A paper published this month on the website of the Archives of Internal Medicine highlights significant failures on the part of researchers to disclose their financial links to the medical industry in their journal articles, and on the part of the publishers to demand this transparency.
The study compared major payments (more than $US1 million each) made to researchers/consultants by orthopedic device companies with financial disclosures made subsequently in their articles published in medical journal.
The study was facilitated by disclosures of payments to consultants made by five medical device companies that were forced by government investigations.
These five companies paid out about $US250 million in 2007, with almost half of that going to 41 doctors, 32 of whom wrote or were co-authors on orthopedic journal articles the next year. In the majority of articles, the topic was directly related to the company payments.
Of these 32 medical doctors and doctoral researchers, only seven declared their financial interests in every article they published. Eleven researchers made no disclosures at all in the 30 articles they published.
One of the authors of the study described their findings as representing “massive, dramatic system failure”.
Dr Marcia Angell, a former editor of the New England Journal of Medicine said that the study was “one more indication of the widespread corruption of the medical profession by industry money”.
“The journals’ lax enforcement of disclosure policies probably reflects the fact that journals too are dependent on industry support,” she said.
The International Committee of Medical Journal Editors has recently proposed better disclosure policies, but each journal sets its own policy, and clearly some have not done a good job of this.
The recently enacted health care reform legislation will facilitate more of these sorts of disclosures through the stringent “sunshine” provisions that are part of the new law.
Beginning in 2013, the law requires pharmaceutical and device companies to disclose payments (including those made in kind) to doctors, and these disclosures will be available in a national online database. The database will include the name, address and specialty of the recipient, the value of the payment, the date it was made, the reason for the payment and the product to which it was linked.
*Dr Lesley Russell is the Menzies Foundation Fellow at the Menzies Centre for Health Policy, University of Sydney/ Australian National University and a Research Associate at the US Studies Centre, University of Sydney. She is currently a Visiting Fellow at the Centre for American Progress in Washington DC.
[Eleven researchers made no disclosures at all in the 30 articles they published.]
Maybe they are all remiss but before “naming and shaming” you would need to be sure that they are publishing on the same topic for which they received payments. The disclosure statements that authors have to sign only stipulate mandatory disclosure if it directly relates to the article. In the last ten years (at least) I have never known of any submission process to a scientific journal that does not require all authors to sign a disclosure notice–of course, still on honour, though the senior submitting author would usually have an idea, though again I wouldn’t expect all the paperwork to be checked throughly (there is more and more of it and scientists don’t get any help with all this increased paperwork to do their jobs. In the commercial world there are armies of assistants and helpers for all this kind of stuff but nothing like that in most research environments except Big Pharma and Biotech.)
[..journals’ lax enforcement of disclosure policies…]
It is an honour system so I do not know what “lax enforcement” can mean. There is no magical means of verification, and imagine the effort and cost of trying to check all authors. Obviously the only solution is the proposed 2013 database. On the other hand I would be pretty sure that if discovered the author would suffer some consequences, not least immediate publishing of the failure to disclose in the same journal and maybe a threat of retraction of the paper. I do not know but in the case of medicos they surely must risk reprimand or even being struck off, depending on how outrageous the omission.
Gerard Henderson, Sydney Institute! Who are the donors ? Please do tell! It goes on everywhere in the PR business.