Dianthus Medical Blog Archive

Lack of transparency at the BMJ

I like the British Medical Journal. I really do. They publish some really great papers. They are also very much among the leaders in terms of publication ethics. They are one of the few journals who have espoused the contributorship model, which makes things much clearer than the traditional authorship model used by many journals. They were also writing about and acting on competing interests and the importance of declaring them as long ago as the 1990s. They have been a shining beacon of transparency and a force for higher standards in biomedical publishing.

So it pains me to criticise the BMJ, but I'm afraid that's what I'm going to do in this post.

The BMJ recently published an article that defended the role of alternative medicine courses in universities, and described efforts to close them down as a "witch hunt". I don't want to get into critiquing the article itself: eminent academic and blogger David Colquhoun has done an excellent job of that in the comments on the article, and I have little to add to what he has said.

No, what I find concerning is the way that the BMJ's normally high standards of transparency have slipped in this case. The article in question was written by Ray Moynihan, who makes his living from writing about the pharmaceutical industry, and has published a book that's heavily critical of the industry. Given the common cause between those who dislike the pharmaceutical industry and those who support alternative medicine, that would seem to me to be a relevant competing interest, which, in a journal that normally prides itself on high standards of transparency, should be disclosed to readers. However, the article was accompanied by no statement of competing interests.

Curious about whether this was simply an oversight or a deliberate weakening in the BMJ's policy of transparency, I submitted a response to the article on 18 February. My response (needless to say, accompanied by a declaration of competing interests as being a paid shill of Big Pharma) was as follows:

As David Colquhoun points out, Ray Moynihan, as a journalist, makes a living from this sort of thing. In fact Moynihan is quite well known as an anti-pharma compaigner, and even has a book on the subject, which I dare say is available from all good bookshops.

This seems particularly relevant here, as one of the main marketing techniques of the alternative medicine industry is sowing distrust about the pharma industry. Examples are easy to find. There seems to be common cause, then, between an anti-pharma agenda and a pro-quackeryalternative medicine agenda.

There was a time when the BMJ had quite a strict policy about declaring competing interests for authors of articles in their journal, but there is no statement of competing interests here, even though Moynhihan's interests seem highly relevant to the article. Please be assured that I'm not accusing Moynihan of trying to hide anything: there is no statement of competing interests saying "none declared", there is just a complete lack of any statement.

This seems odd. Could one of the BMJ editors explain whether this was an oversight, or is it no longer considered necessary to publish details of authors' competing interests?

It is now 10 days since I submitted my response, but it has not yet been published. I know that they received it and that it wasn't the victim of an unfortunate computer glitch. So I wonder why they haven't published it?

Failure to declare relevant competing interests may be a sign of a reduced commitment to transparency, but could equally be a simple oversight. However, it is hard to see failure to publish a response asking about declarations of competing interests as anything other than a reduced commitment to transparency.

This is a shame. I thought the BMJ placed a high value on transparency in their publications. It seems that that value may be slipping.

Update 2 March:

My response has finally appeared on the BMJ website, which is good. It remains worrying, however, that it was delayed for almost 2 weeks before it was published.

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