Editor`s Opinion: The Process of Trust

     Let’s face it. Generally, we do not spend much time considering processes until something goes awry. Why worry about the “how” when the train runs on time, the computer hums cooperatively, and the wound heals as it should? Why worry about how manuscripts are incorporated into scientific publications when your favorite journals arrive every month?

     Long-time readers — many of you loyal to Ostomy Wound Management for more than 25 years — know about the continually increasing rules and regulations that guide the dissemination of medical information, especially those relevant to OWM. For example, our mothership, HMP Communications, has scrupulously separated from the continuing education segment of the company in proactive compliance with federal regulations. To this effect, activities involving continuing education are restricted and are overseen by the North American Center for Continuing Education (NACCME). In addition, authors must disclose actual or perceived potential conflicts of interest regarding their involvement, minimal though it may be, with industry.

     These new policies will further enhance not only the integrity of the publications and programs presented, but also the need for editors and reviewers to be more vigilant about blatant commercialism. Without the dedication of our expanding corps of Editorial Advisory and Review Board members, we would not be able to implement and apply these augmented editorial requirements to our ever-increasing number of manuscript submissions.

     So… why should anyone worry about a publication process that seems to work just fine? Ask the readers, reviewers, and editors of a variety of medical journals who made headlines last year for publishing articles on hormone replacement allegedly written by so-called ghostwriters hired by a pharmaceutical company instead of the listed authors.1 Examination of the processes used in the publication of these articles is part of a continuing investigation by the Senate Finance Committee into drug industry influences on doctors. Why is this a problem? Consider the response of one of the physicians, alleged not to have written her own publication, when asked to comment on the inquiry: “It kind of makes me laugh that with what goes on in the Senate…they are worried that something is ghost-written.”

     Well, dear doctor, let us explain why few clinicians are laughing. Senators do not pretend to write their own bills. Clearly, many studies are conducted with the support of industry — nothing is wrong with that if it is disclosed as a matter of honesty, integrity, and trust. If clinicians make recommendations, we (the readers) want to be confident that guidance is based on their best judgment and an unbiased interpretation of their observations, regardless of financial compensation or personal relationships. Readers have the right to know a potential conflict of interest may exist — failure to disclose violates the editorial policies of most peer-reviewed scientific journals, along with our trust.

     Through the years, OWM, as a matter of routine, has asked reviewers to disclose any conflicts of interest and recuse themselves from reviewing manuscripts toward which they may have some bias. We also strive to safeguard against unsubstantiated claims of product or protocol greatness, seeking to legitimize the information we proliferate (inadequate/biased peer review also has come under legal scrutiny in situations where reviewers accepted for publication manuscripts with faulty information). Ultimately, we rely on the honesty of our authors and reviewers. If they declare no potential conflict of interest, we have to trust them.

     Negative newspaper headlines and Senate investigations reflect poorly on all of us. They diminish public confidence in the process of scientific communications and taint the honesty and integrity of our profession. We — the OWM editorial staff and Advisory and Review Board members — are doing all we can to protect our readers from suspect practices. You, our readers, can do the same by alerting us to potential problems with our process. We may commit the occasional typographical, grammatical, or production error but we strive to expand your knowledge (and your horizons) with information that, like us, can be trusted.

This article was not subject to the Ostomy Wound Management peer-review process.