title: Levels of Influence: Habituation and the Prevalence of Declared Conflicts of Interest.
abstract: BACKGROUND
  The International Committee of Medical Journal Editors has devised a system of mandatory disclosure, under which authors are required to disclose all conflicts of interest and the sources of support for the submitted research. Because payments from industry to physicians generally are common, it is likely that many authors of medical manuscripts will have information to disclose. As a result, the signal-to-noise ratio of such declarations may be low, thereby undermining the effectiveness of disclosure. To our knowledge, the comparative prevalence of such conflicts has not been reported.
  
  
  METHODS
  We identified 100 consecutive scientific articles from the 2014 volumes of 3 journals with high impact factors: Pediatrics, The Journal of Bone & Joint Surgery (JBJS), and The New England Journal of Medicine (NEJM). Each study was categorized by funding source and other relationships with industry.
  
  
  RESULTS
  In Pediatrics, 17 of 100 studies had a declared relationship with industry. Industry relationships were declared in 68 and 77 of the studies in JBJS and NEJM, respectively.
  
  
  CONCLUSIONS
  Industry relationships were common in studies in NEJM and JBJS, but rare in Pediatrics. The high prevalence of conflicts of interest may weaken the meaning of declarations and undermine any bias-reducing effect intended by the disclosure system.
authors.affiliation: Haverford High School, Havertown, Pennsylvania.
authors.forename: Jillian R H
authors.initials: JR
authors.lastname: Bernstein
authors.affiliation: University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.|Harvard Law School, Cambridge, Massachusetts.
authors.forename: George
authors.initials: G
authors.lastname: Maliha
authors.affiliation: University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Jaimo
authors.initials: J
authors.lastname: Ahn
authors.affiliation: University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania Joseph.Bernstein@uphs.upenn.edu.
authors.forename: Joseph
authors.initials: J
authors.lastname: Bernstein
mesh_terms: D016265:Conflict of Interest; D030881:Disclosure; D006801:Humans; D011643:Publishing