Silence from Frontiers on financial conflict of interest in publications

Yesterday, an article was published in Nature, written by the co-founder of Retraction Watch and executive director or the Center For Scientific Integrity, Ivan Oransky, who says that Retractions are increasing, but not enough. I agree with Oransky, and it made me remember a letter I sent to Frontiers a year ago. Frontiers is the 3rd most-cited and 6th largest research publisher.

On May 28th, 2021, I sent a letter to co-founder and CEO of Frontiers Kamila Markram, making her aware of that a number of the articles published in Frontiers fail to inform of a researcher’s financial conflict of interest. I received no response.

On June 4th, 2021, I forwarded the letter to Chief Publishing Officer Mirjam Eckert. Seven weeks later I received an email from one of their Research Integrity Specialists who assured me that “we are investigating your concerns regarding these publications and we will inform you once we have determined the appropriate course of action.” Since then, there has been nothing but silence. Here is the letter I sent:

“For the attention of Chief Publishing Officer Mirjam Eckert, PhD

Frontiers

psychiatry.editorial.office@frontiersin.org

psychiatry@frontiersin.org                                                June 4th 2021

Conflict of interest not reported.

Dear Mrs. Mirjam Eckert

I have previously written to Mrs. Kamila Markram about this matter, but unfortunately, she has not responded. Therefore, I am contacting  you.

I am a former HSEQ Chief Executive, now ME-patient and writer at the website www.melivet.com. I have written an article about what seems to be a non-reported financial conflict of interest in a number of scientific articles published in Frontiers: Undisclosed financial conflict of interest in Norwegian ME-research.

Reference is made to the article by Gotaas ME, Stiles TC, Bjørngaard JH, Borchgrevink PC, Fors EA.: Cognitive Behavioral Therapy Improves Physical Function and Fatigue in Mild and Moderate Chronic Fatigue Syndrome: A Consecutive Randomized Controlled Trial of Standard and Short Interventions. Front Psychiatry. 2021 Apr 12;12:580924. doi: 10.3389/fpsyt.2021.580924.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

However, author T. C. Stiles planned the study, developed the treatment manual, designed the 8-week Cognitive Behavioural Therapy (CBT) intervention, and reviewed the text. The intervention took place at the Coperio health centre. Coperio is a commercial company, solely owned by T. C. Stiles. Please see the official company information here: https://www.proff.no/roller/coperio-holding-as/trondheim/hovedkontortjenester/IEP6NMC10NZ/

Coperio has an agreement with the Central Norway Regional Health Authority (Helse Midt-Norge HF), a state-owned regional health authority, for rehabilitation and treatment of CFS/ME-patients. For several years, Coperio also had an agreement with the Norwegian Labour and Welfare Administration (NAV) for referral of patients to a project with the aim to get patients rapidly back to work.

Coperio is currently treating CFS/ME-patients with a 10-week CBT programme similar to the 8-week programme described in the article. 

Research

Since the establishment of Coperio in 2002, T.C. Stiles has co-authored at least 79 published scientific articles, thereof 21 clinical trials. A majority of these articles are on subjects and treatments related to his company’s services.

It seems Frontiers has published at least nine other relevant articles by Stiles where the conflict of interest has not been reported. These are:

  1. Vethe D, Kallestad H, Jacobsen HB, Landrø NI, Borchgrevink PC, Stiles TC. The Relationship Between Improvement in Insomnia Severity and Long-Term Outcomes in the Treatment of Chronic Fatigue. Front Psychol. 2018 Sep 21;9:1764. doi: 10.3389/fpsyg.2018.01764. eCollection 2018.PMID: 30298037 
  • Jacobsen HB, Glette M, Hara KW, Stiles TC. Metacognitive Beliefs as Predictors of Return to Work After Intensive Return-to-Work Rehabilitation in Patients With Chronic Pain, Chronic Fatigue and Common Psychological Disorders: Results From a Prospective Trial. Front Psychol. 2020 Feb 6;11:70. doi: 10.3389/fpsyg.2020.00070. eCollection 2020.PMID: 32116900 
  • Jacobsen HB, Aasvik JK, Borchgrevink PC, Landrø NI, Stiles TC. Metacognitions Are Associated with Subjective Memory Problems in Individuals on Sick Leave due to Chronic Fatigue. Front Psychol. 2016 May 13;7:729. doi: 10.3389/fpsyg.2016.00729. eCollection 2016.PMID: 27242634 
  • Aasvik JK, Woodhouse A, Jacobsen HB, Borchgrevink PC, Stiles TC, Landrø NI. Subjective memory complaints among patients on sick leave are associated with symptoms of fatigue and anxiety. Front Psychol. 2015 Sep 8;6:1338. doi: 10.3389/fpsyg.2015.01338. eCollection 2015.PMID: 26441716 
  • Brage, Jonassen Rune, Stiles Tore C., Landrø Nils. I. Dysfunctional Metacognitive Beliefs Are Associated with Decreased Executive Control Front Psychol. 2017  doi: 10.3389/fpsyg.2017.00593   
  • Jacobsen HB, Klungsøyr O, Landrø NI, Stiles TC, Roche BT. MINDflex Training for Cognitive Flexibility in Chronic Pain: A Randomized, Controlled Cross-Over Trial. Front Psychol. 2020 Dec 21;11:604832. doi: 10.3389/fpsyg.2020.604832. eCollection 2020.PMID: 33408670 
  • Østergaard T, Lundgren T, Rosendahl I, Zettle RD, Jonassen R, Harmer CJ, Stiles TC, Landrø NI, Haaland VØ. Acceptance and Commitment Therapy Preceded by Attention Bias Modification on Residual Symptoms in Depression: A 12-Month Follow-Up. Front Psychol. 2019 Aug 29;10:1995. doi: 10.3389/fpsyg.2019.01995. eCollection 2019.PMID: 31555180 
  • Aasvik JK, Woodhouse A, Stiles TC, Jacobsen HB, Landmark T, Glette M, Borchgrevink PC, Landrø NI. Effectiveness of Working Memory Training among Subjects Currently on Sick Leave Due to Complex Symptoms. Front Psychol. 2017 Jan 6;7:2003. doi:10.3389/fpsyg.2016.02003. eCollection 2016.PMID: 28111555 
  • Lyche P, Jonassen R, Stiles TC, Ulleberg P, Landrø NI. Cognitive Control Functions in Unipolar Major Depression with and without Co-Morbid Anxiety Disorder. Front Psychiatry. 2010 Dec 21;1:149. doi:10.3389/fpsyt.2010.00149. eCollection 2010. PMID: 21423456 

I kindly ask your opinion on this matter, and also Frontiers plans for investigating and appropriate actions in this case. A correction or an erratum mentioning this undeclared conflict of interest would seem to be an important step to take.

I am currently writing a follow-up article on this matter, and kindly ask your rapid response. It will be published on my website www.melivet.com and possibly also in a Norwegian newspaper.

Please also let me know if you need further information.

Kind regards,

Nina E. Steinkopf

Former HSEQ Chief Executive

Now; ME-patient and writer at www.melivet.com

Seven weeks later Frontiers assured me that “we are investigating your concerns regarding these publications and we will inform you once we have determined the appropriate course of action.” Since then, there has been nothing but silence.

So; now I reach out to my readers and kindly ask for your comments or advice on this matter.

All the best,

Nina E. Steinkopf

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