Conflicts of interest and the risk of bias are inevitable in urolithiasis research

This review examines data from stone conferences and research journals to assess whether justifiable concerns exist about possible bias in urolithiasis research and if so, how they can be minimized. Conflict of interest (COI) policies of two major urological congresses and three symposia dedicated to stone research were reviewed. Disclosure slides were viewed in webcasts and were evaluated for robustness and speaker compliance with respect to policy. Additionally, disclosure and COI policies of ten Science Citation Index (SCI)-approved journals were assessed and compared with actual declarations in published papers on urolithiasis. It was observed that disclosure and conflict declarations are frequently conflated in congresses and journals. Differences between the two ideologies appear to be ignored or unappreciated. Disclosures in the major urological meetings revealed a high percentage of financial relationships with industry. In dedicated stone conferences, more than two-thirds of speakers failed to display a declaration slide. Both scenarios generate questions about objectivity. Disclosure and COI statements in journals varied widely in format, detail and content. It is concluded that there exists a misinformed and incorrect perception in urolithiasis research that disclosure of potential COIs somehow validates a study as being objective and unbiased. Current policies and practices at conferences and in published papers create a setting in which concerns of bias prevail. Changes, including the establishment of a universal policy, insistence of independent and explicit declarations of disclosures and conflicts, implementation of sanctions for transgression and the introduction of intensive scrutiny by reviewers are required to minimize doubts.