Supplements are the cause of much debate in the world of journal publishing. Supplements are criticized for the fact that often they are funded by an external source, and journals have been known to shy away from their publication . But is refusing to publish supplements the only answer? At Arthritis Research & Therapy, we feel that - if subjected to the full rigors of peer review - supplements can provide invaluable educational resources, exploring themes in a detailed and focused way that might not always be possible in the main journal.
At Arthritis Research & Therapy, we have decided that the potential risk of a loss of objectivity in industry-sponsored supplements can be managed by scrupulous attention to the peer-review process. Therefore, in our experience, the benefit of publishing supplements greatly outweighs any perception of loss of objectivity. We should note that our colleagues in the pharmaceutical industry have embraced our approach with no efforts to circumvent our rules, as far as we know.
We consider proceedings, review collections, and meeting abstracts for inclusion as supplements. Examples of recent supplements are easily accessed on the journal website. It will be apparent that the emphasis is on the molecular and cellular basis of immune and inflammatory mechanisms of disease. The underwriting by the sponsor of the cost of peer review and production ensures that the high-quality publication is freely available. Outlined below is the procedure that we follow when considering any potential supplements for the journal. We recognize the potential for competing interests to influence the content of articles where there is industry involvement, but we believe that by adhering to a stringent publication process we negate this risk with our supplement content.
So, what is the procedure? First, in a change from the approach taken by many journals, we appoint an 'internal' Supplement Editor (usually from the journal's Editorial Board), whose role is to select peer reviewers and assess the suitability of the supplement articles for publication in the journal. This internal editor is selected by the Editors-in-Chief, and the sponsor's approval is not sought in making this appointment. Before their appointment, internal editors are asked to declare any potential conflicts of interest, and full disclosures are included in both online and print versions of any supplements. In cases in which internal editors receive a stipend, this is paid for by the publisher - not the sponsor. All conflict of interest disclosures associated with supplement publications follow the National Library of Medicine policy for indexing supplement articles in MEDLINE .
For some supplements, particularly where articles are commissioned externally, there may be an 'external' Supplement Editor as well as the internal editor. Before their appointment, external supplement editors must be approved by the Editors-in-Chief. Their role is to identify the subject matter and propose suitable authors for the individual supplement articles, with the proviso that all content must be approved by the Editors-in-Chief. The external editor is not involved in the peer review of any of the articles once submitted. They are also asked for full conflict of interest disclosures, which are included in the supplement publication alongside those of the internal editor.
One of the common criticisms levied against supplements is that the articles are not peer-reviewed to the journal's normal standards. At Arthritis Research & Therapy, supplement articles go through the same thorough peer-review process as articles do in the main journal . The Editors-in-Chief have full editorial control, including the ability to ask authors to make extensive revisions, and reserve the right to reject articles that do not meet the journal's standards. And in accordance with the guidelines of the International Committee for Medical Journal Editors , all contracts clearly include information about editorial control and the role of the internal supplement editor.
In addition to disclosures from the individual editors, sources of funding for a supplement are prominently displayed on the supplement title page, and funding is also acknowledged in each individual article. We ensure that supplements can be clearly distinguished as separate from the main journal content on the journal homepage. As with all of our articles, individual authors declare their conflicts of interest. This complies with the good publication practice (GPP2) guidelines . We also adhere to the guidelines of the European Medical Writers Association  by ensuring that the involvement of any medical writers is disclosed in an article's acknowledgments section along with their sources of funding.
We hope that by ensuring that there is full transparency of disclosures from everyone involved in supplements and following strictly the peer-review procedure described above, we avoid the potential pitfalls of supplement publishing. The guidelines of the International Committee of Medical Journal Editors themselves state that supplements 'serve useful purposes' and it is our responsibility as editors to ensure that they continue to be useful without allowing ourselves to be subject to industry influence. By publicly disclosing our policy for supplement review here, we hope that other journals will be more open about their peer-review policies for supplements and that they adopt similarly stringent practices in the future.
JB and FM are employees of BioMed Central and receive fixed salaries. PL and RM are the Editors-in-Chief of Arthritis Research & Therapy and receive an annual honorarium.
Conflict of Interest Disclosure and Journal Supplements in MEDLINE® Fact Sheet [http://www.nlm.nih.gov/pubs/factsheets/supplements.html] webcite
Graf C, Battisti WP, Bridges D, Bruce-Winkler V, Conaty JM, Ellison JM, Field EA, Gurr JA, Marx M, Patel M, Sanes-Miller C, Yarker YE, for the International Society for Medical Publication Professionals: Good publication practice for communication company sponsored medical research: the GPP2 guidelines.