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The Policies for the Disclosure of Funding and Conflict of Interest in Surgery Journals: A Cross-Sectional Survey

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Abstract

Background

Industry through its funding of research and through its relationships with study authors can influence the results of research. Most journals have policies for reporting funding and disclosing conflict of interest (COI) to mitigate the influence of industry on research. The objective of this study is to assess the policies of surgery journals for the reporting of funding and the disclosure of COI.

Methods

We described the prevalence and characteristics of funding and COI policies of journals indexed under "Surgery" in the Journal Citation Reports. We extracted data from publicly available information and through simulation of manuscript submission.

Results

Of the 186 eligible journals, 171 (92%) had policies for reporting of funding. None of the policies described procedures to deal with non-reporting or underreporting of funding. Of the 186 journals, 183 (99%) had a policy for disclosure of COI. All journals with a COI policy required disclosure of financial interest, while 96 (52%) required the disclosure of non-financial interests. Only 24 (13%) policies described how non-disclosure of COI affects the editorial process, and none described procedures to verify COI disclosure. Of the policies that required disclosing COI, 94 (51%) also required reporting the source of financial COI.

Conclusions

Most journals have policies for reporting of funding and disclosure of financial COI. However, many do not have clear policies for disclosing non-financial COI. Major limitations in the policies include the lack of processes for the verification of disclosed interests and for dealing with underreporting of funding and of COI.

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Data availability

Not required. The lead author EAA is the guarantor of the study and accepts full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish. EAA affirms that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned have been explained. The corresponding author EAA attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted

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Funding

The authors received no specific funding for this work.

Author information

Author notes

  1. Mohamad El Moheb and Basil S. Karam have Joint first authorship.

Authors and Affiliations

  1. Faculty of Medicine, American University of Beirut, Beirut, Lebanon

    Mohamad El Moheb, Basil S. Karam, Lama Assi & Maria Armache

  2. Clinical Research Institute, American University of Beirut, Beirut, Lebanon

    Assem M. Khamis & Elie A. Akl

  3. Center for Systematic Reviews for Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon

    Elie A. Akl

  4. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada

    Elie A. Akl

  5. Department of Internal Medicine, American University of Beirut, Riad-El-Solh, P.O. Box: 11-0236, Beirut, 1107 2020, Lebanon

    Elie A. Akl

Authors
  1. Mohamad El Moheb
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  2. Basil S. Karam
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  3. Lama Assi
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  4. Maria Armache
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  6. Elie A. Akl
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Contributions

ME, BSK, and EAA conceived and designed the study. ME and BSK coordinated the study throughout. EAA had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. ME, BSK, LA, and MA extracted the data. ME, BSK, AMK, and EAA analyzed and interpreted the data. ME, BSK, MA, and LA wrote the first draft of the manuscript with EAA. All authors critically revised the manuscript and approved the final version.

Corresponding author

Correspondence to Elie A. Akl.

Ethics declarations

Competing interests

AMK and EAA are authors on several papers on conflict of interest. The remaining authors have no conflict of interest to declare.

Ethical approval

The study involved no human subjects and required no ethical approval or consent to participate.

