- Email: [email protected]
How PM&R Manages Bias in Scientific Publications
Editor’s Page
How PM&R Manages Bias in Scientific Publications Stuart M. Weinstein, MD We can never completely eliminate bias from our personal or professional lives, nor should we. Although it is likely that the complete absence of bias would prevent some major conflicts from occurring, bias also can serve as a positive stimulant. For example, bias catalyzed the race to the moon, the unraveling of the human genome, and (regardless of the outcome) recently prompted the greatest voter turnout in the history of the United States. If bias is ubiquitous, then it follows that bias exists in science—not only in scientific research, but also in the dissemination of scientific results. Accepting the principle that bias cannot be totally eliminated, it then follows that in scientific publications it must be effectively managed so that the end-user (the reader) is adequately informed and prepared to contextually evaluate the impact of such bias on reported outcomes. The salient point is that of the following stakeholders—authors, editors, peer reviewers, readers—the reader is the most vulnerable to the effects of bias and, therefore, in any given situation, the publication’s editor must offer measures to allow the reader to reasonably assess its influence. In scientific research and reporting, bias manifests primarily as conflicts of interest (COI), which has been succinctly defined by Dr. Faith McLellan, PhD, former senior North American editor of the Lancet, as “a situation in which a relationship, usually financial, has the potential to bias one’s judgment” [1]. Contrary to the glaring examples presented by Dr. McLellan, COI usually are more subtle and often are open to interpretation; thus, the reader must bear this interpretative burden. Full and complete disclosure is the process offered by editors to assist with this analysis. It is critical to state that although the significance of potential COI may be open to debate, the disclosure of same should not be left to any one person’s pondering. In developing PM&R’s policies, much effort was directed at a fair and comprehensive approach toward managing COI and disclosure. Dozens of sources, including other scientific journals and organizations, were examined as to their existing policies and procedures reflecting COI and disclosure. The PM&R editorial board adopted some key features of these existing policies, ultimately designing and implementing the current Conflict of Interest and Policy and Disclosure Form (see http://ees.elsevier.com/ pmrjournal/img/Disclosure_Form.doc). All editors, reviewers, and authors are required to complete the PM&R Disclosure Form, and this information is stored confidentially at the PM&R editorial office. The author information is published as a footnote to his or her individual article with a reference key that is also published in each issue and available online. These PM&R policies and forms will be consistently re-evaluated and updated as necessary to meet or exceed the contemporary standards that are enacted by most scientific journals. The purpose of full disclosure is not meant to be punitive or offensive. Rather, it is meant to allow the reader to draw his or her own conclusions regarding the level of bias that may have influenced the reported information, outcomes, and conclusions. Of course, full and honest disclosure is the responsibility of the disclosing individual. Situations might arise in which flagrant COI (such as those identified by Dr. McLellan) require pre-emptive action by a journal editor, possibly even denying publication (if discovered before publication). In general, however, the role of a journal editor is to disseminate scientific information that advances knowledge; journal editors cannot effectively act as policemen. As the end-user of this journal, it is ultimately up to the PM&R 1934-1482/09/$36.00 Printed in U.S.A.
S.M.W. University of Washington, Seattle, WA 98195. Address correspondence to: S.M.W.; e-mail: [email protected] Disclosure: nothing to disclose Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org
© 2009 by the American Academy of Physical Medicine and Rehabilitation Vol. 1, 97-98, February 2009 DOI: 10.1016/j.pmrj.2009.01.001
97
98
Weinstein
reader to decide the significance of any particular conflict. As suggested by Dr. McLellan, future trends might encourage more widespread public debate, thereby including one additional vulnerable stakeholder in the process, the patient. But, for now, PM&R stands in common with many other scientific journals, providing a mechanism to manage what appears to be an increasing occurrence (COI).
EDITOR’S PAGE
Any feedback from the readers to the editor is welcome and may enhance the overall value of the current process.
REFERENCE 1. McLellan F. Conflict of interest: A prescription for change. PM&R 2009;1:99-100.
