Doctors versus “Big Pharma”: is it justifiable to judge research by its authors?

[xchrom]

http://blogs.scientificamerican.com/unofficial-prognosis/2012/10/27/doctors-versus-big-pharma-is-it-justifiable-to-judge-research-by-its-authors/

Doctors use different standards to judge scientific research depending on who funded it. They judge research funded by industry as less rigorous, have less confidence in the results, and are less likely to prescribe new drugs than when the funding source is either the NIH or unknown – even when the apparent quality of the research is the same.

Those were the results of a study published by Harvard researchers Dr. Aaron Kesselheim and colleagues in the New England Journal of Medicine last month. The story has received a fair amount of coverage since then, including being analyzed by the Scientific American Guest Blog, the Los Angeles Times, and the New York Times.

There’s a question of ethical and practical relevance embedded in this: is it justifiable to judge a paper by its author or funding source – even when you cannot discern a difference in quality?

The perspective from much of the medical side seems to be a definite yes. The divide between doctors and so-called “Big Pharma” is nothing new. Pharma has a bad reputation in the medical community, and there is history to back it. One of the most well-known scandals involved Vioxx being taken off the market in 2004 after Merck admitted it withheld information about known adverse risk of heart disease, resulting in tens of thousands of deaths. In 2008, physician and former Editor in Chief of the New England Journal of Medicine Marcia Angell wrote, “Bias in the way industry-sponsored research is conducted and reported is not unusual and by no means limited to Merck.” In 2011, Harriet Washington published a piece in The American Scholar highlighting some of the ways industry has misled and manipulated data, which include: comparing a new drug against a placebo rather than against another treatment option, comparing drugs to competitors in wrong dosages, pairing a drug with one known to work well, ending a trial prematurely when they see “clues that the trial is going south,” and cherry-picking only positive findings to report. This type of behavior can and should be called out as scientific misconduct, and those who commit it must be held accountable.

[bemildred]

1. How would you know? Are their studies of the studies? Who financed them? nt

[MountainLaurel]

2. Every article in a peer-reviewed journal

Has to indicate conflicts of interest on the part of the authors as well as funding sources. If that information isn't in a submitted draft, that manuscript will not be reviewed, let alone accepted.

[bemildred]

3. I know all that, that wasn't the question.

The question was how would you know whether to judge a study by it's authors? Conflicts of interest would only be used if one was ALREADY judging the study by its authors. If one was not judging the study by its authors, one would not need to consider their conflicts of interest, everybody has conflicts of interest.

I am pointing out the circularity, and therefore the lack of objectivity, in using such conflicts of interest to determine whether to use such conflicts of interest to evaluate the study.

You have to look only at the internals of the study, or not pretend to be objective, since you are judging the study by its source, not it's content.

Peer review amounts to a jury, we know about juries, don't we?

[Celebration]

4. shouldn't it be "all of the above"?

As more comes out about "big pharma" not publishing studies with negative results, it isn't exactly rocket science for discerning doctors to wonder exactly what studies are being hidden that conflict with the conclusions of a "pro" big pharma drug.

I mean, you can't have it both ways. "Big pharma" wants credibility. Once they publish ALL results or ALL studies, and ALL data, then those who look at their funded studies with a skeptical eye could change their tune.

In the meantime, expect people to roll their eyes.

[gkhouston]

5. ^^ This. n/t

[Sgent]

6. I can't understand how

IRB's allow this in the first place.

Once you've started a study with actual human subjects, how can not reporting the results be ethical? I guess if there is something that invalidates the study (wrong drugs given, etc.) then maybe... but otherwise allowing the results to be buried seems like a violation of the parameters under which the study was performed.