Industry payments to physician journal editors

Background: Open Paymentsis a United States federal program mandating reporting of medical industry payments to physicians, thereby increasing transparency of physician conflicts of interest (COI).Study objectives were to assess industry payments to physician-editors, and to compare their financial COI rate to all physicians within the specialty. Methods and Findings: We performed a retrospective analysis of prospectively collected data, reviewing Open Paymentsfrom August 1, 2013 to December 31, 2016. We reviewed general payments ("payments… not made in connection with a research agreement") and research funding to "top tier" physician-editors of highly-cited medical journals. We compared payments to physician-editors and to physicians-by-specialty. In 35 journals, 333 (74.5%) of 447 "top tier" editors met inclusion criteria (US-based physician-editors). Of these, 212 (63.7%) received industry-associated payments in the study period. In an average year, 141 (42.3%) of physician-editors received any direct payments (to themselves rather than their institutions; includes general payments and research payments), 66 (19.8%) received direct payments >$5,000 (threshold designated by the National Institutes of Health as a Significant Financial Interest) and 51 (15.3%) received direct payments >$10,000. Mean annual general payments to physician-editors was $55,157 (median 3,512, standard deviation 561,885, range 10-10,981,153). Median general payments to physician-editors were mostly higher compared to all physicians within their specialty. Mean annual direct research payment to the physician-editor was $14,558 (median 4,000, standard deviation 34,471, range 15-174,440), and mean annual indirect research funding to the physician-editor's institution was $175,282 (median 49,107, standard deviation 479,480, range 0.18-5,000,000). The main study limitation was difficulty in identifying "top tier" physician-editors. Though we aimed to study physician-editors primarily responsible for making manuscript decisions, we were unable to confirm each editor's role. Conclusions: A substantial minority of physician-editors receive payments from industry within any given year, and most editors received payment of some kind during the four-year study period. There were significant outliers. Given the extent of editors' influences on the medical literature, more robust and accessible editor financial COI declarations are recommended.