Some Medical Journals Say Science Should Be More Important Than Lobbyists
A Stand for Scientific Independence
Here are excerpts from a recent Washington Post article on how some medical journals are fighting to rid themselves of outside control, corruption and racketeering.
by Susan OkieEditors at the world's most prominent medical journals, alarmed that drug companies are exercising control over research results, have agreed to adopt a uniform policy that reserves the right to refuse to publish drug company-sponsored studies unless the researchers involved are guaranteed scientific independence.
The New England Journal of Medicine, the Lancet, the Annals of Internal Medicine and the Journal of the American Medical Association (JAMA) are among the journals that have agreed to publish a joint editorial in mid-September outlining the new policy, which was drafted by a committee of editors over the last several months.
The unprecedented move could have a significant impact on how medical research is conducted and reported by giving researchers more leverage in their dealings with the pharmaceutical industry. Drug corporations are eager to insert their own claims in these prestigious journals because doctors view such journals as credible sources of information to help them decide which drugs to prescribe to patients.
Editors said the new policy is a response to companies' increasingly tight hold over how research is done -- and, in many cases, over whether and how the results are made public. In recent years, drug companies have become the dominant funder of biomedical research, especially of large studies of medicines' safety and effectiveness.
The authors who receive top billing on drug studies published in respected, peer-reviewed journals are usually medical school professors who are experts in their fields, but much of the research is paid for, and in large measure carried out, by companies with an enormous financial stake in the outcome. Company employees usually collect and analyze the data, and they often decide how it should be presented and write the reports.
In large, company-sponsored drug trials involving multiple hospitals, all of the information collected is typically held by the company, said Marcia Angell, former editor in chief of the New England Journal of Medicine. "Not even the principal author sees all the data," she said.
As editor of the journal, Angell recalled, she sometimes received manuscripts from company-sponsored studies that had the "methods" section -- the explanation of how the study was carried out -- left blank. "They'd say, 'This is proprietary,' " she said.
The journal editors decided to act after several recent cases involving charges that drug companies tried to withhold research results or present them in the most favorable way, several said during interviews last week.
"It's become a huge problem," said Frank Davidoff, who as editor of the Annals of Internal Medicine was among those who decided to take a stand on the issue at an international meeting of medical journal editors in May in Philadelphia.
The decision was praised by several observers of biomedical studies who have become alarmed about the influence of the drug industry on the integrity of medical research.
Surveys of the medical literature have shown that studies paid for by drug companies are more likely than those with other sponsors to show results favorable to the product tested, said Lisa Bero, a professor of clinical pharmacy and health policy at the University of California at San Francisco.
The journal editors decided to issue the joint editorial in response to "three or four well-known egregious examples, and many less well-known" cases in which companies tried to block publication of unfavorable studies or tried to put a positive spin on the findings, said Davidoff, who stepped down as editor of the Annals in July.
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