Healthy Skepticism Library item: 14757

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Publication type: news

Bye-bye commercial bias
The Australian 2001 May 23

Full text:

Never look a gift horse in the mouth, goes the adage, and the University of Nottingham, in England, certainly did not.
Last winter, when British American Tobacco offered the university £3.8 million ($10.3 million) to finance a centre for research on business ethics, with no strings attached, the university gratefully accepted. One of its academics, however, did not acquiesce so readily.
Because Richard Smith, a professor of medical journalism at Nottingham, also happens to be editor-in-chief of the British Medical Journal, he was able to air his protests before a large and concerned audience of biomedical researchers. A few weeks ago, the BMJ polled its readers on the matter. It asked whether Nottingham ought to return the money to BAT. It also asked whether Smith should resign his chair if the university kept the cash. When the internet poll ended on May 10, having garnered more than 1000 responses, the voters had decreed by a small margin – 55 percent to 45 percent – that Smith should resign. And resign he will. By a far larger margin, however – 84 percent to 16 percent – the voters opined that Nottingham ought to give the money back. The university, though, had not promised to make its policy by plebiscite and so it will not oblige.
Should it? To Nottingham’s critics, allowing a firm from one of the world’s least socially responsible industries to sponsor a centre for the study of corporate responsibly smacks of the ludicrous. But such curiosities are not new. Alfred Nobel made his fortune from dynamite, yet the Nobel Peace Prize is a coveted tribute. The Wellcome Trust, Britain’s largest medical charity, received its original endowment from a drug firm. Press and broadcasting baron Rupert Murdoch recently endowed a chair in media studies at Oxford University. And Harvard has just appointed the first incumbent of a chair modesty entitled the Quincy Jones professorship of African-American music, supported by a Time-Werner endowment.
Smith fears that BAT’s donation amounts to the purchase of respectability by the tobacco firm at the expense of Nottingham’s reputation. A more worrying threat would be if the donation amounted to the purchase by an interested company of scientific research at the expense of the integrity of the researchers and their findings. There is evidence that this has occurred in the past, sometimes in subtle and uncontrollable ways.
If hiring and firing decisions to turn on the interests of sponsors, for example, the independence of research may suffer. Such an incident occurred in April at the University of Toronto, which rescinded its offer of a job to David Healy, who is well known for arguing that the antidepressant drug Prozac raises the risk of suicide among depressives. The university’s Centre for Addiction and Mental Health, where Healy would have worked, receives funds from Eli Lilly, the makers of Prozac. The incident has caused much hand-wringing among Canadian academics, although the university and Eli Lilly deny that the company’s money influenced the centre’s decision to withdraw its offer.
Financial interests can also exert an insidious bias on the results of research. In 1998, a review of literature published in the New England Journal of Medicine showed that authors who supported the use of a certain kind of drug for treating heart ailments were significantly more likely to have a financial relationship with the drug makers than those who did not.
In the same year, a review published in the Journal of the American Medical Association examined articles about the health risks posed by passive smoking. The review’s authors found that they could reliably predict what an article would conclude about the effects of passive smoking by looking at one factor: whether the article’s author had any financial affiliations with the tobacco industry. (No prizes for guessing which way results veered when they did.)
On the face of it, these discoveries look damning, both of science and of scientists. But Smith thinks that mendacity is not always the explanation. Unintentional – even unconscious – bias can have powerful effects. Researchers do try to eliminate this. The standard experimental procedure for a test of a drug’s effects, for example, demands a double-blind trial; that is one where neither the researcher nor the subject knows whether a given pill contains a placebo or a drug. Double-blind design is not meant to imply mendacious intent on the part of researchers or of subjects; it merely takes into consideration the subconscious human bias that subtly creeps into scientific observation.
Nevertheless, to try to abolish bias is impossible, according to Smith. Since he is the editor of one of medicine’s chief journals and because such journals are the gatekeepers of the scientific community, this attitude may depress those committed to maintaining the purity of scientific research. But Smith believes, as do the editors of many other journals, that making the links between researchers and their sponsors plain will do the trick as well as it can be done.
To this end, the editorial boards of many journals are instituting more stringent and wide reaching policies designed to get researchers to disclose their financial interests. The move has most relevance to medical journals that report drug trials. The BMJ already asks authors to declare competing interests and may soon shift to asking for relevant interests because its editors have found that such changes in terminology affect quite significantly the proportion of people who own up.
The Lancet requires that a declaration of all conflicts of interest, past and present, must accompany each article submitted.
JAMA insists that, if there is commercial sponsorship of a study, the authors must sign a form guaranteeing that they, rather than the sponsors, controlled the design, analysis and presentation of data.
Other scientific journals, such as Nature and Science, have less cause for concen, since the research they report tends to be basic rather than commercial. Nevertheless, Nature’s editor Phil Campbell says that within a few months the journal will create a policy on the disclosure of financial interests. Donald Kennedy, who edits Science, says that the journal’s editorial board is also thinking about creating such a policy.
These editors are quick to point out that such requests and the disclosures they elicit are not a watertight way of ensuring the integrity of science. A scientist who is determined to conceal a conflict of interest will have little trouble doing so. But there is a natural check on such trickery – if an observant reader points out the ruse, the journal will publish a correction.
JAMA deputy editor Drummond Rennie says: “We are JAMA, not the FBI or the IRS. Authors have lied to us, signing forms they knew to be wrong. That makes us look like idiots. Then we publish the facts and they look like corrupt idiots.”