Orthopaedic Journals and Conflict of Interest
Vernon T. Tolo, MD

The concern of other medical professionals and the public regarding the role that an author's potential conflict of interest plays in his or her reports of medical research continues unabated. Although essentially all medical journals have required some type of disclosure of potential conflicts of interest from their authors, the format of that disclosure has been inconsistent among journals. While the disclosure of potential conflicts of interest is widely accepted as being necessary, debate continues on how to best use this disclosure information, an issue that continues to confound readers as well as journal reviewers and editors. Despite this debate, it remains essential that an author disclose potential conflicts of interest. As exemplified by the recent interest of the lay press in the use or overuse of growth factors in spinal surgery, the issue of orthopaedic surgeons having industry-related conflicts of interest that could potentially affect the scientific reports that are used to guide orthopaedic patient care remains important to our patients and certainly to our orthopaedic community.

In the first issue of The Journal of Bone and Joint Surgery in 2011, we published an editorial announcing the institution of a basic and new JBJS policy on disclosure of potential conflicts of interest by authors1. The new format for this disclosure was the one proposed by the International Committee of Medical Journal Editors (ICMJE); this format has been adopted by hundreds of medical journals globally. JBJS has employed this form for potential conflict of interest disclosure throughout 2011 and will continue to do so going forward.

Earlier this year, the editors of seventeen other orthopaedic journals (see Appendix) also agreed to adopt the ICMJE form for disclosure of potential conflict of interest of contributors from 2011 forward. An intended benefit of this common form for disclosures is to facilitate the author's reporting without requiring a different form for each of these journals.

This disclosure form serves to provide the basic information on which to assess conflicts of interest, but orthopaedic journals may request additional disclosure information on a journal-by-journal basis. In some cases, an orthopaedic journal may request detailed disclosure of financial arrangements associated with industry ties, but this is not included in the basic ICMJE disclosure form.

However, a more detailed disclosure may be instituted in the future for some journals as a result of a final ruling, effective September 26, 2011, by the Department of Health and Human Services2. This rule requires researchers to disclose any financial interests over $5000 to academic institutions and grant-funding bodies. In addition, the federal requirements stipulate that a researcher's disclosure must be more explicit as to the dollar value of the potential conflict.

Please read the consensus statement below, which was agreed to by the editors of the orthopaedic journals listed in the Appendix. These journals and JBJS-Am have taken this important step to provide our readers with pertinent information on potential conflicts of interest of our contributors. This is a start, but we must continue to be transparent in disclosing these potential conflicts so that we may preserve the integrity of our orthopaedic research literature.


A table listing the editors who agreed to use the ICMJE form is available with the online version of this article as a data supplement at jbjs.org.

Consensus Statement

Readers of articles published in medical journals are entitled to a full disclosure of all financial conflicts of interest of the authors of those articles. In the fall of 2010, after extensive study, the International Committee of Medical Journal Editors, as a part of their “Uniform Requirements for Manuscripts Submitted to Biomedical Journals,” approved a Form for Disclosure of Potential Conflicts of Interest (www.icmje.org). Over the past few months, this form has been adopted by many medical journals throughout the world. At the regular meeting of orthopaedic surgery journal editors and publishers held during the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons in San Diego, California, on February 18, 2011, the editors listed (see Appendix) agreed to adopt this form (in some cases with minor modifications) as a minimum standard for reporting conflicts of interest during 2011 and to use it in the future as the foundation of the author disclosure of conflict of interest for their respective journals. It is our hope that the use of this form will (1) clarify the reporting responsibilities of all authors; (2) facilitate the reporting process, as a common form will be employed by all of the journals listed; and (3) lead to a fuller and clearer understanding of potential author conflicts of interest on the part of our readers.


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