The cohabitation of academia and industry: What position do the medical journals take regarding opinion articles?

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Accepting the general principle that authors should declare their CoI (actual or those that might be perceived) both to the journal directors and readers, the question lies in whether this is sufficient when attempting to offer an opinion. Not being able to publically access the results of particular clinical trials impedes physicians from considering them in their standard practice. This fact led to the announcement, at the end of 2014, by the British Medical Journal (BMJ) that they would not publish educational articles (for example, comments and reviews) or editorials signed by authors with financial CoI with the industry.<a class="elsevierStyleCrossRefs" href="#bib0135">1,2</a> Shortly afterwards, in May 2015, the New England Journal of Medicine (NEJM) published an editorial<a class="elsevierStyleCrossRef" href="#bib0145">3</a> and a series of articles<a class="elsevierStyleCrossRefs" href="#bib0150">4–6</a> in which it declared that collaboration between the industry and academia was necessary to advance the knowledge of diseases and their treatment. The NEJM attempted to contextualize (in short, minimize) the importance of the biases that industry relationship exerts on the medical profession. In the NEJM's view, the prejudice against the industry is exaggerated, and the biases in the professional judgment of physicians can have numerous other causes. The need for collaboration between academia and industry is clear, both for clinical research (in which innovative approaches are being planned<a class="elsevierStyleCrossRefs" href="#bib0170">8,9</a>) and preclinical research (in which hundreds of agreements are produced each year<a class="elsevierStyleCrossRef" href="#bib0180">10</a>). The issue is what position should a medical journal take when publishing opinion articles, in which the authors interpret the data from clinical trials and other types of studies.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>New England Journal of Medicine and the Biomedical IndustryThe NEJM attitude is noteworthy because it was the first journal to require that authors declare their financial agreements with the industry,<a class="elsevierStyleCrossRef" href="#bib0185">11</a> so as to subsequently prohibit the publishing of editorials or reviews written by authors with financial CoI with the companies that owned the drug products the authors are commenting on in the articles.<a class="elsevierStyleCrossRef" href="#bib0190">12</a> However, this attitude is not so striking if we consider 2 facts. In 2002, the NEJM with its current director relaxed the demands so that the above mentioned prohibition only affected authors with “significant financial interests” in a company (or its competitors).<a class="elsevierStyleCrossRef" href="#bib0195">13</a> Since then, experts have been selected with the maximum authority and the “minimum bias possible”,<a class="elsevierStyleCrossRef" href="#bib0200">14</a> whatever that means.The second noteworthy fact is that among the most prestigious journals of general medicine, NEJM publishes the most trials sponsored by biomedical companies. Thus, in the first semester of 2014, NEJM published 55 trials, of which 49% were industry-sponsored. These figures for The Lancet and JAMA, meanwhile, were 38 trials and 32%, and 30 trials and 10%, respectively. BMJ only published 13 clinical trials, none of which were sponsored by the industry.<a class="elsevierStyleCrossRef" href="#bib0205">15</a>It is known that among the most prestigious journals, those that publish more industry-sponsored trials obtained a larger number of citations (which helps gain a high impact factor) and reprints (which results in an improvement in the income statements).<a class="elsevierStyleCrossRef" href="#bib0210">16</a> Additionally, the publication of clinical trials related to the approval of a new drug product or a new indication is accompanied by a significant increase in the number of citations during the first year of the article's publication. Of the 16 articles with these characteristics published in the 3 major journals of general medicine during the first half of 2014, NEJM published 14, The Lancet published 2 and JAMA published none.<a class="elsevierStyleCrossRef" href="#bib0215">17</a> These data suggest that the NEJM attitude toward the industry appears to be “closer” than that of other journals, especially BMJ and JAMA, although this is also helped because the industry wishes to have articles about their products published in the journal with the highest impact factor, NEJM; undoubtedly, a virtuous circle for the interests of both parties.BMJ response (and the attitude of other journals)The NEJM attitude has been answered (not by chance from the pages of the BMJ) by 2 of the exdirectors of the American journal, who lamented the about-face announced by NEJM in pretending that physicians are not subject, as are all humans, to the effects (conscious or unconscious) of financial CoI on their judgment.<a class="elsevierStyleCrossRef" href="#bib0220">18</a> BMJ stated their concerns about the possibility of withdrawing the policies that preclude experts with financial CoI from writing opinion articles. Given that the biases are not always easily detectable, individuals are needed who are not (even obviously) contaminated by commercial interests to evaluate research data.<a class="elsevierStyleCrossRef" href="#bib0225">19</a> BMJ goes further and maintains that experts, when declaring their CoI, can suffer the phenomenon of “moral license”, by which they feel more comfortable writing their biased opinions.<a class="elsevierStyleCrossRef" href="#bib0225">19</a>This topic has been the subject of discussion among other journals.<a class="elsevierStyleCrossRefs" href="#bib0230">20–22</a> The Lancet is not only the second leading journal of general medicine in terms of impact factor but also second in publishing trials sponsored by the industry. The Lancet limited itself to confirming that from the reading of the NEJM articles, their policies would not necessarily change. The Lancet also welcomed the BMJ analysis and concluded that the truth probably lies between the 2 previously mentioned positions.<a class="elsevierStyleCrossRef" href="#bib0245">23</a>The Annals of Internal Medicine stated that they have never had a policy that specifically prohibits the publication of opinion articles from professionals who have financial CoI but that they do not publish many of the editorials and reviews signed by these types of experts. The journal states that it is impossible to create fixed rules on something that is always subject to judgment and, in fact, makes the decision on a case-by-case basis. Furthermore, the journal considers that a policy of zero tolerance does not ensure the objectivity of the opinions.