Answer to the Letter to the Editor of Benjamin John Floyd Dean et al. entitled “No conflict of interest?” concerning “Antibiotic treatment in patients with chronic low back pain and vertebral bone edema (Modic type 1 changes): a double-blind randomized controlled trial of efficacy” by Albert HB et al., Eur Spine J (2013) 22:697–707

The writer of the Letter to the Editor wonders why since several of the authors of the papers are members of the MAST Academy that “no competing interest” was declared. This was not declared because there are/were no competing interests.

The study was conducted from 2007 and the last one-year control was carried out in late 2009. After the independent statistical analysis was done, the paper was written and then sent to the first Journal in 2010. Having fulfilled this task, thoughts regarding the dissemination of this new knowledge to both health care professionals as well as the general public began to develop. Dedicated spine scientists joined the team and MAST was indeed set up as a limited company.

In late 2012, the paper was accepted for publication, and came out on e-pub in February 2013. Until that date no activities had been carried out in the company, and dormant accounts have been filed as can be seen in Companies House. We began working in earnest after the e-pub took place. Since the company was nothing but “an idea” until after e-pub, there was no conflict of interest to declare.

The mission of MAST is to deliver education and training and its ambition is to facilitate research and audit. MAST wishes to raise awareness, deliver information to patients and education/teaching to medics. It has an ambition to establish an audit data collection system for clinicians so that if we treat patients we can capture their outcomes as a community. It wishes to facilitate research.

We want to avoid the situation in which patients were undergoing surgery a decade after it was discovered that Helicobacter pylori played a significant role in peptic ulcers and could be treated with simple antibiotics. Conversely, we wish to ensure—to the degree that we can—that patients are not receiving needless prescriptions for antibiotics just because they complain of non-specific lower back pain.

The advantage of being a UK-based company is that its accounts are open for all to see in the register of Companies House. It was established on a shoestring budget and funded by the scientists themselves. MAST has yet to service its debts, but will then run as a not-for-profit company. To have been attacked for this significant effort is rather disheartening.