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Healthy Skepticism Library item: 2337

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: Journal Article

Spingarn RW, Berlin JA, Strom BL.
When pharmaceutical manufacturers' employees present grand rounds, what do residents remember?
Acad Med 1996 Jan; 71:(1):86-8
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8540971&query_hl=61


Abstract:

PURPOSE. To evaluate the educational effect on residents of a grand rounds given by a pharmaceutical company employee.

METHOD. Using a retrospective cohort study design, the authors questioned 75 housestaff at a university hospital three months after a February 1990 grand rounds on Lyme disease to determine whether the residents’ beliefs about the drug of choice for this disease differed between attendees and non-attendees. Odds ratios, 95% confidence intervals, and logistic regression were used for the analysis of results.

RESULTS. The 22 housestaff who had attended the grand rounds were more likely to choose appropriately the cephalosporin manufactured by the speaker’s company over other drugs for patients with Lyme disease presenting with second-degree heart block (adjusted odds ratio of 8.4; 95% CI 2.1-38.9). However, they also chose it inappropriately for first-degree heart block (adjusted odds ratio of 7.8; 95% CI 1.6-45.5). None of the attendees, compared with 11 (21%) of the non-attendees, named an oral antibiotic for both of two milder presentations, even though oral therapy would be more appropriate (p = .027).

CONCLUSION. The results suggest that grand rounds effectively change residents’ beliefs, but a sponsoring company’s drug may be favored. Information assimilated in this way may not be well supported by the scientific literature and could result in a choice of treatment that is more expensive than other acceptable treatments.

Keywords:
MeSH Terms: Choice Behavior* Conflict of Interest Drug Industry* Drug Utilization/statistics & numerical data* Ethics, Medical Health Knowledge, Attitudes, Practice Humans Internship and Residency/statistics & numerical data* Logistic Models Lyme Disease/drug therapy* Odds Ratio Questionnaires Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. Retrospective Studies

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909