Declaración de conflictos de intereses en investigaciones publicadas en 2 revistas científicas chilenas, entre los años 2002 y 2015 / Declaration of conflicts of interests in studies published in two Chilean scientific journals from 2002 to 2015

INTRODUCCIÓN: Los conflictos de intereses son condiciones en donde el interés primario es influenciado por uno secundario, comprometiendo la confianza en la investigación y difundiendo resultados sesgados. La declaración de conflictos de intereses (DCI) debe tener un fundamento claro, ser útil y parte de la estructura de toda investigación. OBJETIVO: Analizar la presencia de una DCI en las investigaciones publicados en la Revista Chilena de Ortopedia y Traumatología (RCHOT) y la Revista Chilena de Neurocirugía (RNC) en el periodo 2002-2015. MATERIAL Y MÉTODOS: Investigación descriptiva, retrospectiva y documental. Se llevó a cabo una revisión de trabajos publicados en la RCHOT y RNC, entre el 2002 y 2015. Los datos fueron analizados con el programa estadístico SPSS Statistics (versión 21). RESULTADOS: Se revisaron 596 trabajos, encontrándose DCI en 30,5%, siendo principalmente de financiamiento. La RCHOT presentó 70% de DCI, siendo en 2002 del 14% y en 2015 del 90%. La pertenencia del autor principal al comité editorial fue de 14%, y en un 73% de los trabajos, las instituciones de origen tenían representación en ese comité. Para la RNC se encontró un 2,3% de DCI. El 8,4% de los autores principales pertenecían al comité, y el 24% de las instituciones de origen de los trabajos tenían representatividad en el mismo. CONCLUSIONES: La DCI en la RCHOT fue irregular y centrada en el financiamiento. La DCI en la RNC fue casi nula. Es de esperar que esta investigación sea útil para los comités editoriales en el diseño de políticas y en desarrollar sensibilización en relación con una DCI.

INTRODUCTION: Conflicts of interests are situations in which a primary interest is influenced by a secondary interest. It could compromise the reliability of biomedical research and result in the dissemination of biased results. Declarations of conflicts of interests (DCI) must have a clear basis, be useful, and be part of the structure of all research. OBJECTIVE: To analyse the presence of the DCI in studies published in the Revista Chilena de Ortopedia y Traumatologia (RCHOT) and Revista Chilena de Neurocirugía (RNC), between 2002 and 2015. MATERIAL AND METHODS: A descriptive, retrospective and documental was performed by reviewing all papers published in the RCHOT and RNC between 2002 and 2015. All the information was analysed using the statistics program SPSS Statistics (version 21). RESULTS: After reviewing 596 papers, the DCI was found in 30.5% of them, mainly about funding. In RCHOT, 70% of the papers presented a DCI. In 2002 the DCI was 14%, and 90% in 2015. The principal author belonged to the editorial committee in 14%, and in the 73% of the papers, the institution of origin had representation on this editorial committee. In the case of RNC, 2.3% presented a DCI, 8.4% of the principal authors belonged to the editorial committee, and the 24% of the institutions of origin of the papers were represented on this committee. CONCLUSIONS: The presence of a DCI in RCHOT was irregular, and concentrated on funding aspects. The DCI in RNC was almost non-existent. Hopefully, this study will be useful for editorial committees in order to establish editorial policies and develop an awareness of the DCI.

Financial and non-financial conflicts of interest in psychiatry / Conflictos de intereses financieros y no financieros en psiquiatría / Conflitos de interesses financeiros e não financeiros em psiquiatria

A conflict of interests occurs when a doctor is unduly influenced by a secondary interest (i.e., a personal incentive) in his acts concerning one of the primary interests to which he is professionally committed (the welfare of patients, the progress of science or the education of students or residents). One specific variety of conflicts of interests has monopolized the attention of the scientific and lay press: the financial conflicts of interests arising from the relationships between doctors and drug companies. A large literature has described the many, sometimes subtle, ways by which a psychiatrist can be influenced in his prescribing habits or research activities by his relationships with the industry. Some empirical evidence is now available in this area. On the other hand, it has been pointed out that the current debate on this issue is sometimes "affectively charged", or fails to take into account that the interests of patients, families and mental health professionals and those of the industry may be often convergent. Other types of conflicts of interests are beginning now to be discussed. There is evidence that the allegiance of a researcher to a given school of thought may influence the results of studies comparing different psychotherapeutic techniques, thus colliding with the primary interest represented by the progress of science. Political commitment is also emerging as a source of conflicts of interests. Financial and non-financial conflicts of interests are widespread in psychiatric practice and research. They cannot be eradicated, but must be managed more effectively than is currently the case.

