RenalWeek 2009 in San Diego is underway. I just enjoyed a forum on conflict of interest in medicine. One talk, by Rober M. Califf, MD, of Duke University, discussed bias in clinical trial reporting. Most of the speakers focused on financial conflicts of interest. Dr. Califf described a number of nonmonetary conflicts of interest as well.
One of these nonfinancial conflicts involved scientific hubris. For example, you review a paper or a grant and its (potential) results shoot down your own research and ideas. Do you accept the possibility that you are wrong? This work has the potential to make your prior work irrelevant, as well as decreasing your ability to get funding and promotion. The document is well-written and convincing, at least to the other reviewers. Do you allow it to proceed, or do you demand further work to reconcile it with your current hypothesis? Data that may not be feasible, if your personal paradigm is wrong?
We scientific types supposedly worship at the alter of truth and knowledge. We are human, though, and humans like to have explanations for everything. As nature abhors a vacuum, our brains hate missing information or pieces. In other words, we are biologically predisposed to develop hypotheses and patterns for everything around us. We also seem predisposed to defending views in which we are invested.
This source of conflict is rampant in peer review. Qualified peers must have knowledge of the subject area in question, and they will have pre-formed hypotheses about the material. Most reviewers can accept new experiments that advance their ideas, even if the world moves in a new direction. When those pre-formed ideas quash legitimate questions, then they become a source of conflict of interest.
What can one do? One can exclude reviewers based on probable bias. This practice is commonplace for manuscript submission. If a member of your study section could be trouble, you can request that they not review your grant. You should send your stuff to lots of different funding agencies as well; the same proposal may be funded by one agency and triaged by another, just because peer review is subjective and biased in this way.
Human nature simply will not allow all sources of bias to be removed from the world. I hope we in science can consider our own intellectual prejudices and overcome this conflict of interest.
Photos courtesy of PhotoXpress.