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Director, Division of Ambulatory Surgery, Assistant Professor, Department of Anesthesiology (Roberson) Director, Department of Pharmacy, Assistant Professor, Department of Anesthesiology, Texas A & M Health Science Center Scott and White Hospital, Temple, Texas, phatam{at}swmail.sw.org (Meyer)
In Response:
We fully appreciate the comments of Dr. Mychaskiw and colleagues regarding the importance of conflict of interest. Although we responded to this concern raised earlier by Dr. White (1,2), certainly the issue of conflict of interest is of great enough importance that we believe it deserves further elaboration.
Conflict of interest, even the appearance of conflict of interest when none exists, must be avoided in scientific reports. We agree with Dr. White and Dr. Mychaskiw that Dr. Charles McLeskey’s association with Abbott Laboratories should have been disclosed with the published article. Consistent with this intent, Dr. McLeskey’s name and prior title at the time of conduct of the study, Chairman at Scott and White, and his title at submission, Global Medical Director for Abbott Laboratories, were both clearly indicated on the title page of the manuscript submitted to Anesthesia & Analgesia.
However, at some point in the journal’s process of revisions, his title at his current position was deleted. Unfortunately during these several revisions to the manuscript, we focused on the body of the manuscript and failed to notice this deletion. In addition, although Dr. McLeskey was involved in the design and conduct of the study and creation of the original manuscript, the final revisions were completed by the first authors (Meyer and Roberson). Although our action of providing his complete affiliation with a pharmaceutical company clearly shows our intent to fully disclose his role and potential associated conflicts of interest, we were remiss in failing to notice the revision to his title made by the copy editors of Anesthesia & Analgesia.
On Dr. Mychaskiw’s second point, the fact that some patients received prophylaxis was not "ignored" and was clearly discussed as one of the limitations of the study. The number of patients receiving prophylaxis in each group was similar, as seen in Table 1 from the article (3). To suggest that these conditions of the study render it "irrelevant to most clinical situations" is perplexing. The practice of administration of antiemetic prophylaxis remains non-uniform among practitioners in the United States and around the world. At our center alone, we deal with the treatment of postoperative nausea and vomiting in patients who may or may not have received prophylaxis on a daily basis. A definitive answer as to which medication, or combination of medications, is best to treat postoperative nausea and vomiting remains elusive.
References
This article has been cited by other articles:
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  S. L. Shafer Ethics, Marketing, and the Medical Literature Anesth. Analg., August 1, 2006; 103(2): 488 - 488. [Full Text] [PDF]
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