Conflicts of interest in biomedical publications: considerations for authors, peer reviewers, and editors

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.

Peer review ethics in Iranian LIS scholarly journals: a comparison between views of reviewers and authors

Peer review is one of the most efficient ways to ensure the quality of papers for possible publication in scholarly journals. However, the process of peer review is not free of bias and disorders. Many reviewers are unaware of how their attitudes towards the evaluation of scholarly papers may violate Peer Review Ethics (PRE). This paper attempts to analyze the different ethical issues influencing the job of reviewing. The research sample for this study included 7 Iranian library and information journals, 124 Iranian peer reviewers, and 34 authors. Peer reviewers and authors were asked to evaluate the most important ethical elements of peer review in Iranian LIS journals through two different questionnaires based on Rajabali Beglou et al. (2019) research. Findings showed that there was no difference among authors and reviewers in terms of gender in most PRE elements. Also, the level of experience of the authors was not significant in terms of understanding and acceptance of the PRE among reviewers and authors. However, review experiences regarding some PRE elements were significant in respondents’ viewpoints. The experiences reviewers had already gained were influential on their views about PRE. In addition, results showed that there were significant differences among reviewers and authors about the PRE elements in LIS journals. Authorship experiences had not effect on the PRE elements and the dual role of peer reviewing and authorship had no impact on their views.

PUBLONS BASED PROFILING OF TURKISH REVIEWERS AND ACADEMIC INSTITUTIONS

Introduction: Publons is the most prestigious and well-organized platform that allows to evaluate peer review metrics. It also provides publication and citation data as it is synchronized with the Web of Science. There are socio-cultural ties between Central Asian countries and Turkey, and these countries can take Turkey as a model for scientific development. Therefore, it will be useful for Central Asian countries to summarize Turkey's Publons activities. In this study, we used Publons database to list the top institutions, researchers and reviewers in Turkey. Methods: Publons database was used to export the data on October 10, 2021. The top 20 researchers were identified in terms of the number of verified reviews. Additionally, the top 20 institutions were determined in terms of the number of researchers, number of verified reviews and top reviewers. Results: On Publons, 57464 registered researchers from Turkey were found (ranked 7th) and 484 of these researchers had top reviewer status (ranked 16th). A total of 175644 verified reviews were detected from Turkey-based researchers (ranked 16th) and of which 45835 were performed in the last 12 months (ranked 14th). Based on the total number of researchers, four institutions from Turkey were in the top 100 in the world rankings (Hacettepe University, Istanbul Technical University, Istanbul University-Cerrahpasa, and Cukurova University). There were no institutions from Turkey among the top 100 in the lists created according to the number of verified reviews and top reviewers. Conclusion: Turkey has a considerable number of researchers registered with Publons. However, Turkey should follow a scientific route in terms of verified reviews. Turkey and Central Asian countries can create scientific collaborations and cooperative projects. Thus, Central Asian countries will benefit from Turkey's experiences.

Peer Reviewers in Central Asia: Publons Based Analysis

BACKGROUND

The five Central Asian republics comprise of Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan. Their research and publication activities are gradually improving but there is limited data on how good their peer reviewing practices are.

METHODS

We have use the Publons database to extract information on the reviewers registered including the number of verified review, Publons award winners, and top universities in the domain of peer reviewing. This has been analysed overall and country wise.

RESULTS

Of 15,764 researchers registered on Publons, only 370 (11.7%) have verified records of peer-reviewing. There are 8 Publons award winners. There is great heterogeneity in the number of active reviewers across the five countries. Kazakhstan and Uzbekistan account for more than 90% of verified reviewers. Only Kazakhstan has more than 100 active reviewers and 6 Publons award recipients. Amongst the top 20 reviewers from Central Asia, half of them are from the Nazarbayev University, Nur-Sultan, Kazakhstan. Three countries have less than 10 universities registered on Publons.

CONCLUSION

Central Asia has a good number of peer reviewers on Publons though only a minority of researchers are involved in peer reviewing. However, the heterogeneity between the nations can be best dealt with by promoting awareness and international networking including e-learning and mentoring programs.