How PM&R Manages Bias in Scientific Publications Stuart M. Weinstein, MD We can never completely eliminate bias from our personal or professional lives, nor should we. Although it is likely that the complete absence of bias would prevent some major conflicts from occurring, bias also can serve as a positive stimulant. For example, bias catalyzed the race to the moon, the unraveling of the human genome, and (regardless of the outcome) recently prompted the greatest voter turnout in the history of the United States. If bias is ubiquitous, then it follows that bias exists in science—not only in scientific research, but also in the dissemination of scientific results. Accepting the principle that bias cannot be totally eliminated, it then follows that in scientific publications it must be effectively managed so that the end-user (the reader) is adequately informed and prepared to contextually evaluate the impact of such bias on reported outcomes. The salient point is that of the following stakeholders—authors, editors, peer reviewers, readers—the reader is the most vulnerable to the effects of bias and, therefore, in any given situation, the publication’s editor must offer measures to allow the reader to reasonably assess its influence. In scientific research and reporting, bias manifests primarily as conflicts of interest (COI), which has been succinctly defined by Dr. Faith McLellan, PhD, former senior North American editor of the Lancet, as “a situation in which a relationship, usually financial, has the potential to bias one’s judgment” [1]. Contrary to the glaring examples presented by Dr. McLellan, COI usually are more subtle and often are open to interpretation; thus, the reader must bear this interpretative burden. Full and complete disclosure is the process offered by editors to assist with this analysis. It is critical to state that although the significance of potential COI may be open to debate, the disclosure of same should not be left to any one person’s pondering. In developing PM&R’s policies, much effort was directed at a fair and comprehensive approach toward managing COI and disclosure. Dozens of sources, including other scientific journals and organizations, were examined as to their existing policies and procedures reflecting COI and disclosure. The PM&R editorial board adopted some key features of these existing policies, ultimately designing and implementing the current Conflict of Interest and Policy and Disclosure Form (see http://ees.elsevier.com/ pmrjournal/img/Disclosure_Form.doc). All editors, reviewers, and authors are required to complete the PM&R Disclosure Form, and this information is stored confidentially at the PM&R editorial office. The author information is published as a footnote to his or her individual article with a reference key that is also published in each issue and available online. These PM&R policies and forms will be consistently re-evaluated and updated as necessary to meet or exceed the contemporary standards that are enacted by most scientific journals. The purpose of full disclosure is not meant to be punitive or offensive. Rather, it is meant to allow the reader to draw his or her own conclusions regarding the level of bias that may have influenced the reported information, outcomes, and conclusions. Of course, full and honest disclosure is the responsibility of the disclosing individual. Situations might arise in which flagrant COI (such as those identified by Dr. McLellan) require pre-emptive action by a journal editor, possibly even denying publication (if discovered before publication). In general, however, the role of a journal editor is to disseminate scientific information that advances knowledge; journal editors cannot effectively act as policemen. As the end-user of this journal, it is ultimately up to the PM&R 1934-1482/09/$36.00 Printed in U.S.A.
S.M.W. University of Washington, Seattle, WA 98195. Address correspondence to: S.M.W.; e-mail: [email protected] Disclosure: nothing to disclose Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org
© 2009 by the American Academy of Physical Medicine and Rehabilitation Vol. 1, 97-98, February 2009 DOI: 10.1016/j.pmrj.2009.01.001
97
98
Weinstein
reader to decide the significance of any particular conflict. As suggested by Dr. McLellan, future trends might encourage more widespread public debate, thereby including one additional vulnerable stakeholder in the process, the patient. But, for now, PM&R stands in common with many other scientific journals, providing a mechanism to manage what appears to be an increasing occurrence (COI).
EDITOR’S PAGE
Any feedback from the readers to the editor is welcome and may enhance the overall value of the current process.
REFERENCE 1. McLellan F. Conflict of interest: A prescription for change. PM&R 2009;1:99-100.