Helen MacDonald

In case you should fall into any of these pitfalls later, I think it would just have been so easy to have done something which the peer reviewers or the editors or the process would pick up and go, oh, well, you could have, this could have introduced some biases.

So to try and just design something that was sort of so bulletproof and beyond suspicion, I think was, yeah.

Yeah.

And I think the final thing that was interesting about this, and there was an editorial link to this paper that made the point that this is actually a relatively unusual case, because as Stanton was saying, a lot of the talk previously has been around manufactured doubt about the harms.

But this paper is slightly different because it's not about casting doubt on the harms of tanning.

This paper was about actually finding evidence of

promoting tanning or being actually favorable towards tanning which seems like a very unlikely outcome so it was

Ghost management.

Sort of stage management.

arms it's a pincer movement cast out on one side and then you know potentially uh cast out about the the harms and you know maybe throwing some stuff about the positives i think it's really interesting to think about that isn't it to think how much of this is intentional unconscious bias actually manufactured by somebody and how much of this it might be unconscious because it's not necessarily that all of these pieces were were funded directly by the tanning industry it might be that

a particular author declared some financial interest with that industry.

And it's one of the reasons why at the BMJ, when we introduced our policy of

excluding authors with financial conflicts of interest from writing um education content in that area um we just had a very harsh rule for exclusion because we just didn't know how we would remove either the perception that there could be bias or the fact that there could be some unconscious bias even if the author is trying their hardest to manage out any you know

And the reason they have CE... What does the CE marking say?

Or it has to be clear how it's going to be used, I guess.

Because I guess if you're using it as part of a pathway.

No, but what I mean is if you're using a skin cancer app to then move on to another stage in the referral process, then perhaps you'll allow it to be less than 100%, Karl.

Yes, I wanted to add at the end of my tanning section that if you're interested in the tanning paper that you heard about, please have a look at our commercial interest in healthcare collection page.

And keep your eye out for more content coming out that will add to that in 2020.

And if you'd like to see research and clinical practice and education, which is freer and independent from commercial influence, then please do sign our call for action, including sharing your ideas on how that can be done.