Health Nexus: Digital Health and Medical AI is committed to transparent disclosure and appropriate management of financial and non-financial relationships that could influence, or reasonably be perceived as influencing, scholarly judgement.

All participants in the submission, peer-review, editorial, production, and publication processes—including authors, reviewers, editors, editorial board members, guest editors, journal staff, and relevant publisher personnel—must disclose relationships and activities that may create an actual, potential, or perceived conflict of interest.

The existence of a relationship or activity does not necessarily indicate misconduct, bias, or grounds for rejection. Transparent disclosure enables editors, reviewers, readers, and other stakeholders to evaluate its relevance and allows the journal to apply appropriate safeguards.

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1. Definition

A conflict of interest, also referred to as a competing interest, exists when a person’s professional judgement or responsibilities concerning a primary interest may be influenced, or reasonably appear to be influenced, by a secondary financial, personal, professional, academic, institutional, intellectual, political, or commercial interest.

Primary interests may include:

• Accuracy and integrity of research;
• Protection of patients and research participants;
• Fair and independent peer review;
• Objective editorial decision-making;
• Reliable reporting of scientific evidence;
• Protection of the scholarly record.

A conflict may exist even where the individual believes that the relationship has not affected their judgement. The appearance of a conflict may be relevant because undisclosed relationships can undermine confidence in the research and publication process.

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2. Scope of the Policy

This policy applies to:

• All manuscript categories, including research articles, reviews, protocols, technical articles, case studies, perspectives, commentaries, editorials, and letters;
• Research funding, institutional support, commercial sponsorship, and in-kind assistance;
• Authorship, peer review, editorial assessment, special issues, supplements, and commissioned content;
• Data ownership, access, analysis, interpretation, and publication rights;
• Digital-health products, medical devices, software, datasets, algorithms, artificial-intelligence systems, models, platforms, and related intellectual property;
• Relationships existing before submission, arising during review, or becoming relevant after publication.

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3. General Disclosure Principle

Individuals should disclose any relationship or activity that a reasonable reader, reviewer, editor, patient, research participant, or member of the public might consider relevant to the work or to the individual’s role in the publication process.

Where uncertainty exists, disclosure is preferred to non-disclosure.

Disclosure does not automatically imply:

• Research misconduct;
• Bias in the manuscript;
• Ineligibility for authorship;
• Automatic rejection;
• Disqualification from all editorial or reviewing activities.

The editorial office determines whether a disclosed relationship requires no further action, additional explanation, public disclosure, independent review, recusal, reassignment, or another management measure.

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4. Financial Interests

Financial interests that must be disclosed include, but are not limited to:

• Employment or paid appointments;
• Consultancy or advisory work;
• Honoraria and speaking fees;
• Research grants and contracts;
• Travel, accommodation, meeting, or educational support;
• Payment for expert testimony;
• Payment for manuscript preparation, medical writing, statistical analysis, or technical assistance;
• Stock, share, option, equity, or other ownership interests;
• Royalties or licensing income;
• Patents, patent applications, licences, and intellectual-property interests;
• Board membership or fiduciary roles;
• Gifts, equipment, software, datasets, cloud-computing credits, model access, technical services, or other in-kind support;
• Commercial funding provided to the author, research group, laboratory, department, or institution;
• Financial relationships involving a spouse, partner, dependent, or closely connected person where relevant to the work.

No minimum financial threshold applies where a relationship is directly relevant to the submitted work. Authors should disclose the relationship even when they consider the amount too small to affect their judgement.

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5. Non-Financial Interests

Non-financial relationships and activities may also influence, or appear to influence, scholarly judgement.

Relevant non-financial interests may include:

• Personal or family relationships;
• Current or recent professional collaboration;
• Supervisory, mentoring, student, examiner, or employment relationships;
• Academic competition or professional rivalry;
• Serious personal or professional disputes;
• Institutional loyalties or responsibilities;
• Leadership or membership in professional, advocacy, charitable, political, religious, or patient organisations;
• Strong intellectual, theoretical, methodological, political, or ideological commitments directly relevant to the manuscript;
• Public statements or campaigning concerning the subject of the manuscript;
• Participation in regulatory, standards-setting, reimbursement, procurement, or guideline-development activities;
• Access to confidential information or prior knowledge of the submitted work.

