“A conflict of interest exists when professional judgment concerning a primary interest (such as a patient’s welfare or the validity of research) may be influenced by secondary interest (such as financial gain). Perceptions of conflict of interest are as important as actual conflicts of interest.”1
JAMA Cardiology has published a series of articles addressing new therapies in cardiovascular medicine: sacubitril/valsartan for heart failure, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors for dyslipidemia, and sodium-glucose cotransporter-2 inhibitors for diabetes.2- 6 These therapies provide new opportunities to modify the natural history of cardiovascular disease but come at significant cost and mandate awareness of their benefits and risks. Their introduction into clinical care has been associated with questions about financial and regulatory barriers to use according to evidence-based guideline recommendations. Missteps, inappropriate use, potential harm, and unbridled costs are risks with these new therapies. For each of these new interventions, articles have explored guideline implications, cost-effectiveness, modeling exercises, clinical applications, and purported mechanisms of action. The meaningful development of these concepts has necessarily required the involvement of authors who have relationships with study sponsors and, on occasion, authors who are directly employed by study sponsors because of their access to important data. We expect controversy to arise. As the International Committee of Medical Journal Editors definition implies, such authorship overtly introduces conflicts of interest into the pages of JAMA Cardiology. We do not interpret this as a violation of our editorial ethos, but it does raise an important question: how best should editors manage such conflicts?
Yancy CW, Harrington RA, Bonow RO. Author Relationships With IndustryPolicies and Procedures for Authors and Editors of JAMA Cardiology. JAMA Cardiol. 2017;2(11):1181–1182. doi:10.1001/jamacardio.2017.3461