There has been debate in medical journals over the potential for conflicts of interest to bias scientific judgements: “we should pay attention to conflict of interest not only when it is clear that a judgement has been influenced by conflict of interest but simply when it might have been” (Reference SmithSmith, 1994). The BMJ requires authors to complete a detailed questionnaire regarding competing interests. Editorial staff may also be vulnerable to conflicts of interest. The editor of the New England Journal of Medicine was criticised for links with the pharmaceutical industry (Reference GottleibGottleib, 2000).
The drug company Wyeth sponsors the educational organisation Neurolink. Although Neurolink has educational components, it may also fulfil a marketing function. Its educational materials appear to give undue prominence to venlafaxine, manufactured by Wyeth. The Editor of the British Journal of Psychiatry is a member of the Neurolink Advisory Board as well as a member of the working party which produced the ‘depression guide’ (Neurolink Advisory Board, 2000).
The British Journal of Psychiatry has recently included a paper written by two Wyeth employees and a Wyeth consultant (Reference Thase, Entsuah and RudolphThase et al, 2001). This is a commercially valuable paper in which venlafaxine is described as having benefits compared with other antidepressants. It has already been cited in advertisements for Wyeth's venlafaxine preparations. I believe that the paper should have contained a declaration of interest by the Editor of theBritish Journal of Psychiatry, making clear his links with Wyeth. Perhaps the editor of a major medical journal should not have such a prominent link with any drug company.
I hope that the Journal will strengthen its policy on competing interests, including a detailed register of interests for editorial staff, referees and authors (including authors of letters) on its website. This should include the magnitude of payments: there is a big difference between a drug company paying someone £10 travel expenses and £10 000 consultancy fees. Significant competing interests should be summarised in the published articles. At the very least, readers would learn a lot about the dependency between medical research and big business.
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