Routine membership in a professional association does not necessarily constitute a relevant interest, but leadership, policy-making authority, financial responsibility, or active advocacy may require disclosure.

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6. Digital Health and Medical AI Interests

Because the journal publishes research concerning digital technologies and artificial intelligence, authors and other participants must disclose interests involving:

• Ownership, development, licensing, sale, or commercialisation of an AI model, algorithm, software platform, application, medical device, or digital-health service evaluated in the manuscript;
• Employment, consultancy, advisory work, or investment involving the developer, owner, distributor, or competitor of the evaluated technology;
• Provision of proprietary models, application programming interfaces, computing infrastructure, cloud credits, datasets, devices, software licences, or technical personnel;
• Patents or patent applications relating to the technology, method, dataset, model, or clinical use;
• Revenue-sharing, licensing, spin-out, start-up, or commercialisation arrangements;
• Institutional ownership of technology or intellectual property from which an author or institution may benefit;
• Participation in regulatory approval, procurement, reimbursement, validation, or deployment decisions concerning the technology;
• Commercial restrictions affecting data access, model inspection, independent validation, or publication.

Authors must distinguish clearly between independent academic evaluation and research conducted, funded, designed, analysed, or controlled by the developer or commercial owner of the technology.

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7. Authors’ Disclosure Responsibilities

Each author is individually responsible for providing a complete and accurate disclosure.

Authors must disclose:

• All direct financial and non-financial support for the submitted work;
• Relationships and activities outside the submitted work that are relevant to its subject matter;
• Institutional interests that may benefit from the publication;
• Patents and intellectual-property interests, whether pending, issued, licensed, or generating royalties;
• Commercial involvement in any product, service, software, model, device, dataset, or intervention discussed in the manuscript;
• Any agreement that may affect access to data, analysis, interpretation, or publication;
• Any other interest that readers may reasonably consider relevant.

Authors must not rely solely on the corresponding author to determine whether disclosure is required. Each author should review and approve the final conflict-of-interest statement.

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8. Disclosure Period

For support directly related to the submitted work, authors must disclose relevant relationships and activities from the initial conception and planning of the work through submission and publication.

For relationships and activities outside the submitted work, authors should normally disclose relevant interests occurring during the 36 months preceding initial submission.

Authors must also disclose:

• Relevant relationships expected to continue;
• Pending financial or intellectual-property interests;
• Future financial benefits that could reasonably arise from publication;
• Older relationships that remain materially relevant to the submitted work.

The 36-month period is a minimum reporting framework rather than a reason to omit an older relationship that remains relevant.

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9. Funding and Support for the Submitted Work

The conflict-of-interest declaration and the funding statement serve related but distinct purposes.

The funding statement must identify direct support for the submitted work, including:

• The name of each funder or sponsor;
• Grant or contract numbers where applicable;
• Support provided to individual authors;
• Institutional or departmental support;
• Equipment, software, data, computing resources, devices, model access, writing support, or other in-kind assistance;
• The role of the funder or sponsor.

Authors must explain whether the funder or sponsor had any role in:

• Study conception or design;
• Protocol development;
• Participant recruitment;
• Data collection;
• Data management;
• Statistical or computational analysis;
• Interpretation of findings;
• Manuscript drafting or revision;
• Approval of the manuscript;
• The decision to submit for publication;
• Selection of the journal;
• Restriction, delay, or prevention of publication.

Where the funder had no such role, the manuscript should state this explicitly.

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10. Author Access to Data and Publication Independence

Authors must not enter into agreements that prevent them from accessing relevant study data, conducting an independent analysis, interpreting the findings honestly, or publishing the results without improper interference.