Top Central Asian Educational Institutions on Publons: Analysis of Researchers and Reviewers

BACKGROUND

The Publons platform provides integrated information on researchers, peer reviewers, publications and certain author metrics. Central Asia is a potentially growing region in terms of young researchers.

METHODS

Using the inbuilt Publons search, the top institutes of nine countries of Central Asia and neighbours were identified and data on their reviewers, number of publications, number of peer reviews completed were extracted. These were compared with demographics of the countries such as population, gross domestic product, number of physicians and proportion of population enrolled for higher education.

RESULTS

Amongst the top 15 institutes in Central Asia, China has claim to 12 while Kazakhstan has two and Iran has one. The number of top peer reviewers, number of verified reviews and Web of Science indexed publications from these top institutes varied directly with the number of researchers each had. Afghanistan, Tajikistan and Turkmenistan are not performing well on most of these while China seems to be an outlier on the upper edge of the graphs. There is good correlation between the number of researchers in the top institutes per country and both number of publications and number of completed reviews. The number of total publications per top ten institutes of each country has high correlation with various demographic parameters like total population (Spearman rho, ρ = 0.85), gross domestic product (ρ = 0.82), total number of physicians (ρ = 0.72), and number enrolled for higher education (ρ = 0.93).

CONCLUSION

There appears to be much disparity among the rankings, number of researchers, reviewers and published manuscripts across various countries in Central Asia. The gross heterogeneity of Central Asia needs to be minimized by nurturing and mentoring potentially upcoming researchers in publication, peer reviewing as well as in ethics involved.

DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST IN BIOMEDICAL PUBLICATIONS IN VIEW OF THE INTERNATIONAL COMMITTEE OF MEDICAL JOURNAL EDITORS RECOMMENDATIONS

As potential conflicts of interest (COI) are common in biomedical research, handling related issues and managing disclosures is increasingly important. The International Committee of Medical Journal Editors (ICMJE) revised its guidance on COI in 2019 and introduced the latest version of the COI Disclosure Form in 2021. These documents provide guidance regarding COI policy for ICMJE member and non-member journals. The 2019 revision overviews the main changes in the ICMJE policy. The ICMJE prioritizes appropriate COI disclosures by authors and all others involved in scholarly publishing. Increasing the global awareness of the COI updated policies among all stakeholders is essential for strengthening ethical standing of journals.

Outcomes in VKA-treated patients with atrial fibrillation and chronic kidney disease: Clinical trials vs 'real-world'

BACKGROUND

Our objectives were to evaluate the risk of adverse events in a 'real-world' vs 'clinical trial' cohort of atrial fibrillation (AF) patients with chronic kidney disease (CKD).

METHODS

We studied patient-level data for vitamin K antagonist-treated AF patients with a creatinine clearance <60 mL/min from the Murcia AF Project and AMADEUS trial. The study end-points were ischaemic stroke, major bleeding, all-cause mortality, myocardial infarction and intracranial haemorrhage.

RESULTS

This study included 1,108 AF patients with CKD. The annual rate of the composite study outcome of ischaemic stroke, major bleeding and all-cause mortality was higher in the real-world (13.4%) vs AMADEUS (6.6%) cohort with an IRR of 2.04 (95% CI,1.34-3.09), P < .001. Individual annual rates of major bleeding, all-cause mortality and non-cardiovascular mortality were significantly greater in the real-world cohort. Similar findings were demonstrated even after multivariable adjustment, with the composite outcome HR of 2.85 (95% CI,1.74-4.66), P < .001. In a propensity score matched cohort, this risk remained significantly higher in the real-world cohort (IRR 2.95 [95% CI,1.03-10.28], P = .027), as did the risk of major bleeding and all-cause mortality.

CONCLUSION

Vitamin K antagonist-treated AF patients with CKD are exposed to significant annual rates of major adverse events including all-cause mortality. This risk may be under-appreciated in the idealised environment of randomised controlled trials.