<a class="elsevierStyleCrossRef" href="#bib0250">24</a>Lastly, JAMA reported in a commentary the results of an international symposium on CoI.<a class="elsevierStyleCrossRef" href="#bib0255">25</a> This article questions the term “conflicts” of interest and proposes “confluence” of interests. The idea is that the word conflict is pejorative and assumes inappropriate behavior. In contrast, the term confluence involves the converge of both interests, the primary and secondary, and should include not only the financial type but also those regarding personal fame (and that of the institutions), which can be more important than the merely chrematistic (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<a class="elsevierStyleCrossRef" href="#bib0255">25</a>Final thoughtsWhat has been commented on so far is intimately linked to the confidence that journals should obtain (and preserve) from their readers. The position readers take (that of NEJM, BMJ or some other) will make them trust more or less in each journal. It would be appropriate for each journal's editorial team to explicitly state the journal's position; although by observing the CoI that are declared by the signatories of the comments and editorials, readers can learn each journal's policies. There are those who argue that the BMJ attitude is extreme and that many of the true experts in fields such as therapy necessarily have financial CoI, given that many end up collaborating with one or several companies that develop treatments or diagnostic methods in their area of expertise. In certain settings, the idea that only nonexperts remain when individuals who have CoI withdraw from a meeting is repeated with some frequency and with clear intention. This belief, however, is far from the truth, although professionals with more experience in, say, a new drug product are sometimes those who have participated in its clinical development.When we consider potential financial CoI, we should first consider the implementation of clinical trials (and other type of studies) sponsored by biomedical companies. In this regard, there is a useful confirmation list to determine the financial CoI that researchers can have over the course of a clinical study's implementation and publication.<a class="elsevierStyleCrossRef" href="#bib0260">26</a> Additionally, we should consider other activities such as collaboration as advisors, as a member of an expert committee and in the drafting of expert reports for the company that owns the drug product or for its competitors. We should not forget the possession of patents, which is certainly infrequent in our setting. Furthermore, any physician can be a shareholder of one or several companies in the biomedical sector.Ultimately, however, the reality is that BMJ and other journals have no real difficulty in finding experts who lack financial CoI to write editorials and educational articles. Another issue all together is the presence of CoI of other types, but that is another much more complex and slippery story.Conflicts of interestThe authors declare that they have no conflicts of interest." 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In the last 18 months, a controversy was sparked between The New England Journal of Medicine and BMJ, who took 2 opposite positions: the former stated that the negative bias against authors with conflicts of interest with industry is excessive and therefore accept articles from any expert, ensuring that they have the minimum possible bias. BMJ, in contrast, prohibits the publication of these types of article by authors who have financial conflicts of interest with industry. This article discusses the approaches of the 2 journals (and those of others) and reflects on this type of conflict in the medical profession." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "¿Deben las revistas médicas publicar editoriales y artículos de carácter educativo escritos por autores que presentan conflictos de intereses financieros con las industrias farmacéutica y biotecnológica de cuyos productos (o sus competidores) opinan? En los últimos 18 meses se ha desatado una polémica entre The New England Journal of Medicine y BMJ, que plantean 2 posturas opuestas: la primera entiende que el prejuicio negativo contra autores con conflicto de intereses con la industria es excesivo y, por tanto, acepta artículos de cualquier experto procurando que presenten el mínimo sesgo posible. BMJ, por el contrario, prohíbe publicar ese tipo de artículos por autores que tienen conflicto de intereses financieros con la industria. En este artículo se desarrollan las actitudes de ambas (y otras) revistas y se reflexiona sobre este tipo de conflicto en la profesión médica." ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Dal-Ré R, Carné X. La cohabitación de la academia y la industria: ¿qué postura toman las revistas médicas en relación con los artículos de opinión?. Rev Clin Esp. 2016;216:423–426." ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Source: The National Academies of Sciences, Engineering and Medicine.<a class="elsevierStyleCrossRef" href="#bib0165">7</a>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Definition \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Set of circumstances that result in the risk that the professional judgment or activities regarding a primary interest are unduly influenced by a secondary interest \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Interpretation \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">The primary interest that requires protection depends on the purpose of the individual's professional activity. Thus, the primary interests can include promoting and protecting the integrity of the research, the wellbeing of the patients or the quality of the medical education. Physicians and medical researchers accept the primacy of these interests when performing their professional activity. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">The secondary interests include financial benefits, the desire to progress in a professional career, recognition for personal achievements, and favors to friends, family, students and colleagues. \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">The policies on conflicts of interest are focused on the financial type, not because these are necessarily the most corrupting but because they are relatively more objective and quantifiable. \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1239632.