1. Definition of Conflict of Interest

A conflict of interest, also referred to as a competing interest, arises when an individual's professional judgment or responsibilities concerning a primary scholarly interest may be influenced, or reasonably appear to be influenced, by a secondary interest.

Primary interests include:

• Scientific validity and accurate reporting of research.
• Protection of patients and research participants.
• Independent interpretation of research evidence.
• Objective and confidential peer review.
• Fair editorial decision-making.
• Integrity and reliability of the scholarly record.

1.1 Categories of Competing Interests

Relevant secondary interests may include:

• Financial Interests: Research grants, employment, consultancy fees, honoraria, equity ownership, royalties, patents, licensing revenue, or other financial benefits.
• Personal Relationships: Family relationships, close friendships, personal disputes, or other relationships that could affect independent judgment.
• Professional Interests: Supervisory relationships, employment responsibilities, current or recent collaborations, professional competition, or organizational commitments.
• Academic and Intellectual Interests: Strong intellectual commitments, direct academic rivalry, competing research programs, or other interests relevant to the manuscript.
• Institutional Interests: Institutional funding, commercial agreements, relevant intellectual property, institutional ownership, or obligations affecting the conduct or reporting of research.
• Commercial and Technological Interests: Relationships involving pharmaceuticals, medical devices, diagnostic technologies, TCM products, digital health services, AI systems, proprietary datasets, or related commercial activities.

1.2 Actual, Potential, and Perceived Conflicts

The journal considers three related forms of competing interest:

1.3 Relevance and Proportionality

The existence of a professional affiliation, research grant, personal connection, or intellectual position does not automatically establish an unacceptable conflict. Its significance depends on the relationship's nature, closeness, timing, financial or professional importance, and relevance to the manuscript or editorial responsibility.

Individuals should disclose relationships that could reasonably be considered relevant, even when they believe those relationships have not influenced their work.

2. Author Responsibilities

Every author is individually responsible for providing complete, accurate, and timely disclosure of relevant financial and non-financial relationships and activities.

Disclosure must cover relevant interests directly related to the submitted work and other relationships that could reasonably affect, or appear to affect, the authors' interpretation or presentation of the research.

2.1 Types of Conflicts

Authors must consider the following categories:

• Research Funding and Grants: Financial support from commercial, governmental, charitable, institutional, or other sources relevant to the work.
• Employment and Consulting: Paid appointments, advisory positions, consultancy agreements, expert testimony, and other professional financial relationships.
• Ownership and Intellectual Property: Shares, stock options, patents, patent applications, royalties, licenses, and commercialization agreements relevant to the research.
• Honoraria and Material Support: Speaking fees, travel support, equipment, software licenses, datasets, medical devices, computational resources, and other in-kind assistance.
• Professional and Personal Interests: Relevant collaborations, supervisory relationships, academic rivalries, personal relationships, and organizational responsibilities.
• Other Relevant Interests: Any financial or non-financial arrangement that could reasonably influence the design, conduct, analysis, interpretation, or publication of the research.

2.2 Disclosure Requirements

All submitted manuscripts must contain a Competing Interests Statement or equivalent Conflict of Interest Statement.

The declaration must:

• Identify relevant relationships and the individuals concerned.
• Identify relevant companies, institutions, funders, or other entities where appropriate.
• Describe the nature of the relationship or interest.
• Distinguish financial and non-financial interests where necessary.
• Disclose relevant interests even when the authors believe these did not influence the findings.
• Provide an explicit declaration where no relevant competing interests exist.

2.3 Illustrative Disclosure Statements

2.4 Funding and Sponsor Involvement

The Funding Statement and the Competing Interests Statement serve related but distinct purposes.

The Funding Statement must identify financial or material support provided directly for the submitted work, including relevant grant numbers, sponsor identities, and the role of funding organizations.