Peer review guidance: a primer for researchers

The peer review process is essential for quality checks and validation of journal submissions. Although it has some limitations, including manipulations and biased and unfair evaluations, there is no other alternative to the system. Several peer review models are now practised, with public review being the most appropriate in view of the open science movement. Constructive reviewer comments are increasingly recognised as scholarly contributions which should meet certain ethics and reporting standards. The Publons platform, which is now part of the Web of Science Group (Clarivate Analytics), credits validated reviewer accomplishments and serves as an instrument for selecting and promoting the best reviewers. All authors with relevant profiles may act as reviewers. Adherence to research reporting standards and access to bibliographic databases are recommended to help reviewers draft evidence-based and detailed comments.

Conflicts of interest in clinical guidelines, advisory committee reports, opinion pieces, and narrative reviews: associations with recommendations

BACKGROUND

Treatment and diagnostic recommendations are often made in clinical guidelines, reports from advisory committee meetings, opinion pieces such as editorials, and narrative reviews. Quite often, the authors or members of advisory committees have industry ties or particular specialty interests which may impact on which interventions are recommended. Similarly, clinical guidelines and narrative reviews may be funded by industry sources resulting in conflicts of interest.

OBJECTIVES

To investigate to what degree financial and non-financial conflicts of interest are associated with favourable recommendations in clinical guidelines, advisory committee reports, opinion pieces, and narrative reviews.

SEARCH METHODS

We searched PubMed, Embase, and the Cochrane Methodology Register for studies published up to February 2020. We also searched reference lists of included studies, Web of Science for studies citing the included studies, and grey literature sources.

SELECTION CRITERIA

We included studies comparing the association between conflicts of interest and favourable recommendations of drugs or devices (e.g. recommending a particular drug) in clinical guidelines, advisory committee reports, opinion pieces, or narrative reviews.

DATA COLLECTION AND ANALYSIS

Two review authors independently included studies, extracted data, and assessed risk of bias. When a meta-analysis was considered meaningful to synthesise our findings, we used random-effects models to estimate risk ratios (RRs) with 95% confidence intervals (CIs), with RR > 1 indicating that documents (e.g. clinical guidelines) with conflicts of interest more often had favourable recommendations. We analysed associations for financial and non-financial conflicts of interest separately, and analysed the four types of documents both separately (pre-planned analyses) and combined (post hoc analysis).

MAIN RESULTS

We included 21 studies analysing 106 clinical guidelines, 1809 advisory committee reports, 340 opinion pieces, and 497 narrative reviews. We received unpublished data from 11 studies; eight full data sets and three summary data sets. Fifteen studies had a risk of confounding, as they compared documents that may differ in other aspects than conflicts of interest (e.g. documents on different drugs used for different populations). The associations between financial conflicts of interest and favourable recommendations were: clinical guidelines, RR: 1.26, 95% CI: 0.93 to 1.69 (four studies of 86 clinical guidelines); advisory committee reports, RR: 1.20, 95% CI: 0.99 to 1.45 (four studies of 629 advisory committee reports); opinion pieces, RR: 2.62, 95% CI: 0.91 to 7.55 (four studies of 284 opinion pieces); and narrative reviews, RR: 1.20, 95% CI: 0.97 to 1.49 (four studies of 457 narrative reviews). An analysis combining all four document types supported these findings (RR: 1.26, 95% CI: 1.09 to 1.44). One study investigating specialty interests found that the association between including radiologist guideline authors and recommending routine breast cancer screening was RR: 2.10, 95% CI: 0.92 to 4.77 (12 clinical guidelines).

AUTHORS' CONCLUSIONS

We interpret our findings to indicate that financial conflicts of interest are associated with favourable recommendations of drugs and devices in clinical guidelines, advisory committee reports, opinion pieces, and narrative reviews. However, we also stress risk of confounding in the included studies and the statistical imprecision of individual analyses of each document type. It is not certain whether non-financial conflicts of interest impact on recommendations.

