A new analysis finds that 81 percent of authors whose work appeared in the Journal of American Medical Association and the New England Journal of Medicine in 2017 failed to disclose conflicts of interest in the form of industry payments. 

The analysis reviewed 31 clinical trial reports from each of the two journals that were published in 2017 and identified 118 authors who, in total, received $7.48 million dollars in industry payments. The payment information came from Open Payments, a US government website where drug and device makers must report payments to physicians and health care providers. The analysis was posted as a preprint on medRxiv on January 1 and has not yet been peer-reviewed. 

Of the 118 authors on the included papers, only a dozen did not receive any payments, according to the preprint. Of the 106 researchers who received payments, the payments ranged from as little as $6.36 to as much as $1.49 million. Researchers received payments for travel, food, speaking, and consulting services, among other things, STAT News reports. The 23 researchers that received the largest payments received a total of $6.32 million, of which $3 million was undisclosed. 

See “Many Editors of US Medical Journals Receive Industry Funding

The International Committee of Medical Journal Editors (ICMJE) recommends that researchers disclose payments they received in the three years prior to submitting a study for publication, so the analysis included all payments made to researchers between 2014 and 2017. 

When publishing in ICMJE member journals, which includes JAMA and NEJM, researchers are required to follow the disclosure guidelines promoted by the ICMJE—which include disclosing payments. But this expectation was not met by many of the authors of the papers included in the analysis. According to STAT, the authors of the preprint say that their results suggest voluntary disclosure may not be adequate for avoiding financial conflicts or ensuring transparency.

“I’m not surprised, but really, I’m saddened and disappointed,” says Brian Piper, a neuroscientist and medical ethicist at the Geisinger Commonwealth School of Medicine, and one of the authors of the preprint, to STAT. “These are high-impact and highly influential journals. For many Americans, these are the centerpieces of evidence-based medicine. Many physicians subscribe to them. Many journalists turn to them for information.”

An NEJM statement to STAT says that the journal “follows the disclosure rules set by the ICMJE. The editors do review all of the more than 5,000 disclosure forms received each year but do not have access to primary records on which the information entered in the forms may be based. We expect the disclosure forms submitted by authors to be accurate and complete.”

JAMA has not yet responded to a request for comment on the preprint, STAT reports

According to STAT, Piper notes that disclosures that continue to rely on individuals may be a failed approach. Instead, he suggests that journals review Open Payments and provide a link showing payments made to authors.