Where applicable, authors must disclose sponsor involvement in:

• Study conception, design, and protocol development.
• Participant recruitment, data collection, or experimental procedures.
• Data management, statistical analysis, and interpretation.
• Manuscript drafting, revision, or approval.
• Decisions concerning submission, journal selection, or publication restrictions.

Where the funder had no such involvement, authors should state this explicitly. Relevant relationships outside the funding of the submitted work must still be disclosed in the Competing Interests Statement.

2.5 Disclosure Forms and Verification

The Editorial Office may request individual author disclosures using the current ICMJE Disclosure Form or an equivalent journal disclosure mechanism. Completed forms must be submitted to the journal, not directly to the ICMJE.

Authors should disclose relevant support from the conception and planning of the work through publication, together with relevant outside relationships during the reporting period specified by the applicable disclosure form. Older or continuing interests that remain materially relevant must not be omitted solely because they fall outside a standard reporting period.

Where necessary, the journal may request grant information, sponsor agreements, intellectual-property details, institutional disclosure records, or additional explanations.

2.6 Double-Blind Review and Submission Files

Complete author-identifying Competing Interests Statements must be provided to the Editorial Office through the journal's online submission system or appropriate unblinded submission files.

Where a disclosure would reveal author identities during double-blind review, the relevant identifying information should be removed or appropriately anonymized from the reviewer-facing manuscript without concealing methodological information necessary for a fair scientific assessment.

The final published article must contain an accurate and appropriately identified Competing Interests Statement. Authors must review and update their disclosures during revision and production when relevant circumstances change.

2.7 Data Access and Independence

Authors must disclose material agreements that restrict access to research data, independent analysis, interpretation, or publication. Where a sponsor has a proprietary or financial interest in the study's outcome, the Editorial Office may request clarification about the authors' access to study data and their independence in analyzing and reporting the findings.

3. Reviewer Responsibilities

Peer reviewers must provide independent, impartial, and evidence-based assessments. Reviewers must disclose relationships or activities that could influence, or reasonably appear to influence, their evaluation of a manuscript.

3.1 Disclosure Before Accepting Review

Reviewers should inform the Handling Editor of relevant circumstances, including:

• Current or recent collaboration with an author or research group involved in the manuscript.
• Employment within the same institution or closely connected organizational unit.
• Close personal, family, supervisory, mentoring, or professional relationships.
• Direct academic competition or a serious professional dispute.
• Financial interests involving a product, organization, technology, or outcome discussed in the manuscript.
• Relevant patents, commercial partnerships, or proprietary research interests.
• Previous involvement in the research or access to confidential information about the work.
• Any other relationship that could compromise independent scholarly judgment.

3.2 Recusal and Editorial Guidance

Reviewers must decline or withdraw from assignments when a conflict makes independent evaluation inappropriate. Where the significance of a relationship is uncertain, the reviewer should disclose the circumstances and seek editorial guidance before proceeding.

Shared institutional affiliation or prior academic contact does not automatically establish that a review is invalid. The journal considers the closeness, timing, and material relevance of the relationship, while applying more restrictive measures when impartiality cannot reasonably be assured.

3.3 Conflicts Identified During Review

If a reviewer identifies a relevant conflict after accepting an invitation, the reviewer must promptly notify the Handling Editor and await instructions. The journal may continue the review with safeguards, appoint another reviewer, or discontinue the assignment.

3.4 Confidentiality and Misuse of Information

Reviewers must not use unpublished manuscript information for personal, academic, commercial, institutional, or competitive advantage. They must not disclose confidential research materials to unauthorized third parties.

Any proposed use of AI to assist with an assigned review requires prior written authorization from the Editorial Office and compliance with the journal's confidentiality and AI-related requirements.

Additional obligations are set out in the Reviewer Guidelines and AI & Research Integrity Policy.

4. Editor Responsibilities

Editors, editorial board members, guest editors, and editorial personnel must disclose relevant interests that could affect their judgment, responsibilities, or participation in manuscript assessment.

