"Our Conflicted Medical Journals"

Discussion in 'Fibromyalgia Main Forum' started by tansy, Jul 23, 2006.

  1. tansy

    tansy New Member

    The New York Times
    July 23, 2006

    Leading medical journals seem to be having a difficult time disentangling
    themselves from the pharmaceutical and medical device industries. If they
    cannot stop printing articles by scientists with close ties to these
    businesses, they should at least force the authors to disclose their conflicts
    of interest publicly so that doctors and patients are forewarned that the
    interpretations may be biased.

    Two disturbing cases were described in detail by The Wall Street Journal in
    recent weeks. One involved The Journal of the American Medical Association, or
    JAMA; the other an obscure journal known as Neuropsychopharmacology, which is
    published by a leading professional society in the field.

    The article in JAMA must surely have pleased all makers of antidepressant
    drugs. It warned pregnant women that if they stopped taking antidepressant
    medication they would increase their risk of falling back into depression.
    Hidden from view was the fact that most of the 13 authors had been paid as
    consultants or lecturers by the makers of antidepressants. Their financial ties
    were not disclosed to JAMA on the preposterous grounds that the authors did not
    deem them relevant.

    An even more egregious set of events occurred at Neuropsychopharmacology, which
    recently published a favorable assessment of a controversial new treatment for
    depression resistant to conventional therapies. Left unmentioned was that eight
    of the nine authors serve as consultants to the company that makes the device
    used in the therapy. The ninth works directly for the company. Just to make
    things particularly incestuous, the lead author of the study is the journal's
    editor and a consultant to the company. He has been accused in the past of
    promoting therapies in which he had a financial stake.

    It is hard to know whether to be more upset at the journal's failure to
    disclose these ties or at its decision to let such interested parties serve as
    authors in the first place. Early drafts of the article were prepared by a
    professional writer hired by the company. With all those ingredients
    coalescing, it is no wonder that the new therapy was judged as promising and
    well-tolerated intervention for treatment-resistant depression.

    Many journals have been tightening their disclosure and publication policies in
    recent years, and both JAMA and Neuropsychopharmacology plan further
    tightening. But the reforms are not likely to go far enough. It seems
    imperative that more muscle be put into forcing disclosure and publication of
    conflicts of interest. If all leading journals agreed to punish authors who
    fail to reveal their conflicts by refusing to accept further manuscripts from
    them, a lot more authors would be inclined to fess up. Better yet, journals
    should try much harder to find authors free of conflicts. That is the best hope
    for retaining credibility with doctors and the public.

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