Healthy Skepticism Library item: 10728

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Goldstein J.
How to Rile Up the Editor of JAMA
The Wall Street Journal Health Blog 2007 Jun 27
http://blogs.wsj.com/health/2007/06/27/how-to-rile-up-the-editor-of-jama/

Full text:

If you want to rile up Catherine DeAngelis, the editor of JAMA, ask her about doctors who are paid by drug companies to speak to their colleagues.

“No doctor should be on a speakers bureau – none, zero,” DeAngelis said yesterday when she came by Health Blog HQ for a chat. Just in case we didn’t get the message, she added that she once said to a doctor who dodged a tough question during an industry-funded speech, “Do you understand what prostituting yourself is? That’s what you just did.”

Speakers bureaus are just one element of the drug industry’s multi-pronged effort to control the flow of medical information. Industry says its work is essential to keeping doctors informed; critics say the companies present skewed results that favor their drugs. DeAngelis (pictured), whose role at JAMA puts her atop one of the key sources of information for doctors, has to steer a middle course.

She recognizes that it’s essential to publish the results of randomized trials, and she knows that drug and device companies pay for the lion’s share of those expensive tests. But she’s advocated safeguards to keep the results on the level.

A few years ago, she met with editors of some of the world’s most important medical journals (including the New England Journal of Medicine and the Lancet, among others), and they collectively agreed to require that all clinical trials be publicly registered at sites like clinicaltrials.gov before enrolling patients. The idea is to prevent companies from hiding negative results while publishing positive ones.

“They’re trying to do a salami slice,” by publishing only favorable results, DeAngelis says. “If you want to publish in JAMA, you have to add that information [from other studies in the registry]. We know you have it.”

And JAMA requires that an independent biostatistician affirm the findings of industry-funded studies. That rule recently kept a study of one well-known product (she wouldn’t say which one) out of the journal. But DeAngelis soon saw the study published elsewhere. “I just pray that this product is good,” she said. “Because if I find that it isn’t, I will go public. And the company knows it.”

How does DeAngelis reconcile her tough stance on drug information with the pharmaceutical ads that fill JAMA? She notes that ads don’t run in the section of the journal where research studies appear, and says she routinely bars ads that she deems misleading: “A couple weeks ago, the ad people came down and said, ‘You know, you’ve cost us $750,000 this year because you’ve turned down ads.’ I said, ‘Is that all?’”