4.1 Editorial Disclosure and Recusal

Editors must disclose and appropriately manage situations involving:

• Their own manuscripts or research projects.
• Close collaborators, supervisors, students, colleagues, or other relevant professional relationships.
• Financial or intellectual-property interests related to the study.
• Commercial relationships with the sponsor, manufacturer, developer, or other relevant organization.
• Strong personal, academic, or institutional interests that could compromise impartiality.
• Other circumstances that could reasonably call independent editorial judgment into question.

A materially conflicted editor must recuse themselves from the affected manuscript's editorial management and decision-making.

Recusal may include exclusion from reviewer selection, access to confidential reviewer identities, assessment of reviewer recommendations, editorial deliberations, and final manuscript decisions.

4.2 Independent Editorial Assignment

Where an editor has a relevant conflict, the manuscript must be assigned to an appropriately qualified and unconflicted editor. The responsible editor must retain independent control over reviewer selection and the scholarly evaluation process.

If the Editor-in-Chief is materially conflicted, another qualified and unconflicted editor or designated independent person should assume responsibility for the affected decision.

4.3 Manuscripts Submitted by Editors or Board Members

When relevant, the published article should disclose the author's editorial relationship and indicate that independent editorial handling was applied.

4.4 Guest Editors and Special Issues

Guest editors and editors responsible for special issues must comply with the same conflict-of-interest requirements as other journal editors.

Manuscripts submitted by guest editors, their close collaborators, or other individuals with material relationships must be assigned to an independent editor where necessary. Sponsors and commercial partners must not control reviewer selection, editorial decisions, or the publication of unfavorable findings.

4.5 Continuing Editorial Disclosure

Editors and relevant journal personnel should keep their disclosure information current. The journal should maintain appropriate procedures for reviewing editorial interests and making relevant general disclosures publicly available while protecting confidential individual manuscript records.

5. Publisher Responsibilities

Panorama Scholarly Group (PSG), as the publisher of Health Nexus, supports transparent disclosure, editorial independence, responsible financial administration, and effective implementation of conflict-of-interest safeguards.

5.1 Separation of Editorial and Commercial Interests

Scholarly editorial decisions must remain independent of:

• Article Processing Charge payments or waiver requests.
• Advertising revenue, sponsorship, or commercial partnerships.
• Institutional publishing agreements or financial relationships.
• The commercial reputation or influence of authors, funders, or organizations.
• Publisher-owned or commercially connected products, services, or research interests.
• Other financial considerations unrelated to scholarly merit and ethical compliance.

Payment of an APC does not guarantee manuscript acceptance, favorable peer review, or accelerated academic approval.

5.2 Publisher Personnel and Disclosure

Publisher personnel involved in editorial coordination, production, publication ethics, financial administration, or other relevant activities must disclose relationships that could materially affect their responsibilities.

Confidential manuscript information must not be used for personal or commercial advantage. Publisher personnel must not improperly influence reviewer assignments, academic evaluations, or final decisions.

5.3 Institutional and Commercial Relationships

Where the publisher or journal has a relevant institutional or commercial relationship connected with a manuscript's subject matter, an appropriate independent editorial arrangement should be established if the relationship could reasonably compromise scholarly judgment.

Sponsorship of journal activities, special issues, or publication services must not grant the sponsor authority to determine scientific conclusions, reviewer appointments, manuscript acceptance, or suppression of unfavorable results.

5.4 Support for Ethical Oversight

The publisher supports appropriate administrative records, independent editorial procedures, research integrity inquiries, correction of published disclosures, and other measures necessary to maintain the integrity of the journal. Such responsibilities must be exercised without inappropriate interference in academic editorial decisions.

6. Management of Conflicts

Health Nexus evaluates disclosed and subsequently identified competing interests according to their relevance, significance, and potential effect on research integrity or editorial independence.

