Emergency Exorcism, Part 1: Medical journal editors need to do more about pharma ghostwriting

by

CHJ Fellow

April 30, 2010

Dr. Catherine DeAngelis, editor-in-chief of the Journal of the American Medical Association, made some bold statements at last week's Association of Health Care Journalists conference in Chicago.

"I usually talk about conflict of interest wearing a flak jacket," DeAngelis said and proceeded to list all the ways she has gotten tough on authors with ties to the drug or device industries.

For example, she helped pull together 12 prominent journal editors who sit on the International Committee of Medical Journal Editors (ICMJE) and persuaded them to sign a declaration that they would not publish clinical trial results unless the trials had been registered with a site such as ClinicalTrials.gov.

"I thought I was going to get murdered," she said of her proposal. "But it made a gigantic difference."

She also started asking researchers for their study protocols and helped create a universal disclosure form that journals could use to screen for conflicts of interest.

Sharing the stage with DeAngelis was Lisa Bero, a clinical professor of clinical pharmacy at the University of California, San Francisco. She co-authored a study in 2007 that showed that when two groups of researchers studied the same drug, the study that was funded by a drug company tended to cast the drug in a better light.

And not by a small margin.

Study results funded by drug makers were 20 times more likely to favor the drug than studies with no drug company funding. And if the study's conclusion made the drug look good, it was 35 times more likely that the study was funded by the drug company.

"Many people are concerned about the growing proportion of drug trials funded by the drug's manufacturers," Bero said at the time. "Results of drug trials affect what drugs are covered by medical plans, and so what drugs physicians will prescribe. If drug trial outcomes are largely determined by who pays for the trial, we don't really know what the best drug is."

Bero showed in her talk why better disclosure is only part of the solution. She presented a great example from the Journal of Harm Reduction where the authors of a tobacco-related study wrote with sarcasm about how their tobacco company funding couldn't possibly taint their results.

When DeAngelis and other editors say that disclosure will fix conflict of interest problems, reporters need to ask how better disclosure will prevent pharma-sponsored studies from being 20 times more likely to boost a drug's prospects. They also need to ask about the undisclosed secrets still lurking in the scientific archives because there is one thing that no members of the ICMJE have done. They have not made any systematic effort to call researchers to account for the ghostwriting scandal that has been unfolding over the past two years.

To make it easy for them, Antidote will propose some simple steps on Monday.

Next: When there's something spooky in your favorite journal, who you gonna call?

A Controversial Medical Education Program, With (Pharma) Strings Attached

Q&A with Dr. Adriane Fugh-Berman: Ghostwriting sneaks past most journal editors

Q&A with Dr. Adriane Fugh-Berman Part 2: Marketing messages distort medical research

Q&A with Dr. Daniel Carlat: Biting the pharma hand that fed him

Q&A with Dr. Daniel Carlat Part 2: Finding an independent voice in a pharma-sponsored world

Q&A with Thomas Sullivan: Medical education companies don't deserve media abuse

Q&A with Thomas Sullivan Part 2: Medical education companies don't deserve media abuse

Q&A with UCSF's Kim Klausner: Drug industry practices should be an open book

Q&A with Kim Klausner Part 2: Challenging the "normalcy" of pharma ghostwriting

Doctors Behaving Badly: Gynecologist has "excellent" adventure with pharma ghostwriter