Endocrinol Nutr. 2014;61(9):443---444

ENDOCRINOLOGÍA Y NUTRICIÓN

www.elsevier.es/endo

EDITORIAL

There is no bubble, but there are conflicts ofinterests. Efforts to improve the credibility of thescientific process�

La burbuja no existe, los conflictos de intereses sí. Esfuerzos para mejorarla credibilidad del proceso científico

Albert Lecube, Irene Halperin, Didac Mauricio

Endocrinología y Nutrición Editors

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Received 26 September 2014; accepted 29 September 2014

There is no doubt that in current society it is impossible tolive, and even work less, inside a bubble that protects usfrom any external influence. And since the scientific pro-cess is based on trust and credibility, biomedical journalsshould use the statement of potential conflicts of inter-est (CoIs) to guarantee process transparency.1,2 Languageis rich, and conflicts are diverse, and CoIs are therefore alsoknown as competitive loyalties, opposing interests, or dualcommitments. Despite the negative connotations apparentlyassociated to statements of CoIs, they are an indispensabletool which not only does not impair, but may also reinforcethe prestige of those who declare them.

According to the International Committee of MedicalJournal Editors (ICMJE), there is a CoI when an author (orhis/her center), a reviewer, or an editor has a financialor personal relationship, or a competition in the academic orintellectual passion setting that unduly influences his/heractions. CoIs may lead to bias in study design, analysisand/or interpretation.3 It is therefore clear that statement

of CoIs affects all people involved in the editorial process,not only the author.4---6 Noncompliance with this respon-sibility has shaken the confidence of the general public,

� Please cite this article as: Lecube A, Halperin I, Mauricio D. Laburbuja no existe, los conflictos de intereses sí. Esfuerzos paramejorar la credibilidad del proceso científico. Endocrinol Nutr.2014;61:443-444.

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2173-5093/© 2014 SEEN. Published by Elsevier España, S.L.U. All rights r

ealthcare professionals, and scientists in the medical liter-ture published in peer-reviewed journals.4---6 It should alsoe noted that the CoI exists regardless of whether or not anndividual thinks that such relations affect his/her scientificudgment.

Statement of CoIs has been considered essential to guar-ntee the credibility of the scientific process in the past5 years.4---6 However, medical journals do not still addressystematic and uniform statement of CoIs. A relevant partf the excellence process undertaken years ago by the dif-erent editors of Endocrinología y Nutrición is clarificationf the policy on CoIs.

A problem that hinders standardization of CoIs is thatournals usually have different rules regarding their decla-ation, which may cause confusion and increase skepticismn readers who find different information on the same authorepending on the journal.7 Among the recent efforts tomprove the quality of the scientific process, use of uni-orm tools to declare CoIs, so that each author has a singleonsistent document that may be updated over time, hasecome especially popular.2,8 Thus, the ICMJE proposed inctober 2009 use of a common instrument to report CoIs.his is a complex and detailed electronic form with vari-us sections. Potential CoIs related to the work submitted,

hich are described within an indefinite time frame, arerst addressed. Potential general CoIs in the last 3 yearsre then addressed, even if they have no direct relation-hip to the current work. Other significant areas include

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he potential financial relations of relatives and any possibleon-financial CoIs (academic competition, etc.). There arepecific sections to declare financial contributions receivedy researchers either directly or through their institutions.ncome should be declared irrespective of the amount.

The final idea is to facilitate the editorial process, toake it more reproducible and systematic, and to avoid

nconsistencies in reporting of CoIs.2,8

The main limitation of this approach is that importance ofhe truly relevant CoIs (those of interest for both editors andeaders) may be diluted in a long list that does not affect theesearch made in any way. In addition, routine publicationf all potential CoIs of all authors may consume too muchditorial resources and occupy a substantial space in theournal. This is why not all CoIs reported by the authors arenally published. The final decision is the responsibility ofditors, who decide when the potential CoIs are relevant fordequate evaluation of an article and when they should beublished to be known by the readers.3

Statement of CoIs, as previously discussed, not onlyffects authors, but also reviewers and editors themselves.hus, there is still a long and difficult way ahead. Resultsf a survey that focused on national cardiovascular jour-als of the European Society of Cardiology show that onlyne-fourth of the journals have policies regarding CoIs ofeviewers, and that half of them only ask reviewers toefuse the invitation if any potential CoI exists.2 Exclu-ion of reviewers secondary to the existence of CoIs is veryncommon. Finally, more than 80% of the journals have noolicies related to declaration of CoIs by editors that mayead to delegate decisions to other editors or associatedditors.

To sum up, we think that, as editors of a medical jour-

al, we should see to it that statement of any potential CoIsllows for improving the transparency of the scientific pro-ess and the credibility of the information provided. It is

question of recognizing that interests, and also conflicts

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f interest, exist, that they are not concealed or masked,ecause readers should be able to assess the actual con-itions in which the work presented has been conducted.ather than a negative connotation, we want to convey the

dea that statement of CoIs should be taken as an examplef the integrity of the author and his/her co-authors whichositively redounds to the quality of the scientific processnd the credibility by readers.

eferences

. Council of Science Editors. CSE’s white paper on pro-moting integrity in scientific journal publications. Editorialpolicy committee (2005---2006). Available from: http://www.CouncilScienceEditors.org

. Alfonso F, Timmis A, Pinto FJ, Ambrosio G, Ector H, KulakowskiP, et al. Políticas de conflicto de intereses y requisitos parasu declaración en las revistas cardiovasculares nacionalesde la Sociedad Europea de Cardiología. Rev Esp Cardiol.2012;65:471---8.

. Alfonso F, Segovia J, Heras M, Bermejo J. Publicación de ensayosclínicos en revistas científicas: consideraciones editoriales. RevEsp Cardiol. 2006;59:1206---14.

. Blum JA, Freeman K, Dart RC, Cooper RJ. Requirements and def-initions in conflict of interest policies of medical journals. J AmMed Assoc. 2009;302:2230---4.

. DeAngelis CD, Fontanarosa PB. Resolving unreported conflicts ofinterest. J Am Med Assoc. 2009;302:198---9.

. Studdert DM, Mello MM, Phil M, Brennan TA. Financial conflictsof interest in physicians’ relationships with the pharmaceuticalindustry. Self-regulation in the shadow of federal prosecution.N Engl J Med. 2004;351:1891---900.

. Drazen JM, de Leeuw PW, Laine C, Mulrow C, DeAngelis CD,Frizelle FA, et al. Toward more uniform conflict disclosures. Theupdated ICMJE conflict of interest reporting form. N Engl J Med.

2010;363:188---9.

. Drazen JM, van der Weyden MB, Sahni P, Rosenberg J, Marusic A,Lane C, et al. Uniform format for disclosure of competing interestin ICMJE journals. N Engl J Med. 2009;361:1896---7.