For commercially sponsored or proprietary research, the journal may require a responsible author to confirm:

Authors must disclose:

• Whether they had direct access to the complete dataset;
• Whether access is continuing;
• Whether the sponsor controlled data storage or analysis;
• Whether an independent statistician or analyst reviewed the data;
• Whether contractual restrictions affected publication;
• Whether the sponsor had authority to approve, delay, modify, or prevent submission.

The editorial office may request relevant agreements or contracts for confidential review.

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11. Required Author Declaration

Every submission must contain a conflict-of-interest statement, including where no relevant interests exist.

Suggested statement where no relevant interests exist:

Suggested statement where interests exist:

Suggested statement for technology developers:

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12. Disclosure Form

The journal may require each author to complete the current ICMJE Disclosure Form or an equivalent journal disclosure form.

Submission of a completed form does not replace the requirement to include a concise conflict-of-interest statement in the manuscript.

Authors must submit completed forms to the journal, not to the ICMJE.

The editorial office may request:

• Clarification or additional detail;
• Updated disclosure forms;
• Relevant institutional disclosure records;
• Funding or sponsor agreements;
• Patent or intellectual-property information;
• Confirmation from all authors.

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13. Updating Disclosures

Authors must update their disclosures when a relevant relationship or activity:

• Begins after submission;
• Ends during peer review or production;
• Changes materially;
• Becomes newly relevant to the manuscript;
• Is identified as previously omitted or inaccurately described.

Updated disclosures must be provided promptly and no later than approval of the final publication proofs.

Publication of an article does not end the authors’ obligation to notify the journal of a material omission or error in the published statement.

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14. Reviewers

Reviewers must disclose any relationship or activity that could influence, or reasonably appear to influence, their assessment of a manuscript.

A reviewer should normally decline or seek editorial guidance where the reviewer:

• Works at the same institution or organisational unit as an author;
• Has recently collaborated or published with an author;
• Has a current supervisory, student, mentoring, examiner, or employment relationship with an author;
• Has a close personal, family, or financial relationship with an author;
• Has a serious academic rivalry or professional dispute with an author;
• Has a financial interest in the product, company, model, device, or outcome under review;
• Is developing a directly competing product or research programme;
• Has previously reviewed the same manuscript and cannot provide an independent assessment;
• Participated in the research or has confidential prior knowledge of it;
• Cannot provide an objective review because of a strong intellectual, political, commercial, or institutional commitment.

Reviewers must disclose relevant relationships before accepting an invitation and must contact the editor if a conflict becomes apparent after review has begun.

Reviewers must not use unpublished information obtained through peer review to advance personal, academic, institutional, financial, or commercial interests.

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15. Editors and Editorial Board Members

Editors and editorial board members must disclose financial and non-financial relationships relevant to their journal responsibilities.

An editor must recuse themselves from a manuscript where the editor:

• Is an author or contributor;
• Has a close personal or professional relationship with an author;
• Works in the same department or closely connected institutional unit;
• Has recently collaborated with an author;
• Has supervised, been supervised by, or examined an author recently;
• Has a financial or intellectual-property interest in the subject or outcome;
• Is involved in a directly competing project, product, or commercial organisation;
• Has expressed a position that materially compromises impartial assessment;
• Has any other relationship that could reasonably call editorial independence into question.

A conflicted editor must not:

• Select reviewers;
• Access confidential reviewer identities unnecessarily;
• Participate in editorial discussion;
• Recommend or make a decision;
• Influence another editor’s handling of the manuscript.

The manuscript must be assigned to an independent editor with no relevant conflict.

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16. Submissions by Editors and Board Members

Editors, board members, journal staff, and publisher personnel may submit manuscripts to the journal, but they receive no preferential treatment.

Such manuscripts must be handled under an independent process:

• The submitting individual must have no editorial authority over the manuscript;
• An independent handling editor must be appointed;
• Reviewers must be selected independently;
• The submitting individual must not access confidential editorial records beyond those available to an ordinary author;
• The final decision must be made by an editor without a relevant conflict;
• The editorial relationship should be disclosed in the published article where appropriate.

