Discussion
This study found that the majority of US-based physician editors of
high-impact infectious disease journals received non-research payments
for consulting, travel fees, and speaking compensations from the
healthcare industry for the past three years. Nearly one-third of the
editors received research funding for their research from the industry
for the past three years. The median non-research payment amounts to the
editors were higher than those reported among regular infectious disease
physicians ($130 to $220 per year) in the US.[1]
However, our findings were consistent with previous studies and the
financial relationships between journal editors and the healthcare
industry are also prevalent in many specialties other than infectious
diseases.[5,8,10-12] Using the US Open Payments Database, Nguyen et
al. reported that all physician urology journal editors received
industry payments between 2015 and 2021.[8] Liu et al. found that
50.6% of physician editors of 52 US influential medical journals
received non-research payments from the healthcare industry in 2014, and
only 32.7% of the journals had conflicts of interest policies for their
journal editors.[5] Haque et al. found that nearly 80% of oncology
journal editors accepted the non-research payments from 2013 to
2018.[11]
Given that journal editors are often well-experienced clinicians and
researchers who may hold high positions, such as university professors
and institutional directors, the large and widespread payments to these
editors are not surprising. However, journal editors bear significant
responsibilities, not only in selecting publications and ensuring the
utmost integrity of medical research but also in disseminating research
findings to clinicians and patients to improve patient care. Therefore,
managing conflicts of interest among journal editors is of particular
importance. Several international groups, such as the Committee on
Publication Ethics and the International Committee of Medical Journal
Editors, developed guidelines for managing conflicts of interest for
journal editors.
Nevertheless, only two journals have published their policies on their
webpages, and none have publicly disclosed their editors’ conflicts of
interest. This lack of transparency is particularly troubling given the
influential role that journal editors play in shaping medical knowledge
and practice. While it’s understandable that some editors may maintain
financial ties with the healthcare industry for conducting research or
contributing their expertise through consulting services toward the
development of innovative treatments, the absence of transparent
disclosure mechanisms leaves a void that could potentially be filled by
skepticism and mistrust.[13] Therefore, as a minimum standard,
editors should be forthright about their financial relationships with
the healthcare industry. This transparency not only aligns with ethical
best practices but also serves to bolster the credibility of both the
editors and the journals they represent, ultimately contributing to
improved patient care through more trustworthy medical research.
This study has a few limitations. First, this study did not include
non-physician editors and editors who were in countries other than the
US, as the Open Payments Database only covers physicians with medical
licensure in the United States. Therefore, the financial conflicts of
interest among the whole journal editors could be underestimated.
Additionally, there are possibilities of inaccuracies in the Open
Payments Database, though physicians can dispute any payment data if
they find errors in the data.