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Healthy Skepticism Library item: 19328

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: Electronic Source

Braillon A
Stimulating the interest for conflicting scientific debates
The American Journal of Medicine Blog 2011 Feb 25
http://amjmed.blogspot.com/2011/02/stimulating-interest-for-conflicting.html


Full text:

The conflict of interest issue is now a crisis of credibility for the medical profession, despite early warnings; it requires a comprehensive framework.(1) Therefore, I am seriously puzzled by some editors’ naïve pledge for reporting “potential” conflict of interest.(2)

The International Committee of Medical Journal Editors never investigated the reasons why it failed for so long to implement an efficient policy. Chimonas et al confirmed that current journal disclosure practices do not yield consistent information regarding authors’ industry ties.(3) Their proposal to use company data to move to a system of full, verifiable transparency is in fact irrelevant. Secrecy “needs” some transparency to give public trust and to maintain preferred hierarchies of power.

Will editors and reviewers succeed if someone wants to mask a conflict? Companies repeatedly cope with regulations which ought to grant for transparency. In 2004, the Sarbanes–Oxley Act (2002) failed to prevent many major affairs (eg. Enron, Vivendi-Universal). In 2008, the new regulation did not prevent even more serious affairs (eg. Lehman Brothers Holdings was certified by the US Securities and Exchange Commission). Moreover, for a long time, consultancy fees have been just the tip of the conflict of interest iceberg. As early as mild 90’s, I observed some doctors engaged in insider trading schemes. Only those who are too voracious are caught.(4)

The bottom line for an article is simple: Is there scientific evidence — regardless of any conflict— or not? This means that scientific controversies must be possible. The editor must accept for publication responses to promote controversies and not hide himself behind the excuse of “the lack of space”. Among the editors, I must cite Joseph S. Alpert, MD, from the Green Journal, who dared to disclose serious breaches in scientific ethics and in evidence that many hid.(5,6)

Lastly, I propose to add at the end of each conflict of interest statement “Neither the editor and the reviewers, nor the institution where the work was performed seriously investigated the authors’ conflict of interest.”

Interest for conflict: Alain Braillon was recently sacked for whistleblowing.(HealthWatch, october 2010, issue 79, p3-7 available at http://href.fr/healthwatch_oct10.pdf)

 

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Cases of wilful misrepresentation are a rarity in medical advertising. For every advertisement in which nonexistent doctors are called on to testify or deliberately irrelevant references are bunched up in [fine print], you will find a hundred or more whose greatest offenses are unquestioning enthusiasm and the skill to communicate it.

The best defence the physician can muster against this kind of advertising is a healthy skepticism and a willingness, not always apparent in the past, to do his homework. He must cultivate a flair for spotting the logical loophole, the invalid clinical trial, the unreliable or meaningless testimonial, the unneeded improvement and the unlikely claim. Above all, he must develop greater resistance to the lure of the fashionable and the new.
- Pierre R. Garai (advertising executive) 1963