (COI) and disclosure policies, which now include posted disclosure statements from all our editorial board members. So far as we are aware, Psychiatric Times is the only major psychiatric journal to require this of its editorial board, as well as of our regular writers.

But our readers are also sophisticated enough to know that such disclosures do not guarantee scientific or journalistic objectivity and accuracy. Indeed, there is an important sense in which arguments over COI policies miss the scientific point. The critical questions readers ought to be asking of scientific journals about a given article are:

• Was the article based on well-designed and appropriately analyzed studies?
• Did the authors have access to unpublished and perhaps “negative” studies bearing on the drug or drugs in question?
• Do the claims in the article comport with the best available data, or are they “spun” in a way that reflects bias?

I believe these are actually more important questions than those relating to the researcher’s or author’s “ties” to the pharmaceutical industry, although readers should be made aware of relevant commercial affiliations that could bear on the author’s objectivity.

In an important and provocative commentary, Drs Donald F. Klein and Ira D. Glick argue that “the complex COI issue cannot be dealt with by an editorial fix”^1(p3026) and that editors must make more concerted efforts to evaluate the raw data on which a study’s claims are based. In principle, I agree. But as Klein and Glick acknowledge, “many current articles far exceed the statistical capabilities of so-called peer reviewers (and the readers) . . . [and] how to meet the expenses of engaging expert statistical and scientific reviewers is certainly a problem.”^1(p3025) It is safe to say that no Editor-in-Chief, even one assisted by a full-time staff of biostatisticians, could possibly review and evaluate all the data behind every article that appears in the journal and still meet publication deadlines. We do not live in the “best of all possible worlds,” but in this all-too-imperfect one. And yet-as Klein and Glick correctly argue-scientific journals must do more to restore the public’s trust in medical science than merely publish COI disclosure statements.

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