Suggested published statement:

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17. Guest Editors and Special Issues

Guest editors must disclose relevant financial, institutional, personal, professional, and intellectual interests before appointment and throughout the special-issue process.

Guest editors must recuse themselves from manuscripts involving:

• Their own work;
• Current or recent collaborators;
• Students, supervisors, colleagues, or close institutional associates;
• Commercial partners or competitors;
• Products, organisations, grants, or intellectual property in which they have an interest.

The Editor-in-Chief or an independent designated editor retains oversight of special issues and may replace a guest editor, reassign a manuscript, obtain additional review, or overturn a recommendation where necessary to protect editorial independence.

Sponsorship of a special issue must be disclosed and must not give the sponsor control over reviewer selection, editorial decisions, article conclusions, or publication of unfavourable findings.

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18. Journal Staff and Publisher Personnel

Journal staff and relevant Panorama Scholarly Group personnel must disclose interests that could affect manuscript handling, production, fee administration, corrections, investigations, or publication decisions.

Publisher personnel must not:

• Influence acceptance or rejection for commercial reasons;
• Use confidential manuscript information for private benefit;
• Link editorial decisions to payment, sponsorship, advertising, or institutional relationships;
• Interfere with an editor’s independent management of a conflict;
• Provide preferential treatment to authors, organisations, or commercial partners.

Article Processing Charge payments, discounts, waivers, institutional arrangements, or sponsorship must remain separate from scholarly assessment and editorial decision-making.

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19. Institutional Conflicts

An institutional relationship may require disclosure where an author’s university, hospital, laboratory, company, institute, or research centre:

• Owns relevant patents, equity, software, datasets, models, or commercial rights;
• Receives funding or royalties connected with the subject of the manuscript;
• Has entered into a commercialisation or licensing agreement;
• May gain financially or reputationally from the findings;
• Controls data access or publication rights;
• Has a contractual relationship with the study sponsor.

Institutional disclosure does not replace disclosure of the individual author’s own relationships.

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20. Commercially Sponsored Research

Research supported by a commercial entity is eligible for consideration, provided that the relationship is disclosed fully and the research satisfies the journal’s standards for independence, transparency, methodology, ethics, and data integrity.

Authors must disclose:

• The sponsor’s identity;
• The form and value category of support, where requested;
• The sponsor’s role in the research and manuscript;
• Whether sponsor employees are authors or contributors;
• Who controlled the protocol and statistical analysis plan;
• Who had access to the data;
• Who performed the analysis;
• Whether publication rights were restricted;
• Whether the sponsor reviewed the manuscript before submission;
• Whether authors were free to publish unfavourable or inconclusive findings.

Sponsor review for confidential information, intellectual-property protection, or factual accuracy must not permit suppression, distortion, or indefinite delay of publication.

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21. Management of Disclosed Interests

Depending on the nature and significance of a disclosed interest, the journal may:

• Determine that no further action is necessary;
• Request clarification or a more detailed disclosure;
• Publish the relationship with the article;
• Require an independent statistical, technical, methodological, clinical, or ethical review;
• Require confirmation of data access or analytical independence;
• Appoint an independent handling editor;
• Exclude or replace a reviewer;
• Require an editor or guest editor to recuse themselves;
• Request revision of claims or interpretation;
• Decline a manuscript where the conflict cannot be managed adequately;
• Take post-publication action where an undisclosed conflict affects the reliability or interpretation of the article.

Management measures will be proportionate to the risk and will consider the closeness, magnitude, duration, timing, and relevance of the relationship.

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22. Publication of Disclosure Statements

Relevant author disclosures and funding information will normally be published with the article.

The published record may include:

• A competing-interests statement;
• A funding statement;
• A sponsor-role statement;
• A data-access statement;
• An editorial-recusal statement;
• Other explanatory information necessary for readers to evaluate the work.

The journal may edit disclosure statements for clarity, consistency, privacy, and relevance without changing their substantive meaning.

Personal information that is not relevant to evaluating the article will not ordinarily be published.

