| Leslie E. Packer, PhD 2006-07-23, 4:23 pm |
| In a previous thread, On Sat, 22 Jul 2006 11:18:32 -0400, "Jo"
<jocohen@comcast.net> wrote:
>
>"Gadget Man" <james@tonez.co.uk> wrote in message
<snip of spam>
>
>
>--CAVEAT EMPTOR.....
>
>Jo
Speaking of which, there's an editorial in today's NY Times that
highlights some ongoing concerns about pharmacotherapy research. When
I used to teach research design/stat for grad psych students and then
later on, for physicians, I always told them to check for footnotes or
statements that might indicate a conflict of interest, bias, etc.
But when authors intentionally omit such statements of interest and
journals don't do enough to insist on full disclosure, it's harder to
evaluate research. The following isn't specific to TS and doesn't
even mention TS, but I think/hope it's on-topic because the same
issues apply to research evaluating treatment of tics.
--------------
Editorial
Our Conflicted Medical Journals
Published: 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 “a 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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