The ADA's policy on duality of interest. Implications for publications.

Since 1979, the American Diabetes Association has had a policy requiring officers, members of the Board of Directors, and senior staff members to annually provide a written declaration of relevant duality of interest. Under this policy, a declaration of duality of interest is reviewed by the Audit Committee, and the involved member voluntarily withdraws from decisions if the duality of interest might be perceived as influencing him or her to act contrary to the interests of the Association. The policy has functioned well and has protected the interests of the Association. The American Diabetes Association has decided to extend the policy to include all authors, editors, and editorial board members of ADA consumer and health care publications. In extending the policy to authors the American Diabetes Association is not breaking new ground without precedent, but is following the lead of prestigious journals such as Science, The New England Journal of Medicine, and the. Journal of the American Medical Association (1-3). Each journal instituting conflict of interest policies has had some variations in the details of the policies. Some journals also require manuscript reviewers to declare in writing conflicts of interest, but most have chosen not to do so, perhaps fearing a revolt by hard-pressed volunteer reviewers. The ADA has chosen not to include a written declaration for reviewers, but reviewers are expected, as they always have been, to disqualify themselves if they are aware of a clear conflict. In practice this conflict usually involves a close association with one of the authors of the manuscript being reviewed. The American Diabetes Association did not blindly follow the lead of other journals when extending its policy, but carefully reviewed the arguments on all sides of the issue. Using the existing policy as a guide, the Publications Policy Committee developed a policy outline. The Association's journal editors all had an opportunity to provide commentary, and its Board of Directors discussed and approved the policy. Beginning in July 1994, in addition to signing a copyright assignment and statement denying duplicate publication, all authors submitting manuscripts will be required to sign a duality of interest statement at the time of submission of the manuscript. The Association labels the declaration "duality of interest" to avoid the pejorative implications of the term "conflict of interest." The ADA definition of duality of interest focuses primarily on interests with financial implications, specifically listing employment, membership on boards, committees, and advisory panels of organizations, stock ownership by the author or immediate family, paid consultative or advisory arrangements, and grant or research support.