Disclosure of financial conflicts of interest may worsen medical bias

"Journals, professional associations, clinical guideline developers, and others need to worry not just that disclosure provides a band-aid to the real problem of the [conflict of interest] itself, but that any attempt to stem the trouble through disclosure policies may actually be worsening the problem," say the editors of PLoS Medicine writing in an editorial that discusses the response to a paper published in the Journal last month, which examined the financial conflicts of interest of members of the American Psychiatric Association (APA) responsible for updating the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Media coverage about these findings raised concerns about the financial ties between many of the experts responsible for defining mental health conditions and treatments and the pharmaceutical companies that sell drugs for mental health. It is widely known that financial conflicts of interest impair objectivity and integrity in medicine.

But the editors ask: "are disclosure mandates simply a band-aid on an unrelenting problem of bias?"

The editors argue that although disclosure makes explicit and transparent details that are important to the interpretation, credibility, and value of the information presented, overemphasis and reliance on disclosure policies leaves the real problem of the conflict of interest unaddressed, and, according to studies in social science, may actually make the situation worse.

The editors say: "disclosure policies will never be the solution and are very likely exacerbating the problem of bias in medicine."

They continue: "Indeed, if disclosure worsens bias, then this is a game-changer for discussion and debate about managing conflicts of interest in medicine."