Healthy Skepticism Library item: 5490

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Publication type: news

Tanner L.
JAMA says it was misled by researchers
Associated Press 2006 Jul 12
http://seattlepi.nwsource.com/health/1500AP_Journals_Conflicts.html

Notes:

Ralph Faggotter’s Comments:

Neither patients nor doctors nor anyone else can make fully rational and informed decisions without transparency in the declaration of conflicts of interest amongst authors.

This is the least we should be able to expect from our medical journals.

Unfortunately it is not always forthcoming.

Full text:

Wednesday, July 12, 2006 · Last updated 5:23 p.m. PT

JAMA says it was misled by researchers

By LINDSEY TANNER
AP MEDICAL WRITER

CHICAGO — For the second time in two months, the Journal of the American Medical Association says it was misled by researchers who failed to reveal financial ties to drug companies.

The studies’ validity – and the prestigious journal’s reputation – are at stake, and JAMA is tightening its policies for researchers as a result.

“This is costing us,” said Dr. Catherine DeAngelis, JAMA’s editor-in-chief. “It’s costing us really good articles and God knows what it’s costing us in ads.”

But DeAngelis said her main concern is the impact on readers, who she said need to know about researchers’ financial conflicts of interest to properly evaluate their studies.

The latest incident, disclosed in letters to the editor and a correction in Wednesday’s journal, involves a study showing that pregnant women who stop taking antidepressants risk slipping back into depression.

Most of the 13 authors have financial ties to drug companies including antidepressant makers, but only two of the them revealed their ties when the study was published in February.

Antidepressant use during pregnancy is controversial and some studies have suggested that the drugs could pose risks to the fetus.

“For readers to be able to make informed judgments about potential biases in this study, they should have been made aware of all of these associations and potential conflicts of interest,” Dr. Adam Urato of Tufts University-New England Medical Center, wrote in a letter to JAMA editors.

The earlier incident involved a study in the May 17 journal that said rheumatoid arthritis patients taking Humira or Remicade faced risks of developing several cancers and serious infections.

Study co-author Dr. Eric Matteson of Mayo Clinic has worked with Remicade’s maker in developing a similar new drug and he and co-researcher Dr. Tim Bongartz have been paid consultants to Abbott for unrelated work. The ties were not disclosed until after publication.

Matteson called the omissions “errors of oversight,” not an attempt to conceal, but journal editors asked the Mayo Clinic to investigate.

DeAngelis said it’s not the first time she’s reported authors’ omissions to their institutions, and she hopes it will help curb the practice.

“It would be wonderful if 100 percent of the authors understand that you have to disclose,” DeAngelis said Tuesday.

The authors of the depression study defended their research in a separate letter to the editor published Wednesday. Lead author Dr. Lee Cohen, of Massachusetts General Hospital, who is on the speaker’s bureau for eight drug companies, disputed that such ties could influence the findings.

The business ties were not disclosed because “we did not view those associations as relevant” partly because the research was funded by the government, not industry.

Such conflicts are age-old problems haunting medical journals, which compete to publish the best research.

Dr. Jerome Kassirer, a former New England Journal of Medicine editor and an outspoken critic of doctors’ conflicts of interest, said it would be impossible for medical journals to reject all research with industry ties.

If industry ties were an obstacle to getting research published, “you’d have no research on drugs,” Kassirer said.

Still, industry-funded drug research tends to have more favorable results than other studies, and those ties need to be revealed so readers can have “a healthy skepticism,” he said.

The New England Journal of Medicine also requires financial disclosures from authors, although not before accepting an article for publication as JAMA is now doing, said Dr. Jeffrey Drazen, the journal’s editor.

The Center for Science in the Public Interest recommended Tuesday that editors adopt a three-year ban from publishing in their journals in failure-to-disclose cases.

But Drazen and DeAngelis said that would be impractical and unnecessary.

“Editors have very long institutional memories,” Drazen said. “I think that’s adequate in this case.”

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