Toxicological assessment of Tobacco Heating System 2.2: Findings from an independent peer review

Offering safer alternatives to cigarettes, such as e-cigarettes and heated tobacco products, to smokers who are not willing to quit could reduce the harm caused by smoking. Extensive and rigorous scientific studies are conducted to assess the relative risk of such potentially modified risk tobacco products compared with that of smoking cigarettes. In addition to the peer review of publications reporting individual studies, we aimed to gauge the plausibility of the evidence to the scientific community and appreciate likely necessary additions prior to regulatory submission. Therefore, we sponsored a two-tier peer review organized by an independent third party who identified, recruited, and managed 7 panels of 5-12 experts whose identity remains unknown to us. The reviewers had access to all publications and raw data from preclinical and clinical studies via a web portal. The reviewers were asked questions regarding study design, methods, quality of data, and interpretation of results to judge the validity of the conclusions regarding the relative effects of the Tobacco Heating System 2.2 compared with cigarettes. Once their conclusions were submitted, the experts had the opportunity to participate in an anonymized online debate with their fellow panel members. We present here the results obtained from this innovative peer review effort which revealed supportive or very supportive of the study methods and results, and support the robustness of the studies and validity of the conclusions.

Real-world Evidence versus Randomized Controlled Trial: Clinical Research Based on Electronic Medical Records

Real-world evidence (RWE) and randomized control trial (RCT) data are considered mutually complementary. However, compared with RCT, the outcomes of RWE continue to be assigned lower credibility. It must be emphasized that RWE research is a real-world practice that does not need to be executed as RCT research for it to be reliable. The advantages and disadvantages of RWE must be discerned clearly, and then the proper protocol can be planned from the beginning of the research to secure as many samples as possible. Attention must be paid to privacy protection. Moreover, bias can be reduced meaningfully by reducing the number of dropouts through detailed and meticulous data quality management. RCT research, characterized as having the highest reliability, and RWE research, which reflects the actual clinical aspects, can have a mutually supplementary relationship. Indeed, once this is proven, the two could comprise the most powerful evidence-based research method in medicine.

Rheumatology science and practice in India

The practice of rheumatology in a country like India presents its own unique challenges, including the need to manage patients in a cost-constrained setting, where the lack of uniform government funding for healthcare merits the need to optimize the use of cheaper medicines, as well as devise innovative strategies to minimize the use of costlier drugs such as biologic disease-modifying agents. Use of immunosuppressive agents is also associated with increased risks of infectious complications, such as the reactivation of tuberculosis. In this narrative review, we provide a flavor of such challenges unique to Rheumatology practice in India, and review the published literature on the management of common rheumatic diseases from India. In addition, we critically review existing guidelines for the management of rheumatic diseases from this part of the world. We also discuss infectious etiologies of rheumatic complaints, such as leprosy, tuberculosis, and Chikungunya arthritis, which are often encountered here, and pose a diagnostic as well as therapeutic challenge for clinicians. There remains a need to identify and test more cost-effective strategies for Indian patients with rheumatic diseases, as well as the requirement for more government participation to enhance scant facilities for the treatment of such diseases as well as foster the development of healthcare services such as specialist nurses, occupational therapists and physiotherapists to enable better management of these conditions.

Guidelines for management of rheumatic diseases in developing countries from basics to real-world situation: relevance, need, and processes for development

Guidelines or recommendations help to provide uniform standards in medical practice. The development of guidelines requires adherence to pre-defined norms prescribed by different international organizations such as the European League against Rheumatism (EULAR). We searched Pubmed and LILACS to identify published papers in five major rheumatic diseases (rheumatoid arthritis, systemic lupus erythematosus, spondyloarthropathies, osteoarthritis, and scleroderma) from different countries based on their economic prosperity and could find a lack of published literature from most economically weaker regions. Similarly, published guidelines in these rheumatic diseases were sparse from Asia and Africa, which are economically developed to a lesser extent than other regions of the world. Considering differing economic realities driving patient care in different regions of the world, unique challenges in certain geographic areas such as musculoskeletal manifestations of infectious diseases like leprosy and tuberculosis, as well as distinct risk of malignancies and other comorbid conditions, National Rheumatology societies should work towards developing more guidelines for rheumatic diseases from regions such as Asia and Africa, while following strictly the prescribed norms for the same. With a paucity of guidelines for such regions currently, an alternative (although less preferable) suggestion would be that major international societies, whose guidelines are widely read and followed the world over, should consider inputs from experts from diverse regions of the world while developing these guidelines.