Additional information

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Appendices

Appendix 1. List of Included Journals

  • Journal of Neurosurgery-Spine

  • Neurosurgical Focus

  • European Journal of Cardio-Thoracic Surgery

  • Journal of Korean Neurosurgical Society

  • Journal of Plastic Reconstructive and Aesthetic Surgery

  • Techniques in Coloproctology

  • Langenbecks Archives Of Surgery

  • Hernia

  • Journal of Visceral Surgery

  • Obesity Surgery

  • Jama Facial Plastic Surgery

  • World Journal of Surgery

  • Annals of Surgery

  • International Journal of Colorectal Disease

  • Neurosurgical Review

  • Surgery Today

  • Minerva Chirurgica

  • World Neurosurgery

  • Eklem Hastaliklari Ve Cerrahisi-Joint Diseases and Related Surgery

  • Photomedicine and Laser Surgery

  • Bone & Joint Journal

  • Annals of Thoracic and Cardiovascular Surgery

  • Neurologia Medico-Chirurgica

  • Jsls-Journal of the Society of Laparoendoscopic Surgeons

  • Asian Journal of Surgery

  • Journal of Hepato-Biliary-Pancreatic Sciences

  • Heart Surgery Forum

  • Canadian Journal of Surgery

  • Journal of Cataract and Refractive Surgery

  • Seminars in Cutaneous Medicine and Surgery

  • Clinics in Colon and Rectal Surgery

  • Journal of Thoracic and Cardiovascular Surgery

  • Hpb

  • British Journal of Surgery

  • Wound Repair and Regeneration

  • Journal of the American College Of Surgeons

  • Scandinavian Journal of Surgery

  • Journal of Neurology Neurosurgery and Psychiatry

  • Journal of Neurointerventional Surgery

  • Jama Otolaryngology-Head & Neck Surgery

  • Annals of the Royal College of Surgeons of England

  • Surgical Laparoscopy Endoscopy & Percutaneous Techniques

  • Journal of Craniofacial Surgery

  • Plastic and Reconstructive Surgery

  • Microsurgery

  • European Surgical Research

  • Minimally Invasive Therapy & Allied Technologies

  • Journal of Laparoendoscopic & Advanced Surgical Techniques

  • Computer Aided Surgery

  • Journal of Investigative Surgery

  • Ostomy Wound Management

  • Plastic Surgery

  • Annales De Chirurgie Plastique Esthetique

  • International Surgery

  • Computer Assisted Surgery

  • Cirugia Y Cirujanos

  • European Surgery-Acta Chirurgica Austriaca

  • Surgical and Radiologic Anatomy

  • Journal of Cardiac Surgery

  • Interactive Cardiovascular and Thoracic Surgery

  • Annals of Thoracic Surgery

  • British Journal of Neurosurgery

  • Neurosurgery

  • Pediatric Neurosurgery

  • Cleft Palate-Craniofacial Journal

  • Liver Transplantation

  • Digestive Surgery

  • Surgical Infections

  • World Journal of Surgical Oncology

  • Ophthalmic Plastic and Reconstructive Surgery

  • Journal of Plastic Surgery and Hand Surgery

  • Journal of Orthopaedic Surgery

  • International Journal of Surgical Pathology

  • Clinical Orthopaedics and Related Research

  • Progress in Transplantation

  • Jama Surgery

  • Journal of Vascular Surgery

  • Annals of Transplantation

  • Aesthetic Plastic Surgery

  • Advances in Skin & Wound Care

  • International Journal of Medical Robotics and Computer Assisted Surgery

  • Indian Journal of Surgery

  • Acta Chirurgica Belgica

  • Zentralblatt Fur Chirurgie

  • Journal of Cardiovascular Surgery

  • Acta Neurochirurgica

  • Journal of Neurosurgical Sciences

  • Operative Neurosurgery

  • International Journal of Oral and Maxillofacial Surgery

  • Lasers in Medical Science

  • International Journal of Computer Assisted Radiology and Surgery

  • Stereotactic and Functional Neurosurgery

  • Journal of Hand Surgery-European Volume

  • Archives of Orthopaedic and Trauma Surgery

  • Childs Nervous System

  • Journal of Endovascular Therapy

  • Annals of Vascular Surgery

  • Vascular and Endovascular Surgery

  • Journal of Vascular Surgery-Venous and Lymphatic Disorders

  • Bmc Surgery

  • Chirurg

  • Unfallchirurg

  • Pediatric Surgery International

  • Orthopaedics & Traumatology-Surgery & Research

  • Journal of Reconstructive Microsurgery

  • Annals of Plastic Surgery

  • Facial Plastic Surgery

  • Turk Gogus Kalp Damar Cerrahisi Dergisi-Turkish Journal of Thoracic and Cardiovascular Surgery