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23. Undisclosed or Inaccurate Interests

Failure to disclose a relevant relationship may arise from misunderstanding, oversight, incomplete reporting, negligence, or deliberate concealment.

Where a possible omission is identified, the journal may:

1. Request an explanation from the relevant person;
2. Request an updated disclosure form;
3. Review supporting records or agreements;
4. Consult an independent editor or ethics adviser;
5. Pause peer review, acceptance, production, or publication;
6. Determine whether the omission affected editorial handling or interpretation of the work;
7. Correct the disclosure statement;
8. Contact an institution, funder, employer, or other responsible body where justified.

An inadvertent and promptly corrected omission will not automatically be treated as misconduct. Deliberate concealment of a relationship required by journal policy may constitute publication misconduct.

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24. Post-Publication Action

If a relevant interest is discovered after publication, the journal will assess:

• Whether the published disclosure is inaccurate or incomplete;
• Whether the omitted relationship affects interpretation of the article;
• Whether editorial or peer-review independence was compromised;
• Whether data access, analysis, or publication freedom was restricted;
• Whether the article’s findings remain reliable.

Possible actions include:

• Updating online metadata;
• Publishing a correction;
• Publishing an editorial clarification;
• Publishing an expression of concern;
• Reassessing the article independently;
• Retracting the article where the conflict is connected with unreliable findings, serious misconduct, or a fundamentally compromised publication process.

A conflict-of-interest omission alone does not automatically require retraction. The appropriate action depends on its effect on the reliability and integrity of the scholarly record.

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25. Confidentiality of Disclosure Information

Disclosure information submitted to the editorial office will be handled confidentially before publication and will be accessed only by persons who require it for editorial, ethical, legal, administrative, or production purposes.

The journal may disclose relevant information where necessary to:

• Manage peer review and editorial decisions;
• Investigate a credible concern;
• Correct the scholarly record;
• Comply with law or a binding regulatory requirement;
• Consult an institution, funder, ethics committee, or competent authority.

The journal will seek to avoid unnecessary disclosure of personal financial information or private relationships.

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26. Complaints and Appeals

An author, reviewer, editor, reader, or other affected party may raise a concern regarding the disclosure or management of a conflict of interest.

A complaint should:

• Identify the manuscript or article where applicable;
• Describe the undisclosed or improperly managed relationship;
• Provide supporting evidence where available;
• Explain how the relationship may be relevant to the publication process or published findings;
• Use professional and non-defamatory language.

Appeals concerning conflict-of-interest management should identify a material factual, procedural, or policy error. Mere disagreement with the journal’s reasonable management decision does not by itself establish grounds for appeal.

Complaints and appeals should, where practicable, be considered by an editor or responsible person who was not directly involved in the original decision.

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27. Sanctions

Where deliberate concealment, false disclosure, editorial interference, peer-review manipulation, or another serious breach is substantiated, the journal may:

• Reject the manuscript;
• Withdraw an acceptance decision;
• Replace a reviewer or editor;
• Remove an individual from an editorial or reviewer role;
• Publish a correction, expression of concern, or retraction;
• Restrict future submissions or journal participation for a defined period;
• Notify co-authors, institutions, employers, funders, ethics committees, or other journals;
• Take other proportionate action under the Publication Ethics policy.

Sanctions will take account of intent, seriousness, recurrence, effect on the scholarly record, risk to patients or the public, and the individual’s cooperation with the journal.

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28. External Standards

This policy is informed by recognised guidance concerning disclosure and management of relationships and activities in medical publishing.

• ICMJE: Disclosure of Financial and Non-Financial Relationships and Activities
• ICMJE Disclosure Form
• WAME: Conflict of Interest in Peer-Reviewed Medical Journals
• COPE Core Practices

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29. Policy Review

This policy may be revised to reflect developments in medical publishing, digital health, artificial intelligence, commercial research, intellectual property, research funding, publication ethics, and applicable legal or regulatory requirements.

Authors, reviewers, editors, and other participants are responsible for consulting the current version of the policy and updating their disclosures whenever relevant circumstances change.