Risk of bias assessment of randomised controlled trials in high-impact ophthalmology journals and general medical journals: a systematic review

Evidence-based treatments in ophthalmology are often based on the results of randomised controlled trials. Biased conclusions from randomised controlled trials may lead to inappropriate management recommendations. This systematic review investigates the prevalence of bias risk in randomised controlled trials published in high-impact ophthalmology journals and ophthalmology trials from general medical journals. Using Ovid MEDLINE, randomised controlled trials in the top 10 high-impact ophthalmology journals in 2015 were systematically identified and critically appraised for the prevalence of bias risk. Included randomised controlled trials were assessed in all domains of bias as defined by the Cochrane Collaboration. In addition, the prevalence of conflict of interest and industry sponsorship was investigated. A comparison with ophthalmology articles from high-impact general medical journals was performed. Of the 259 records that were screened from ophthalmology-specific journals, 119 trials met all inclusion criteria and were critically appraised. In total, 29.4% of domains had an unclear risk, 13.8% had a high risk and 56.8% had a low risk of bias. In comparison, ophthalmology articles from general medical journals had a lower prevalence of unclear risk (17.1%), higher prevalence of high risk (21.9%) and a higher prevalence of low risk domains (61.9%). Furthermore, 64.7% of critically appraised trials from ophthalmology-specific journals did not report any conflicts of interest, while 70.6% did not report an industry sponsor of their trial. In closing, it is essential that authors, peer reviewers and readers closely follow published risk of bias guidelines.

Improving the adaptability of WHO evidence-informed guidelines for nutrition actions: results of a mixed methods evaluation

BACKGROUND

Over the past decade, the World Health Organization (WHO) has implemented a standardized, evidence-informed guideline development process to assure technically sound and policy-relevant guidelines. This study is an independent evaluation of the adaptability of the guidelines produced by the Evidence and Programme Guidance unit, at the Department of Nutrition for Health and Development (NHD). The study systematizes the lessons learned by the NHD group at WHO.

METHODS

We used a mixed methods approach to determine the adaptability of the nutrition guidelines. Adaptability was defined as having two components; methodological quality and implementability of guidelines. Additionally, we gathered recommendations to improve future guideline development in nutrition actions for health and development. Data sources for this evaluation were official documentation and feedback (both qualitative and quantitative) from key stakeholders involved in the development of nutrition guidelines. The qualitative data was collected through a desk review and two waves of semi-structured interviews (n = 12) and was analyzed through axial coding. Guideline adaptability was assessed quantitatively using two standardized instruments completed by key stakeholders. The Appraisal Guideline for Research and Evaluation questionnaire, version II was used to assess guideline quality (n = 6), while implementability was assessed with the electronic version of the GuideLine Implementability Appraisal (n = 7).

RESULTS

The nutrition evidence-informed guideline development process has several strengths, among them are the appropriate management of conflicts of interest of guideline developers and the systematic use of high-quality evidence to inform the recommendations. These features contribute to increase the methodological quality of the guidelines. The key areas for improvement are the limited implementability of the recommendations, the lack of explicit and precise implementation advice in the guidelines and challenges related to collaborative work within interdisciplinary groups.

CONCLUSIONS

Overall, our study found that the nutrition evidence-informed guidelines are of good methodological quality but that the implementability requires improvement. The recommendations to improve guideline adaptability address the guideline content, the dynamics shaping interdisciplinary work, and actions for implementation feasibility. As WHO relies heavily on a standardized procedure to develop guidelines, the lessons learned may be applicable to guideline development across the organization and to other groups developing guidelines.

Industry sponsorship and research outcome

BACKGROUND

Clinical research affecting how doctors practice medicine is increasingly sponsored by companies that make drugs and medical devices. Previous systematic reviews have found that pharmaceutical-industry sponsored studies are more often favorable to the sponsor's product compared with studies with other sources of sponsorship. A similar association between sponsorship and outcomes have been found for device studies, but the body of evidence is not as strong as for sponsorship of drug studies. This review is an update of a previous Cochrane review and includes empirical studies on the association between sponsorship and research outcome.