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Conflicts of Interest. Definition and interpretation." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib0135" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Medical journals and industry ties" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Chew" 1 => "C. Brizzell" 2 => "K. Abbasi" 3 => "F. Godlee" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "BMJ" "fecha" => "2014" "volumen" => "349" "paginaInicial" => "g7197" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25432164" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0140" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Authors’ reply to Smith, Forsyth, Coffey and Prendergast, and Soskolne" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "F. Godlee" 1 => "M. Chew" 2 => "C. Brizzell" 3 => "K. Abbasi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "BMJ" "fecha" => "2015" "volumen" => "350" "paginaInicial" => "h42" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25569018" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0145" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Revisiting the commercial–academic interface" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.M. Drazen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMe1503623" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2015" "volumen" => "372" "paginaInicial" => "1853" "paginaFinal" => "1854" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25946285" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0150" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Conflicts of interest: reconnecting the dots – reinterpreting industry–physician relations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L. Rosenbaum" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMms1502493" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2015" "volumen" => "372" "paginaInicial" => "1860" "paginaFinal" => "1864" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25946288" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0155" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Understanding bias – the case for careful study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L. Rosenbaum" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMms1502497" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2015" "volumen" => "372" "paginaInicial" => "1959" "paginaFinal" => "1963" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25970055" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0160" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Beyond moral outrage – weighing the trade-offs of COI regulation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L. Rosenbaum" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMms1502498" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2015" "volumen" => "372" "paginaInicial" => "2064" "paginaFinal" => "2068" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25992752" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0165" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "Available from: <a class="elsevierStyleInterRef" id="intr0010" href="http://www.nationalacademies.org/hmd/Reports/2009/Conflict-of-Interest-in-Medical-Research-Education-and-Practice.aspx">http://www.nationalacademies.org/hmd/Reports/2009/Conflict-of-Interest-in-Medical-Research-Education-and-Practice.aspx</a> [accessed 28.04.16]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Conflict of interest in medical research, education and practice" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "The National Academies of Sciences, Engineering and Medicine, Health and Medicine Division" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2009" "editorial" => "The National Academic Press" "editorialLocalizacion" => "Washington, DC" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0170" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Public-private partnerships as driving forces in the quest for innovative medicines" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Goldman" 1 => "C. Compton" 2 => "B.B. Mittleman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/2001-1326-2-2" "Revista" => array:5 [ "tituloSerie" => "Clin Transl Med" "fecha" => "2013" "volumen" => "2" "paginaInicial" => "2" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23369569" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0175" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Clinical trials transformation initiative. Available from: <a id="intr0015" class="elsevierStyleInterRef" href="http://www.ctti-clinicaltrials.org/who-we-are">http://www.ctti-clinicaltrials.org/who-we-are</a> [accessed 28.04.16]" ] ] ] 9 => array:3 [ "identificador" => "bib0180" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Academic partnerships 2015" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "B. Huggett" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/nbt.3522" "Revista" => array:6 [ "tituloSerie" => "Nat Biotechnol" "fecha" => "2016" "volumen" => "34" "paginaInicial" => "372" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27054985" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S073510970500522X" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0185" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dealing with conflicts of interest" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.S. Relman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM198405033101809" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1984" "volumen" => "310" "paginaInicial" => "1182" "paginaFinal" => "1183" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6709012" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0190" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "New information for authors and readers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.S. Relman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199007053230111" "Revista" => array:5 [ "tituloSerie" => "N Engl J Med" "fecha" => "1990" "volumen" => "323" "paginaInicial" => "56" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2355959" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0195" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Financial associations of authors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.M. Drazen" 1 => "G.D. Curfman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMe020074" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2002" "volumen" => "346" "paginaInicial" => "1901" "paginaFinal" => "1902" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12063375" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0200" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "N