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Why Focus Only on Financial Interests?

Acquavella, John F.

doi: 10.1097/01.ede.0000198180.42227.a1

From Amgen, Global Epidemiology, Thousand Oaks, CA.

Correspondence: John F. Acquavella, Amgen, Global Epidemiology, One Amgen Center Drive, Mail Stop 24-1-C, Thousand Oaks, CA 91320-1799. E-mail:

This commentary reflects the personal views of the author and was not subject to review or approval by his employer.

In 1995, the founding editor of Epidemiology wrote: “The objectivity of the [scientific] process depends on each contribution receiving its due regard, whatever the motivations for bringing it. It depends on judging a work on its merits, rather than on the inferred state of mind of the author.”1

This principle guided the journal's early operations. Epidemiology instituted blind peer review to ensure, to the extent possible, that authors’ affiliations would not influence the evaluation of their submissions. This put all submissions on an equal footing and ensured a diversity of views on important issues. Authors were required only to list employer and funding source, but no other declarations were required.

The proposed financial-only disclosure policy2 will change the very fabric of the journal. It will likely reduce submissions from authors who would be required to disclose perhaps extensive financial details, and it will also make it more difficult for many readers to objectively review papers by authors who have disclosed interests. Such a fundamental change begs for a detailed rationale and explanation of what the editors hope to accomplish. Is disclosure meant to alert readers to possible fraudulent submissions or, instead, to warn of subtle influences on authors’ analyses and interpretations of study results? What exactly is the evidence that “financial interests can corrupt the integrity of the scientific process” to an extent greater than other interests?

A unique aspect of the policy is that it requires disclosure for authors and reviewers alike. How or when such disclosure would occur for reviewers is unclear and requires more specification. On the face of it, this policy change seems likely to selectively narrow the ranks of reviewers to exclude those with financial interests.

Why focus only on financial interests? Sure, there is the tobacco industry, but there have also been instances of fraud in academia. One does not implement policy based on outliers. The editors’ statement that “Conflicts of interest can affect many stages of data collection and analysis” is not specific to financial interests. Indeed, Horton,3 as editor of The Lancet, labeled as fallacious the view that financial interests cause the most concern. No one has marshaled evidence that financial interests are more influential than, say, strong ideologic beliefs (eg, social or environmental activism).

Interests are frequently symmetric. To give one obvious example: for every epidemiologist who testifies on behalf of industry in a toxic tort case, there is an epidemiologist who testifies on behalf of the plaintiff. Is the latter devoid of interests worth disclosing? The policy encourages voluntary disclosures, but disclosures of such nonfinancial interests are very rare. To differentiate financial interests as worthy of disclosure is making a subjective value judgment unless there is evidence that such interests are uniquely worthy of concern. If we are introspective, it likely reflects a preference (a bias) among interests, not a search for objectivity.

The potential consequences of financial-only disclosure have received little attention. It is axiomatic that readers would find it difficult to be objective in the face of prejudicial information. Other negative consequences include: stifling criticism (which must be labeled as coming from someone who has an admitted conflict of interest), redirecting publications to journals without disclosure policies (reducing the range of views available to readers), discouraging financial support for research (due to concern that eventual publications will not get a fair hearing), and making collaborations between scientists with competing interests less likely. We should be supporting epidemiologists who work honorably with industry funding, many of whom have unrestricted publication clauses in their research contracts. The proposed policy reflects badly on them.

Is there value to disclosure of financial interests? Again, there is no evidence. Do readers tend to react like Raveendran and Gitanjali4 and stigmatize work affiliated with financial interests: “The credibility rating [of a paper] goes down when a project is funded by a drug company that has an interest in its outcome”3; or is there some beneficial use of the disclosed information? Horton's view is that disclosure does not heal the “wound” inflicted by financial or other interests.3

There is value for Epidemiology to remain different from the major clinical journals that have adopted financial disclosure policies. The journal's focus should be on science and methodology—where most readers are experts—and not on prejudicial information that is almost always of limited relevance. That would provide readers with a unique opportunity these days: to judge each paper on its merits rather than on the inferred state of mind of the author.1

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Elizabeth Delzell provided helpful comments on an earlier draft of this commentary.

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JOHN ACQUAVELLA is Senior Director and Head of Global Epidemiology at Amgen, Inc. His research interests include pharmacoepidemiology and occupational and environmental epidemiology. He has adjunct professorships in epidemiology at the University of Massachusetts at Amherst School of Public Health and at the Arnold School of Public Health at the University of South Carolina, and he is President-Elect of the American College of Epidemiology. He has written previously on conflict of interest; see “The Politics of Identity in Epidemiology” (Annals Epidemiol. 1997;7:431–433).

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1. Rothman KJ. Conflict of interest. The new McCarthyism in science. JAMA. 1993;269:2782–2784.
2. Editors. Our policy on conflict of interest. Epidemiology. 2005;16:273–274.
3. Horton R. Conflicts of interest in clinical research: opprobrium of obsession? Lancet. 1997;349:1112–1113.
4. Raveendran R, Gitanjali B. Letter to the editor. Lancet. 1997;349:1173–1174.
© 2006 Lippincott Williams & Wilkins, Inc.