Healthy Skepticism Library item: 5845

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Publication type: news

Wang S.
Simply Disclosing Funds Behind Studies May Not Erase Bias
The Wall Street Journal 2006 Aug 4
http://online.wsj.com/article/SB115464956078626387.html

Full text:

Think you can’t be bought for the price of a pen? Neither do most
people.
But we can be notoriously poor at judging ourselves, and our honesty,
psychologists say.

For example, biomedical researchers reprimanded for failing to disclose
financial ties to companies whose drugs or medical devices they study
seem
baffled over what they did wrong.

In the past few weeks, several top journals have published corrections
noting that authors of papers failed to reveal they had served as paid
consultants or speakers for companies whose products they studied,
often
receiving thousands of dollars. Such conflicts of interest are emerging
as a
major concern in research.

Studies show that even small gifts create feelings of obligation, and
that
those feelings can influence subsequent decisions, so why do many
researchers feel they’re immune to conflicts of interest?

Just as we fool ourselves into thinking we’re more ethical, kind and
generous than we are, so scientists can be blind to the very real
possibility that their work is inappropriately influenced by financial
ties.
These psychological processes usually operate so subtly that people
aren’t
aware that such ties can bias their judgment.

Receiving gifts and money creates the desire, often unconscious, to
give
something back, says Max Bazerman of Harvard Business School. Even
small
gifts can have an influence. Charities that send out free address
labels,
for example, get more in donations than those that don’t.
Customers who are given a 50-cent key chain at a pharmacy spend
substantially more in the store.

Conflicts can be hard to recognize, because “cognitive bias” comes into
play. “The mind has an enormous ability to see the world as we want,”
says Dr. Bazerman.

We are more likely to scrutinize information when it’s inconsistent
with how
we want to see things, something psychologists call motivated
skepticism. If
a study about an anticipated new drug is sponsored by the manufacturer,
“we
don’t kick into a higher gear of criticism,” says psychologist David
Dunning
of Cornell University. “We just accept the findings” if they are
positive,
without digging too hard for possible flaws in methodology or
statistics.

Studies of psychiatric drugs by researchers with a financial conflict
of
interest — receiving speaking fees, owning stock, or being employed by
the
manufacturer — are nearly five times as likely to find benefits in
taking
the drugs as studies by researchers who don’t receive money from the
industry, according to a review of 162 studies published last year in
the
American Journal of Psychiatry. Studies that the industry funded, but
in
which the researchers had no other financial ties, didn’t have
significantly
different results than nonindustry-funded studies.

Studies can be designed in ways that boost the likelihood that results
will
come out a certain way, says Lisa Bero of the University of California,
San
Francisco. A new treatment can be compared with a placebo, instead of
with a
treatment already in use, making finding a significant statistical
difference between the two more likely. Dosage and timing of
medications,
which make a big difference in their effectiveness and side effects,
can
also be manipulated, she says.

While studies in reputable journals are reviewed by experts in the
field
prior to publication, data require interpretation, which opens the door
to
subjectivity. If the numbers don’t show an overall benefit of a drug,
for
instance, scientists with financial ties to the company might dig
deeper to
find one, perhaps to one small group, say, white women over 50 years of
age.

Because it’s rare for studies to show that one variable clearly causes
an
outcome, there’s always room for doubt. Conflicted individuals, says
Prof.
Bazerman, “continue to have doubts long after objective observers are
convinced by the evidence,” as when some tobacco executives refused to
admit
that smoking is related to risk of cancer.

But simply disclosing financial ties, as many journals require of
authors,
may not help. In fact, it may make things worse. For one thing, readers
don’t know how much, if at all, a conflict has skewed the reported
results.

In a 2005 experiment done by Harvard’s Daylian Cain and colleagues,
volunteers were given advice about how much money was in a jar of
coins.
In some cases, the advisers were unconflicted, and the volunteers used
the
advice to make good guesses about the coins (which they saw only
fleetingly
and from a distance). In other cases, the advisers had a monetary
incentive
to overestimate the value of the coins. The volunteers knew this, and
adjusted the advice downward. But they didn’t adjust enough, and
overestimated the value.

Disclosure poses another problem: It may unconsciously tempt
researchers to
exaggerate their findings or put an even more pro-company spin on their
data
to counteract the expected reader skepticism. “If disclosure encourages
you
to cover your ears, it makes me shout louder,” Dr. Cain says.