The purpose of conflict management is to reduce inappropriate influence while applying safeguards proportionate to the circumstances. Disclosure alone may be sufficient in some cases, while other relationships require recusal or additional independent assessment.

6.1 Preliminary Evaluation

The Editorial Office may assess:

• The nature, closeness, and duration of the relationship.
• Its relevance to the manuscript's subject matter and findings.
• Its financial, professional, intellectual, or institutional significance.
• Whether the relationship was disclosed accurately and promptly.
• Whether appropriate safeguards can protect independent evaluation.
• Whether readers require additional information to evaluate the publication.

6.2 Management Measures

Depending on the circumstances, the journal may:

• Determine that the disclosed relationship does not require additional action.
• Request clarification or a more complete disclosure statement.
• Publish an appropriate author competing-interests statement.
• Request additional information about funding, sponsor involvement, data access, or analytical independence.
• Assign an independent Handling Editor.
• Exclude or replace a reviewer with a material conflict.
• Require an editor, guest editor, or other relevant person to recuse themselves.
• Seek independent statistical, clinical, methodological, or technical evaluation.
• Request clarification or revision of claims whose interpretation may be affected by a relevant interest.
• Suspend assessment while a significant unresolved concern is examined.
• Decline a manuscript where a material conflict cannot be adequately managed and publication would compromise applicable editorial or research integrity standards.

6.3 Publication Is Not Automatically Prohibited

6.4 Conflicts Identified During Editorial Assessment

Where a relevant conflict is discovered after peer review has begun, the journal may reassess the involvement of affected reviewers or editors, obtain an independent review, and reconsider any decision materially influenced by the relationship.

The journal should preserve appropriate records of significant conflict-management decisions while protecting confidential personal information, reviewer identities, and unpublished manuscript materials.

6.5 Appeals Concerning Conflict Management

Authors or other affected parties may raise a reasoned concern regarding a material conflict or an improperly managed editorial decision through the journal's Complaints & Appeals Policy. Such matters should be assessed by an appropriately unconflicted individual.

7. Post-Publication Disclosure

Authors remain responsible for notifying the Editorial Office when a material omission, inaccurate statement, or previously undisclosed competing interest is identified after publication.

Concerns may also be raised by readers, reviewers, institutions, funders, or other parties with relevant supporting information.

7.1 Assessment of Undisclosed Interests

The Editorial Office may:

1. Identify the relevant publication and alleged omission.
2. Request clarification from the author or other party involved.
3. Examine relevant disclosure forms, institutional records, sponsor agreements, or other appropriate evidence.
4. Determine whether the interest was relevant at submission or became relevant later.
5. Evaluate whether the omission affected editorial independence, research interpretation, or the reliability of the article.
6. Select a proportionate corrective or investigative response.

7.2 Correction of the Published Record

Where an omitted interest requires disclosure but the article's principal findings remain reliable, a formal Correction or another appropriate transparent update may be issued.

The correction should identify the relevant interest and explain the necessary amendment, subject to applicable privacy and publication integrity requirements.

7.3 Expressions of Concern and Retractions

An Expression of Concern may be appropriate when a credible and consequential issue remains unresolved and readers should be informed while further assessment is pending.

Retraction may be considered where an undisclosed interest is associated with serious research unreliability, compromised publication integrity, or another circumstance satisfying the journal's Retraction Policy.

Nondisclosure of a competing interest does not automatically require retraction. The journal considers the evidence, significance of the relationship, reliability of the findings, and adequacy of available corrective measures.

7.4 Honest Omission and Deliberate Concealment

An inaccurate or incomplete declaration may result from misunderstanding, oversight, negligence, or intentional concealment. The journal distinguishes these circumstances using available evidence and appropriate procedures.

Deliberate concealment of a material interest required by journal policy may constitute publication misconduct. An inadvertent omission that is promptly corrected does not automatically establish misconduct.

Relevant post-publication actions are governed by the Corrections Policy and Retraction Policy.

