OBJECTIVE To assess the effect of disclosing authors' conflict of interest declarations to peer reviewers at a medical journal. DESIGN Randomized controlled trial. SETTING Manuscript review process at the Annals of Emergency Medicine. PARTICIPANTS: Reviewers (n=838) who reviewed manuscripts submitted between 2 June 2014 and 23 January 2018 inclusive (n=1480 manuscripts). INTERVENTION Reviewers were randomized to either receive (treatment) or not receive (control) authors' full International Committee of Medical Journal Editors format conflict of interest disclosures before reviewing manuscripts. Reviewers rated the manuscripts as usual on eight quality ratings and were then surveyed to obtain "counterfactual scores"-that is, the scores they believed they would have given had they been assigned to the opposite arm-as well as attitudes toward conflicts of interest. MAIN OUTCOME MEASURE Overall quality score that reviewers assigned to the manuscript on submitting their review (1 to 5 scale). Secondary outcomes were scores the reviewers submitted for the seven more specific quality ratings and counterfactual scores elicited in the follow-up survey. RESULTS Providing authors' conflict of interest disclosures did not affect reviewers' mean ratings of manuscript quality (Mcontrol=2.70 (SD 1.11) out of 5; Mtreatment=2.74 (1.13) out of 5; mean difference 0.04, 95% confidence interval -0.05 to 0.14), even for manuscripts with disclosed conflicts (Mcontrol= 2.85 (1.12) out of 5; Mtreatment=2.96 (1.16) out of 5; mean difference 0.11, -0.05 to 0.26). Similarly, no effect of the treatment was seen on any of the other seven quality ratings that the reviewers assigned. Reviewers acknowledged conflicts of interest as an important matter and believed that they could correct for them when they were disclosed. However, their counterfactual scores did not differ from actual scores (Mactual=2.69; Mcounterfactual=2.67; difference in means 0.02, 0.01 to 0.02). When conflicts were reported, a comparison of different source types (for example, government, for-profit corporation) found no difference in effect. CONCLUSIONS Current ethical standards require disclosure of conflicts of interest for all scientific reports. As currently implemented, this practice had no effect on any quality ratings of real manuscripts being evaluated for publication by real peer reviewers.

中文翻译：

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在同行评审中揭示作者的利益冲突的影响：随机对照试验。

目的评估在医学期刊上将作者的利益冲突声明披露给同行审阅者的效果。设计随机对照试验。《急诊医学年鉴》中的《设置手稿》审查过程。参加者：审稿人（n = 838），审阅了2014年6月2日至2018年1月23日（含）之间提交的手稿（n = 1480手稿）。干预在审稿之前，将审稿人随机分配为接受（治疗）或不接受（对照）作者的完整国际医学杂志编辑委员会格式，以披露利益冲突。审阅者对手稿的评价与往常一样是在8个质量等级上，然后进行了调查，以得出“反事实评分”，也就是说，他们认为如果将他们分配给相反的机构，他们会得到的分数以及对利益冲突的态度。主要观察指标审稿人在提交审稿时为稿件指定的总体质量得分（1至5级）。次要结果是审阅者针对后续调查中得出的七个更具体的质量评分和反事实评分所提交的评分。结果提供作者的利益冲突披露信息不会影响审稿人对手稿质量的平均评分（Mcontrol = 2.70（SD 1.11），满分5分; Mprocessing = 2.74（1.13），满分5分;平均差异0.04,95％置信区间-0.05到0.14），甚至对于有公开冲突的手稿（Mcontrol = 2.85（1.12），满分5分； Mprocessing = 2.96（1.16），满分5；平均差0.11，-0.05至0.26）。相似地，审阅者指定的其他七个质量评级中的任何一个均未观察到治疗效果。审稿人承认利益冲突是重要事项，并认为可以在披露利益冲突时予以纠正。但是，他们的反事实得分与实际得分没有差异（Mactual = 2.69； Mcounterfactual = 2.67；均值差异0.02，0.01至0.02）。报告冲突时，对不同来源类型（例如，政府，营利性公司）的比较没有发现效果上的差异。结论当前的道德标准要求所有科学报告都披露利益冲突。按照目前的做法，这种做法对由真正的同行评审员评估出版的真实手稿的质量等级没有影响。