Journal guidelines and author position weren’t associated with self-reporting of financial interests; however, dollars received had a significant effect. Photo: Getty Images.

Transparency in clinical trials is vital to ensure the accuracy and neutrality of the studies and their results. Medical researchers who publish their work in a journal are required to disclose financial relationships involving companies they mention in the article; however, a recent study found that in ophthalmology journals, the majority of clinical researchers fail to self-report their conflicts of interest.

The study group evaluated articles from several prestigious ophthalmology journals including Ophthalmology, JAMA Ophthalmology, American Journal of Ophthalmology and Investigative Ophthalmology & Visual Science. Self-reported relationships were defined in the study as the companies listed in the article’s conflict of interest disclosures. That data was then compared with Open Payments Database (OPD)-reported relationships, defined as the list of companies that reported payments to the author within 36 months before submission. The main outcome measure was the proportion of authors who reported none of their OPD-reported relationships. The term “authorship” was used by the researchers to assess cases when an author published multiple articles.

Of the 660 total authorships (486 unique authors), a sizable 63% reported none of their OPD-reported relationships, 17% reported some and only 1% reported all. The remaining 19% had no conflicts of interest to disclose.

Authors who received more money during the reporting period were more likely to self-report financial relationships, which the researchers noted is consistent with previous study findings. Author position and self-reporting had no association.

Although the researchers hypothesized that self-reporting would be higher in journals with more stringent policies for disclosing conflicts of interest, they found that this wasn’t necessarily the case. “The proportion of authorships who self-reported none of their relationships was not significantly different between journals that require reporting of all relationships compared with journals that only require reporting of relevant relationships (adjusted percentage: 61.4% vs. 64.3%),” they wrote in their paper on the study.

The researchers proposed several reasons why authors may fail to report a financial relationship, one being that they might consider the relationship to be irrelevant to their research. “Some journals instruct authors to disclose only ‘relevant’ relationships, imposing a subjective decision on the author to determine when relevancy is strong enough to warrant reporting,” the researchers wrote. “Authors may also omit reporting a relationship because they judge that relationship to be insignificant in terms of type or value.” Another explanation for the low self-reporting rate is that authors could be unaware of payments listed in the OPD.

To ensure we can accurately interpret clinical studies, the researchers argued that steps must be taken to help increase self-reporting of conflicts of interest. In addition to a consistent guideline for disclosure among journals, they suggested the idea that publications could move away from self-reporting altogether and rely solely on the OPD. “Industry reporting may be more reliable than author self-reporting, as reflected by the high number of relationships reported in the OPD that are omitted by authors,” they wrote.

The researchers concluded, “Incomplete self-reporting in ophthalmology research gives the impression of lack of transparency and undermines confidence in the objectivity of ophthalmology research findings. Investigators registered in the OPD would be well-advised to be aware of the content of their OPD entries and to consider this content when self-reporting financial relationships in research manuscripts.”