SOME medical journals have become an important but under-recognised obstacle to scientific truth-telling. These journals have devolved into information-laundering operations for the pharmaceutical industry.
Here is how it works: a pharmaceutical company sponsors a scientific meeting. Speakers are invited to talk about a product and paid a hefty fee. They are chosen for their views about a drug or because they are adaptable towards the needs of the company paying their fee. The meeting takes place; the speaker delivers a talk. A communications company records the lecture and converts it into an article for publication, usually as part of a collection of papers emanating from the symposium. This collection is offered to a medical publisher for an amount that can run into hundreds of thousands of pounds.
The publisher then seeks a reputable journal to publish the papers based on the symposium , commonly as a supplement to the main journal. The peer-review process may be minimal or non-existent.
Publication of the supplement appears to benefit all parties. The sponsor obtains a publication whose content it has influenced hugely but which appears under the imprint of a journal that confers on the work a credibility that the company has bought, not earned. The publisher receives a tidy, high-margin revenue.
Why is this practice wrong and dangerous? The scientific quality of research in the thousands of industry-sponsored supplements published each year is notoriously inferior to the research published in properly peer-reviewed scientific journals. The process of publication has been reduced to marketing dressed up as legitimate science.
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Pharmaceutical companies have found a way to circumvent the protective norms of peer-review. In many cases, they are able to seed the research literature with weak science that they use to promote their products to physicians.
Even what may seem like good research studies can hide sinister scenarios of buried bad news. Clinical triallists, for example, can begin with the goal of studying one outcome, but, when that result is less favourable than the sponsor would have liked, scientists may then choose (or be forced) to report a different, more positive, outcome.
A team of Oxford University researchers, led by An-Wen Chan, concluded that the results of clinical trials may be “unreliable” and “spurious”, overestimating the benefits of a treatment. Some companies go farther. They may choose not to publish results that point to a lack of effect, or drug safety problems.
GIaxoSmithKline (GSK) was accused in 2004 of failing to publish research about an antidepressant given to children and adolescents. On the basis of these concerns Eliot Spitzer, New York’s Attorney-General, filed a claim for fraud against GSK. Under fierce criticism GSK disclosed results from multiple studies that cast its drug in a more negative light than had been apparent from the available published reports.
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MMR: Science & Fiction, by Richard Horton, Granta Books, £7.99