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Many factors, including professional andpersonal relationships and activities, caninfluence the design, conduct, and reportingof the clinical science that informs healthcare decision. The potential for conflict ofinterest exists when these relationships andactivities may bias judgement (1). Manystakeholders—editors, peer reviewers,clinicians,educators,policymakers,patients, and the public—rely on thedisclosure of authors’ relationships andactivities to inform their assessments. Trustin the transparency, consistency, andcompleteness of these disclosures isessential.Ten years ago, the InternationalCommittee of Medical Journal Editors(ICMJE) adopted the “ICMJE Form for theDisclosure of Potential Conflicts ofInterest” as a uniform mechanism forcollectingandreportingauthors’relationships and activities that readersmight consider relevant to a published work(2). The goal was to avoid the confusion(and often ensuing controversy) createdwhen journals vary in how they collect andreport this information. We believe auniform disclosure form has been helpful,but problems remain. First, the softwaresupporting the current form is increasinglyproblematic, making its use difficult orimpossible for an increasing number ofauthors. More important, however, is thatmany authors and readers misunderstand,misapply, or misinterpret the disclosures.Although some individuals violate thepublic trust by purposefully hiding relevantrelationships and activities, we believemost authors are committed to transparentreporting and consider it as vital to theadvancementofclinicalscience.Nonetheless, disagreement, confusion, andDOI: http://dx.doi.org/10.4314/ejhs.v30i1.1January 2020controversy regarding authors’ disclosuresarise when opinions differ over whichrelationships and activities to report. Anauthor might not report an item that othersdeem important because of a difference inopinion regarding what is “relevant,”confusion over definitions, or a simpleoversight. Some authors may be concernedthat readers will interpret the listing of anyitem as a “potential conflict of interest” asindicative of problematic influence andwrongdoing, a concern often raisedregarding the requirement to report publiclyfunded grants. For their part, some readersfail to recognize that their own relationshipsand activities influence how they assess thework of others and what they deem to be a“conflict” for others or themselves.