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.