Excluding the experts?
======================

* Stephen Choi

Steve Arshinoff is concerned that *CMAJ*'s new conflict of interest policy1 will censor legitimate science from the journal. This is certainly not the intention of the policy, which does not apply to original research papers but is restricted to narrative review articles and commentaries. The editors are well aware that companies producing drugs and medical devices frequently conduct research and fund clinical trials; the resultant papers will continue to be considered and published in the journal on the basis of their scientific merit.

Commentaries and narrative reviews, on the other hand, do not follow protocols and are inherently prone to bias. Arshinoff suggests that authors who receive a substantial income from drug companies can maintain their objectivity. His own case in this regard notwithstanding, there is ample evidence that many physicians who receive income or gifts from drug companies are indeed influenced and are more likely to hold favourable views of the products of those companies than might otherwise be the case.2,3

Readers also understand that financial conflicts of interest can challenge authors' objectivity. Given that the information published in the journal is used by our readers to practise medicine, that patient care is at stake and that public trust in physicians understandably erodes when drug companies influence the care that physicians provide, the editors feel a responsibility to safeguard the highest possible level of objectivity in those pages of the journal most directly devoted to the practice of medicine.

## References

1.  1. Conflicts of interests and investments [editorial]. CMAJ 2004;171(11):1313.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czoxMToiMTcxLzExLzEzMTMiO3M6NDoiYXRvbSI7czoyMjoiL2NtYWovMTczLzgvODQ5LjIuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 

2.  2. Wazana A. Physicians and the pharmaceutical industry: Is a gift ever just a gift? JAMA 2000;283:373-80.
    
    [CrossRef](http://www.cmaj.ca/lookup/external-ref?access_num=10.1001/jama.283.3.373&link_type=DOI) 
    
    [PubMed](http://www.cmaj.ca/lookup/external-ref?access_num=10647801&link_type=MED&atom=%2Fcmaj%2F173%2F8%2F849.2.atom) 
    
    [Web of Science](http://www.cmaj.ca/lookup/external-ref?access_num=000084732400030&link_type=ISI) 

3.  3. Stelfox HT, Chua G, O'Rourke K, Detsky AS. Conflict of interest in the debate over calcium-channel antagonists. N Engl J Med 1998;338(2):101-6.
    
    [CrossRef](http://www.cmaj.ca/lookup/external-ref?access_num=10.1056/NEJM199801083380206&link_type=DOI) 
    
    [PubMed](http://www.cmaj.ca/lookup/external-ref?access_num=9420342&link_type=MED&atom=%2Fcmaj%2F173%2F8%2F849.2.atom) 
    
    [Web of Science](http://www.cmaj.ca/lookup/external-ref?access_num=000071341300006&link_type=ISI)