Definition

A conflict of interest exists when financial or personal relationships, affiliations, or beliefs influence, or appear to influence, professional judgment. Financial interests include employment, consultancy, grants, honoraria, ownership of shares, patents, and paid expert testimony. Non-financial interests include personal relationships, academic competition, institutional ties, and political, religious, or ideological commitments.

Authors

Authors disclose all conflicts of interest and all sources of funding, with grant numbers, on the title page and in the Declarations section of the manuscript. Authors describe the funder's role in study design, data collection, analysis, writing, and the decision to publish. Authors with no conflicts state: "The authors declare no conflict of interest."

Reviewers

Reviewers decline an invitation when they share an institution with any author, have collaborated with any author within the past three years, have a close personal relationship or rivalry with any author, hold a financial interest in the outcome, or recognize the authors despite anonymization.

Editors

Editors and editorial board members step aside from manuscripts by their students, close colleagues, members of their own department, and collaborators within the past three years. Another editor with no conflict handles such manuscripts.

Undisclosed conflicts

Conflicts discovered after submission or publication go through the COPE flowcharts and lead to a correction, an expression of concern, or a retraction, depending on the effect on the work.