OBJECTIVES

To investigate whether industry sponsored drug and device studies have more favorable outcomes and differ in risk of bias, compared with studies having other sources of sponsorship.

SEARCH METHODS

In this update we searched MEDLINE (2010 to February 2015), Embase (2010 to February 2015), the Cochrane Methodology Register (2015, Issue 2) and Web of Science (June 2015). In addition, we searched reference lists of included papers, previous systematic reviews and author files.

SELECTION CRITERIA

Cross-sectional studies, cohort studies, systematic reviews and meta-analyses that quantitatively compared primary research studies of drugs or medical devices sponsored by industry with studies with other sources of sponsorship. We had no language restrictions.

DATA COLLECTION AND ANALYSIS

Two assessors screened abstracts and identified and included relevant papers. Two assessors extracted data, and we contacted authors of included papers for additional unpublished data. Outcomes included favorable results, favorable conclusions, effect size, risk of bias and whether the conclusions agreed with the study results. Two assessors assessed risk of bias of included papers. We calculated pooled risk ratios (RR) for dichotomous data (with 95% confidence intervals (CIs)).

MAIN RESULTS

Twenty-seven new papers were included in this update and in total the review contains 75 included papers. Industry sponsored studies more often had favorable efficacy results, RR: 1.27 (95% CI: 1.17 to 1.37) (25 papers) (moderate quality evidence), similar harms results RR: 1.37 (95% CI: 0.64 to 2.93) (four papers) (very low quality evidence) and more often favorable conclusions RR: 1.34 (95% CI: 1.19 to 1.51) (29 papers) (low quality evidence) compared with non-industry sponsored studies. Nineteen papers reported on sponsorship and efficacy effect size, but could not be pooled due to differences in their reporting of data and the results were heterogeneous. We did not find a difference between drug and device studies in the association between sponsorship and conclusions (test for interaction, P = 0.98) (four papers). Comparing industry and non-industry sponsored studies, we did not find a difference in risk of bias from sequence generation, allocation concealment, follow-up and selective outcome reporting. However, industry sponsored studies more often had low risk of bias from blinding, RR: 1.25 (95% CI: 1.05 to 1.50) (13 papers), compared with non-industry sponsored studies. In industry sponsored studies, there was less agreement between the results and the conclusions than in non-industry sponsored studies, RR: 0.83 (95% CI: 0.70 to 0.98) (six papers).

AUTHORS' CONCLUSIONS

Sponsorship of drug and device studies by the manufacturing company leads to more favorable efficacy results and conclusions than sponsorship by other sources. Our analyses suggest the existence of an industry bias that cannot be explained by standard 'Risk of bias' assessments.

Statement on Publication Ethics for Editors and Publishers

The digitization and related developments in journal editing and publishing necessitate increasing the awareness of all stakeholders of science communication in the emerging global problems and possible solutions. Journal editors and publishers are frequently encountered with the fast-growing problems of authorship, conflicts of interest, peer review, research misconduct, unethical citations, and inappropriate journal impact metrics. While the number of erroneous and unethical research papers and wasteful, or 'predatory', journals is increasing exponentially, responsible editors are urged to 'clean' the literature by correcting or retracting related articles. Indexers are advised to implement measures for accepting truly influential and ethical journals and delisting sources with predatory publishing practices. Updating knowledge and skills of authors, editors and publishers, developing and endorsing recommendations of global editorial associations, and (re)drafting journal instructions can be viewed as potential tools for improving ethics of academic journals. The aim of this Statement is to increase awareness of all stakeholders of science communication of the emerging ethical issues in journal editing and publishing and initiate a campaign of upgrading and enforcing related journal instructions.