Engl J Med" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.M. Drazen" 1 => "Fifteen years" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "fecha" => "2015" "volumen" => "373" "paginaInicial" => "1774" "paginaFinal" => "1775" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0205" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "pii:S0895-4356(16)00048-2. doi:10.1016/j.jclinepi.2016.01.017 [Epub ahead of print]" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Compliance with prospective trial registration guidance remained low in high-impact journals and has implications for primary end point reporting" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Dal-Ré" 1 => "J.S. Ross" 2 => "A. Marušić" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "J Clin Epidemiol" "fecha" => "2016" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0210" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Dal-Ré R. Publicación de separatas de artículos científicos para la industria farmacéutica. In: Dal-Ré R, Carné X, Gracia D, directores. Luces y sombras en la investigación clínica. Madrid: Triacastela; 2013. p. 541–54. Available from: <a id="intr0020" class="elsevierStyleInterRef" href="http://www.fundaciogrifols.org/es/web/fundacio/-/05-luces-y-sombras-en-la-investigacion-clinical">http://www.fundaciogrifols.org/es/web/fundacio/-/05-luces-y-sombras-en-la-investigacion-clinical</a> [accessed 28.04.16]" ] ] ] 16 => array:3 [ "identificador" => "bib0215" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Number of citations 1 year after publication of trial results and their relation to medicines regulatory approval" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R. Dal-Ré" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/bcp.12832" "Revista" => array:6 [ "tituloSerie" => "Br J Clin Pharmacol" "fecha" => "2016" "volumen" => "81" "paginaInicial" => "786" "paginaFinal" => "788" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26588052" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0220" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Justifying conflicts of interest in medical journals: a very bad idea" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Steinbrook" 1 => "J.P. Kassirer" 2 => "M. Angell" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "BMJ" "fecha" => "2015" "volumen" => "350" "paginaInicial" => "h2942" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26036926" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0225" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Revisiting the commercial–academic interface in medical journals" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E. Loder" 1 => "C. Brizzell" 2 => "F. Godlee" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "BMJ" "fecha" => "2015" "volumen" => "350" "paginaInicial" => "h2957" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26037508" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0230" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Industry disclosures. More reflective of moral integrity than rules" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "V. Fuster" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Col Cardiol" "fecha" => "2015" "volumen" => "65" "paginaInicial" => "2457" "paginaFinal" => "2458" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0235" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Conflitto di interessi: è ora di abbassare la guardia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L. De Fiore" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1701/1940.21082" "Revista" => array:6 [ "tituloSerie" => "Recenti Prog Med" "fecha" => "2015" "volumen" => "106" "paginaInicial" => "305" "paginaFinal" => "307" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26228720" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0240" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fighting about conflict of interest: where should the balance lie?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D. Misselbrook" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3399/bjgp16X683569" "Revista" => array:6 [ "tituloSerie" => "Br J Gen Pract" "fecha" => "2016" "volumen" => "66" "paginaInicial" => "66" "paginaFinal" => "67" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26823246" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0245" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Offline: the BMJ vs NEJM – lessons for us all" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R. Horton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Lancet" "fecha" => "2015" "volumen" => "385" "paginaInicial" => "2238" "itemHostRev" => array:3 [ "pii" => "S0735109704018534" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0250" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Walking the tightrope of academia–industry relationships" "autores" => array:1 [ 0 => array:2 [ "colaboracion" => "Editors" "etal" => false ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7326/M15-1500" "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "2015" "volumen" => "163" "paginaInicial" => "477" "paginaFinal" => "478" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26168213" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0255" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Confluence, not conflict of interest: name change necessary" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.R. Cappola" 1 => "G.A. FitzGerald" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jama.2015.12020" "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "2015" "volumen" => "314" "paginaInicial" => "1791" "paginaFinal" => "1792" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26402846" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0260" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Financial conflicts of interest checklist 2010 for clinical research studies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.A. Rochon" 1 => "J. Hoey" 2 => "A.W. Chan" 3 => "L.E. Ferris" 4 => "J. Lexchin" 5 => "S.R. Kalkar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Open Med" "fecha" => "2010" "volumen" => "4" "paginaInicial" => "e69" "paginaFinal" => "e91" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21686297" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000021600000008/v1_201610290712/S2254887416300352/v1_201610290712/en/main.assets" "Apartado" => array:4 [ "identificador" => "3982" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Special Article" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000021600000008/v1_201610290712/S2254887416300352/v1_201610290712/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887416300352?idApp=WRCEE"]