May the colleague who truly has no conflict of interest now please stand up!

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

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 Arising from Simultaneous Service by Editors of Competing Journals or Publishers

In this day and age of challenging post-publication peer review and heightened academic scrutiny, editors serve an increasingly important role in screening submissions and managing the quality of information that is published in scholarly journals. Publishers compete for an intellectual market while commercial publishers compete for a commercial share of the market. The assumption argued in this perspective is that having editorial positions in competing journals or publishers (CJPs) may represent competing intellectual, professional and/or financial interests. Thus, based on this assumption, an editor would be expected to show loyalty to a single entity (journal or publisher). Editorial positions on the editorial boards of CJPs, as well as conflicts, financial or other, should be clearly indicated for all editors on the editorial board page of a journal’s website, for transparency. In science and academia, based on these arguments, the author is of the belief that editors should thus generally not serve on the editorial boards of CJPs, or only under limited and fully transparent conditions, even if they serve as editors voluntarily. The author recognizes that not all academics, including editors, might agree with this perspective, so a wider debate is encouraged.

Generating translatable evidence to improve patient care: the contribution of human factors

Generating translatable evidence to improve patient care has proved challenging in reproductive medicine, with many 'add-on' treatments in routine assisted conception clinical practice that have not been reliably tested. This has consequences for patient care; specifically, IVF pregnancy rates have not improved. A change of culture is required in our profession, from indiscriminately applying the latest 'add-on' to large-scale participation in generating reliable translatable evidence.

Research and business - the yin and yang in modern medicine

Yin and yang is a concept of dualism in Chinese philosophy, describing how opposite or contrary forces may be complementary, interconnected and interdependent, and how they may give rise to each other as they interrelate with one another. In line with this, modern clinical research and business can definitely be described as yin and yang. With the increasing need for funding, researchers at a very early stage during the development of a new concept may be forced or tempted to enter the business world. Furthermore, researchers are encouraged and supported by their own universities to collaborate with possible future business partners, not only to acquire funding, but also to explore potential patenting. This collaboration between the business world and research can definitely be very fruitful and provide benefit for both parties, patients and society as a whole, but it may also introduce the risk of premature materialization.