Randomized controlled trials - a matter of design

Randomized controlled trials (RCTs) are the hallmark of evidence-based medicine and form the basis for translating research data into clinical practice. This review summarizes commonly applied designs and quality indicators of RCTs to provide guidance in interpreting and critically evaluating clinical research data. It further reflects on the principle of equipoise and its practical applicability to clinical science with an emphasis on critical care and neurological research. We performed a review of educational material, review articles, methodological studies, and published clinical trials using the databases MEDLINE, PubMed, and ClinicalTrials.gov. The most relevant recommendations regarding design, conduction, and reporting of RCTs may include the following: 1) clinically relevant end points should be defined a priori, and an unbiased analysis and report of the study results should be warranted, 2) both significant and nonsignificant results should be objectively reported and published, 3) structured study design and performance as indicated in the Consolidated Standards of Reporting Trials statement should be employed as well as registration in a public trial database, 4) potential conflicts of interest and funding sources should be disclaimed in study report or publication, and 5) in the comparison of experimental treatment with standard care, preplanned interim analyses during an ongoing RCT can aid in maintaining clinical equipoise by assessing benefit, harm, or futility, thus allowing decision on continuation or termination of the trial.

Promoting Education Regarding Conflict of Interest Management

Even among highly educated health professionals, there is inconsistency in the knowledge and perception concerning both conflict of interest (COI) itself and COI disclosure. The key issue is the credibility of the manuscript, which relies heavily on transparency of COI for the reader. The tendency to disregard the importance of COI disclosure among journal editors has been recently highlighted. For all types of COI, the primary question is how it is managed. To ensure the enforcement of the declared journal COI policies, it is crucial that not only authors, but also those who are involved in the assessment of manuscripts, be educated and informed of the updated guidelines concerning COI disclosure.

Ensuring the Quality, Fairness, and Integrity of Journal Peer Review: A Possible Role of Editors

A growing body of literature has identified potential problems that can compromise the quality, fairness, and integrity of journal peer review, including inadequate review, inconsistent reviewer reports, reviewer biases, and ethical transgressions by reviewers. We examine the evidence concerning these problems and discuss proposed reforms, including double-blind and open review. Regardless of the outcome of additional research or attempts at reforming the system, it is clear that editors are the linchpin of peer review, since they make decisions that have a significant impact on the process and its outcome. We consider some of the steps editors should take to promote quality, fairness and integrity in different stages of the peer review process and make some recommendations for editorial conduct and decision-making.

Disclosure of Financial Conflicts of Interests in Interventions to Improve Child Psychosocial Health: A Cross-Sectional Study

Academic journals increasingly request a full disclosure of financial conflict of interest (CoI). The Committee for Publication Ethics provides editors with guidance about the course of action in the case of suspected non-disclosure. No prior study has examined the extent to which journal articles on psychosocial interventions disclose CoI, and how journal editors process requests to examine suspected undisclosed CoI. Four internationally disseminated psychosocial interventions were examined. 136 articles related to an intervention, co-authored by intervention developers and published in health sciences journals were retrieved as requiring a CoI statement. Two editors refused consent to be included in the study. COI disclosures and editor responses were coded for 134 articles. Overall, 92/134 (71%) of all articles were found to have absent, incomplete or partly misleading CoI disclosures. Disclosure rates for the four programs varied significantly between 11% and 73%. Journal editors were contacted about 92 published articles with no CoI disclosure or a disclosure that was considered problematic. In 65/92 (71%) of all cases the editors published an ‘erratum’ or ‘corrigendum’. In 16 of these cases the journal had mishandled a submitted disclosure. The most frequent reason for non-publication of an erratum was that the journal had no disclosure policy at the time of the publication (16 cases). Consumers of research on psychosocial interventions published in peer-reviewed journals cannot currently assume that CoI disclosures are adequate and complete. More efforts are needed to achieve transparency.

Essential Components of Educational Programs on Biomedical Writing, Editing, and Publishing

The primary objective of educational programs on biomedical writing, editing, and publishing is to nurture ethical skills among local and international researchers and editors from diverse professional backgrounds. The mechanics, essential components, and target outcomes of these programs are described in this article. The mechanics covers the objectives, design, benefits, duration, participants and qualifications, program formats, administrative issues, and mentorship. The essential components consist of three core schedules: Schedule I Basic aspects of biomedical writing, editing, and communications; Schedule II Essential skills in biomedical writing, editing, and publishing; and Schedule III Interactive lectures on relevant topics. The target outcomes of the programs comprise knowledge acquisition, skills development, paper write-up, and journal publication. These programs add to the prestige and academic standing of the host institutions.