Se produce un conflicto de intereses cuando un médico se siente indebidamente influenciado por un interés secundario (i.e., un incentivo personal) en relación con sus deberes primarios con los cuales está comprometido profesionalmente (el bienestar de los pacientes, el progreso de la ciencia o la educación de los estudiantes o residentes). Una variedad específica de conflictos de intereses ha monopolizado la atención de la prensa científica así como de la no especializada: los conflictos de intereses financieros que surgen de la relación entre médicos y compañías farmacéuticas. Una extensa literatura ha descrito las variadas maneras, a veces sutiles, por medio de las cuales un psiquiatra puede ser influenciado por sus relaciones con la industria al aconsejar hábitos, o en sus actividades de investigación. Hoy en día se puede obtener algo de evidencia empírica en esta área. Por otra parte, se ha señalado que, a veces, el actual debate sobre esta materia se ve "cargado afectivamente" o falla en considerar que los intereses de los pacientes, de sus familias y de los profesionales de la salud mental y los de la industria podrían converger. Actualmente, se está empezando a discutir acerca de otros conflictos de intereses. Existe evidencia de que la cercanía de un investigador a alguna línea de pensamiento puede influenciar los resultados de estudios al comparar diferentes técnicas psicoterapéuticas, chocando, por tanto, con el interés primario representado por el progreso de la ciencia. El compromiso político también está emergiendo como fuente de conflictos de intereses. Conflictos de intereses financieros y no financieros están muy esparcidos en la práctica y la investigación psiquiátricas. No pueden ser erradicados, pero deben ser tratados con mayor eficacia de la que se observa hoy en día.

Ocorre conflito de interesses quando um médico se sente indevidamente influenciado por um interesse secundário (i.e., um incentivo pessoal) em relação aos seus deveres primários, com os quais está comprometido profissionalmente (o bem-estar dos pacientes, o progresso da ciência, a educação dos estudantes ou residentes). Uma variedade específica de conflitos de interesses tem monopolizado a atenção da literatura científica, assim como da não especializada: os conflitos de interesses financeiros que surgem da relação entre médicos e companhias farmacêuticas. Uma extensa literatura tem descrito as variadas maneiras, às vezes sutis, nas quais um psiquiatra pode ser influenciado devido às suas relações com a indústria ao aconselhar hábitos, ou em suas atividades de pesquisa. Hoje em dia, pode-se obter alguma evidência empírica nesta área. Por outra parte, tem-se assinalado que, às vezes, o atual debate sobre esta matéria se vê "carregado afetivamente" ou falha ao considerar que os interesses dos pacientes, de suas famílias, dos profissionais da saúde mental e os da indústria poderiam convergir. Atualmente, está se iniciando a discussão sobre outros conflitos de interesses. Existe evidência de que a proximidade de um pesquisador com alguma linha de pensamento pode influenciar os resultados de estudos ao comparar diferentes técnicas psicoterapêuticas, conflitando, portanto, com o interesse primário representado pelo progresso da ciência. O compromisso político também está emergindo como fonte de conflitos de interesses. Conflitos de interesses financeiros e não financeiros estão muito difundidos na prática e na pesquisa psiquiátricas. Não podem ser erradicados, porém devem ser tratados com maior eficácia em relação ao que se observa hoje em dia.

Ethical Dimension of a Harmonious Physician-Patient Relationship and Its Legal Support / 中国医学伦理学

Reasons why the current physician-patient relationship has not advanced to a truely harmonious stage in our country are multiple.From the ethical point of view,most medical disputes come from the lack of sincerity and humane care,and self-centered and economic benefits oriented concepts from both doctors and patients.From the legal point of view,the research on the important legal cases related to physician-patient relationship is hysteretic and even lacking.The system settling physician-patient conflict is distempered and imperfect.Both the doctors′ and patients′ legal knowledge and consciousness are inadequate.To construct a harmonious physician-patient relationship,we should fasten the process of legislation,protect profits on both sides,strengthen moral education and confirm the ethical demand.

Conflicts of Interests in Judging Medical Futility in Departments of Oncology / 中国医学伦理学

On time of judging medical futility in departments of oncology, conflicts of interests exist,so more attention should be paid to the principles of rule,investigation,preaching and being public.Concrete methods are as follows:education for medical staff should be continued to make further progress;the advanced opinions of medical behaviours should be presented to guide clinical practice;the departments of oncology should cooperate positively with the ethics committees of hospitals.