  • Ophthalmic Surgery Lasers & Imaging Retina

  • Head and Neck-Journal for the Sciences and Specialties of the Head and Neck

  • European Journal of Pediatric Surgery

  • Aesthetic Surgery Journal

  • Surgical Innovation

  • Annals of Surgical Treatment and Research

  • Brazilian Journal of Cardiovascular Surgery

  • International Wound Journal

  • International Journal of Lower Extremity Wounds

  • Digestive Endoscopy

  • Hand Surgery & Rehabilitation

  • International Journal of Surgery

  • Journal of Burn Care & Research

  • Surgery for Obesity and Related Diseases

  • South African Journal of Surgery

  • Journal of Neurosurgical Anesthesiology

  • Journal of Trauma and Acute Care Surgery

  • Diseases of The Colon & Rectum

  • Knee Surgery Sports Traumatology Arthroscopy

  • Transplant International

  • Surgical Endoscopy and Other Interventional Techniques

  • Journal of Gastrointestinal Surgery

  • World Journal of Emergency Surgery

  • American Journal of Transplantation

  • Handchirurgie Mikrochirurgie Plastische Chirurgie

  • Clinical Transplantation

  • Journal of Heart and Lung Transplantation

  • Turkish Neurosurgery

  • Surgery

  • Anz Journal of Surgery

  • Injury-International Journal of the Care of the Injured

  • Journal of Surgical Oncology

  • Journal of Shoulder and Elbow Surgery

  • Thoracic and Cardiovascular Surgeon

  • Journal of Neurological Surgery Part B-Skull Base

  • Journal of Neurological Surgery Part A-Central European Neurosurgery

  • Acta Cirurgica Brasileira

  • Shock

  • Hepatobiliary Surgery and Nutrition

  • Annals of Surgical Oncology

  • American Journal of Surgical Pathology

  • Transplantation

  • Journal of Minimal Access Surgery

  • Endoscopy

  • Colorectal Disease

  • Ceska A Slovenska Neurologie A Neurochirurgie

  • Dermatologic Surgery

  • Journal of Bone and Joint Surgery-American Volume

  • Otolaryngology-Head and Neck Surgery

  • Lasers in Surgery and Medicine

  • Journal of Refractive Surgery

  • Journal of the American Academy of Orthopaedic Surgeons

  • Arthroscopy-The Journal of Arthroscopic and Related Surgery

  • Wounds-A Compendium of Clinical Research and Practice

  • Journal of Hand Surgery-American Volume

  • Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

  • Clinical Neurology and Neurosurgery

  • Burns

  • Journal of Pediatric Surgery

  • Knee

  • British Journal of Oral & Maxillofacial Surgery

  • Cirugia Espanola

  • Neurochirurgie

  • Transplantation Proceedings

  • Neurocirugia

  • Seminars in Vascular Surgery

  • Journal of Cranio-Maxillofacial Surgery

  • Surgical Oncology-Oxford

  • Journal of Foot & Ankle Surgery

  • Journal of Surgical Education

  • Journal of Hand Therapy

  • American Journal of Surgery

  • Journal of Neurosurgery

  • Journal of Surgical Research

  • Videosurgery and Other Miniinvasive Techniques

  • Ejso

  • European Journal of Vascular and Endovascular Surgery

  • Annali Italiani Di Chirurgia

Appendix 2

See Tables 6 and 7

Table 6 Policies requirements for reporting about the involvement of funder and independence * of authors (N = 171)
Full size table
Table 7 Journals requirements for disclosure of non-financial conflict of interest (COI) (N = 96)
Full size table

Appendix 3. Example conflict of interest and funding policies

Conflict of interest policy This conflict of interest policy is an illustrative example designed for medical journals to allow relevant individuals (i.e., the authors, reviewers and editors) to declare any relationships that may create a situation of conflict of interest. It also provides the editorial team of the journal with procedures for the handling of both declared conflicts of interest and failure to accurately declare such conflicts.

Conflict of interest (COI) is defined as “a set of circumstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by a secondary interest” [39]. For the manuscript authors, the primary interest refers to the proper planning, conduct and reporting of the study. For the reviewers, the primary interest refers to the objective evaluation of the manuscript submitted for publication. For the editors, the primary interest refers to the objective evaluation and editorial processing of the manuscript.

Relevant individuals must report all financial and non-financial conflicts of interest (COI). Financial COI includes but is not limited to grant/research support, serving as an advisor, consultant, or public advocate, indirect financial support (e.g., reimbursement for travel, equipment), stock ownership, personal fees, direct employment, honoraria for speaking, writing, or reviewing on the topic discussed in the manuscript, speaker bureaus or board membership, royalties, and patents (planned pending or issued), irrespective of the amount involved. Non-financial COI may include, but is not limited to personal, institutional, and professional opinions and relationships that may hinder scientific objectivity.

The above-mentioned disclosures should also encompass the authors’ relevant work outside the submitted work. It should also cover the authors’ family members and the authors’ institutions. All relationships at within a specified timeframe prior to submission and/or expected in the foreseeable future should be disclosed. Authors must disclose all past, current, and future relationships, so that the editors, reviewers, and readers can decide whether these relationships constitute COI. It is the responsibility of authors to report their COI in a complete, accurate, and timely way. The COI disclosures should be provided at the time of manuscript submission, then updated upon acceptance, and finally be made available to the public.

The above policy also applies to the reviewers and editors. Reviewers and editors who have financial or non-financial COI with regard to the submitted work must report so and recuse themselves from that specific manuscript.

Journals can opt to collect the author COI disclosures discussed above using online repositories, as the ICMJE has recently recommended.

Funding reporting policy It is the responsibility of the corresponding author to report on different aspects of funding: source(s) of funding, research phases for which funding was received, types of funding received (e.g., monetary, non-monetary), value of monetary support and value of non-monetary support, whether the funding provided by any of the funding sources is supported by an entity other than/external to the funding source, and involvement of each funder in the different steps of the research study (including but not limited to design, participant recruitment, collection, management, and analysis/interpretation of the data, medical writing assistance, preparation, review, and approval of the final manuscript, and the decision to submit for publication).

The funding information should be provided at the time of manuscript submission, then updated upon acceptance, and finally be made available to the public. Authors are also required to report whether they had full and independent control of the study.

While the presence of COI or funding disclosures does not preclude the consideration of the paper for publication, the editorial team reserves the right to refuse considering the paper in case appropriate disclosures are not provided, are found to be inaccurate, or in case significant COI or funder involvement is suspected to have compromised the integrity of the study.

It is the responsibility of the editorial team to ensure the COI and funding policy are clearly communicated to the corresponding author and ensure all related procedures are strictly adhered to. It is the responsibility of the corresponding author to communicate these policies to all co-authors. The editorial team may contact authors for more details regarding their disclosures.

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El Moheb, M., Karam, B.S., Assi, L. et al. The Policies for the Disclosure of Funding and Conflict of Interest in Surgery Journals: A Cross-Sectional Survey. World J Surg 45, 97–108 (2021). https://doi.org/10.1007/s00268-020-05771-0

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