Rewarding peer reviewers: maintaining the integrity of science communication

This article overviews currently available options for rewarding peer reviewers. Rewards and incentives may help maintain the quality and integrity of scholarly publications. Publishers around the world implemented a variety of financial and nonfinancial mechanisms for incentivizing their best reviewers. None of these is proved effective on its own. A strategy of combined rewards and credits for the reviewers1 creative contributions seems a workable solution. Opening access to reviews and assigning publication credits to the best reviews is one of the latest achievements of digitization. Reviews, posted on academic networking platforms, such as Publons, add to the transparency of the whole system of peer review. Reviewer credits, properly counted and displayed on individual digital profiles, help distinguish the best contributors, invite them to review and offer responsible editorial posts.

Safeguarding the integrity of science communication by restraining 'rational cheating' in peer review

Peer review is the pillar of the integrity of science communication. It is often beset with flaws as well as accusations of unreliability and lack of predictive validity. 'Rational cheating' by reviewers is a threat to the validity of peer review. It may diminish the value of good papers by unfavourable appraisals of the reviewers whose own works have lower scientific merits. This article analyzes the mechanics and defects of peer review and focuses on rational cheating in peer review, its implications, and options to restrain it.

Plagiarism in scientific research and publications and how to prevent it

Quality is assessed on the basis of adequate evidence, while best results of the research are accomplished through scientific knowledge. Information contained in a scientific work must always be based on scientific evidence. Guidelines for genuine scientific research should be designed based on real results. Dynamic research and use correct methods of scientific work must originate from everyday practice and the fundamentals of the research. The original work should have the proper data sources with clearly defined research goals, methods of operation which are acceptable for questions included in the study. When selecting the methods it is necessary to obtain the consent of the patients/respondents to provide data for execution of the project or so called informed consent. Only by the own efforts can be reached true results, from which can be drawn conclusions and which finally can give a valid scholarly commentary. Text may be copied from other sources, either in whole or in part and marked as a result of the other studies. For high-quality scientific work necessary are expertise and relevant scientific literature, mostly taken from publications that are stored in biomedical databases. These are scientific, professional and review articles, case reports of disease in physician practices, but the knowledge can also be acquired on scientific and expert lectures by renowned scientists. Form of text publications must meet standards on writing a paper. If the article has already been published in a scientific journal, the same article cannot be published in any other journal with a few minor adjustments, or without specifying the parts of the first article which is used in another article. Copyright infringement occurs when the author of a new article, with or without mentioning the author, uses a substantial portion of previously published articles, including past contributions in the first article. With the permission of the publisher and the author, another journal can re-publish the article already published. In that case, that is not plagiarism, because the journal states that the article was re-published with the permission of the journal in which the article is primarily released. The original can be only one, and the copy is a copy, and plagiarism is stolen copy. The aim of combating plagiarism is to improve the quality, to achieve satisfactory results and to compare the results of their own research, rather than copying the data from the results of other people's research. Copy leads to incorrect results. Nowadays the problem of plagiarism has become huge, or widespread and present in almost all spheres of human activity, particularly in science.

Scientific institutions and universities should have a center for surveillance, security, promotion and development of quality research. Establishment of rules and respect the rules of good practice are the obligations of each research institutions, universities and every individual researchers, regardless of which area of science is being investigated. There are misunderstandings and doubts about the criteria and standards for when and how to declare someone a plagiarist. European and World Association of Science Editors (EASE and WAME), and COPE - Committee on Publishing Ethics working on the precise definition of that institution or that the scientific committee may sanction when someone is proven plagiarism and familiarize the authors with the types of sanctions. The practice is to inform the editors about discovered plagiarism and articles are withdrawn from the database, while the authors are put on the so-called black list. So far this is the only way of preventing plagiarism, because there are no other sanctions.