8. Transparency and Accountability

Health Nexus requires relevant competing interests to be disclosed accurately, assessed appropriately, and communicated to readers where necessary for transparent interpretation of the published work.

8.1 Publication of Author Disclosures

All published articles must contain an appropriate Competing Interests Statement, including an explicit declaration when the authors report no relevant competing interests.

Relevant funding and sponsor information must be disclosed separately and accurately. Where applicable, the article should explain restrictions on access to study data or the independence of the analysis and publication process.

The Editorial Office may edit disclosures for clarity, consistency, and relevance without altering their substantive meaning.

8.2 Confidential Reviewer and Editorial Disclosures

Reviewer-specific conflict disclosures are ordinarily confidential editorial records and are not automatically published alongside the article.

Editor and editorial board member interests should be managed transparently, including relevant public disclosures where appropriate. Individual manuscript-handling records, confidential reviewer identities, and protected personal information must remain subject to appropriate confidentiality safeguards.

8.3 Continuing Duty to Update

Authors must update relevant declarations when relationships arise, change materially, or become newly relevant during peer review, revision, acceptance, and production.

Publication does not end the obligation to notify the journal of a material omission or error concerning a previously published disclosure.

8.4 Recordkeeping and Confidentiality

The journal should maintain appropriate internal records of material disclosures, editorial recusals, independent reviewer assignments, and relevant conflict-management decisions.

Such records should be handled in accordance with applicable confidentiality, institutional, and data protection requirements. The existence of a conflict-management record does not itself authorize public disclosure of private information.

8.5 Relationship to AI-Use and Research Integrity Disclosures

The Competing Interests Statement is distinct from the AI-Use Declaration, Funding Statement, Data Availability Statement, and other mandatory scholarly declarations.

Use of an AI tool does not automatically create a competing interest. However, financial ownership, employment, consultancy, intellectual-property rights, or other relevant relationships involving an AI system or its developer may require disclosure.

Authors must satisfy the applicable requirements of each declaration rather than assuming that one disclosure replaces another.

9. Compliance with Standards

This policy is informed by internationally recognized guidance concerning financial and non-financial competing interests, research transparency, independent editorial decisions, and ethical scholarly publishing.

9.1 International Guidance

• International Committee of Medical Journal Editors (ICMJE): Recommendations concerning disclosure of financial and non-financial relationships and activities, author accountability, reviewer responsibilities, editorial recusal, and transparent reporting of study support. ICMJE Disclosure Recommendations
• ICMJE Disclosure Form: A standardized instrument that may be used by journals to obtain author declarations concerning relevant relationships and activities. ICMJE Disclosure Resources
• Committee on Publication Ethics (COPE): Core Practices concerning competing interests, editorial independence, research integrity, peer review, and the management of conflicts involving authors, reviewers, editors, journals, and publishers. COPE Core Practices
• Applicable Institutional and Legal Requirements: Relevant institutional disclosure obligations, research funding conditions, professional rules, data protection requirements, and laws concerning financial or professional interests.

9.2 Relationship to Other Journal Policies

This policy should be read together with the journal's Author Guidelines, Publication Ethics Policy, Publication Ethics Requirements, Reviewer Guidelines, Peer Review Process, AI & Research Integrity Policy, Corrections Policy, Retraction Policy, and Complaints & Appeals Policy.

Where a concern raises questions of research misconduct, independent editorial assessment, data reliability, or the integrity of a published article, the relevant specialized journal policy and procedures must also be applied.

9.3 Independence from External Organizations

References to ICMJE, COPE, or other organizations identify guidance informing the journal's ethical framework. They do not independently establish formal membership, accreditation, certification, endorsement, or indexing status.

9.4 Policy Review

Health Nexus may periodically review and update its conflict-of-interest requirements to reflect developments in medical research, research funding, commercialization, artificial intelligence, intellectual property, editorial governance, and international scholarly publishing standards. Material changes should be communicated transparently and coordinated with related journal policies.