Monday 20 January 2014

Worms Run Amok At The BMJ

As noted here in the autumn, the BMJ has decided to ban publication of "any study that is partly or wholly funded by the tobacco industry", a move described by BAT's Chief Scientific Officer as "anti-science".

No matter their motives, this justifiably led to many responses under the original announcement logically calling for the same treatment - in the name of consistency - to be meted out to pharma-funded research as well.

It seems that - in their myopic zeal to appease the tobacco control industry - the BMJ has popped open a can of particularly damaging worms which are currently wriggling all over the journal's credibility. As Former BMJ Editor Richard Smith illustrated on Friday in a piece entitled "Should journals stop publishing research funded by the drug industry?" (emphases mine).
The BMJ and its sibling journals have stopped publishing research funded by the tobacco industry for two main reasons: the research is corrupted and the companies publish their research to advance their commercial aims, oblivious of the harm they do. But these arguments apply even more strongly to research funded by the drug industry, and we suggest there is a better way to communicate the results of trials that would be safer for patients. 
Prescribed drugs are the third leading cause of death, partly because of flaws in the evidence published in journals
In contrast to tobacco funded research, which is comparatively rare, two thirds of the clinical trials published in major journals such as the Lancet or New England Journal of Medicine are funded by the drug industry. In addition, companies use ghost writers to promote misleading trials in scores of secondary publications and reviews in major journals. These, just like the original research, often carry the names of opinion leaders, which seems to give the articles credibility. This common practice is scientific fraud.
Smith, and co-petitioner Peter C Gøtzsche of the Nordic Cochrane Centre, highlight many egregious abuses by pharmaceutical companies, including these.
Merck scientists knew already in 1996 that rofecoxib (Vioxx) might cause thrombosis, but the company published numerous misleading studies in prominent journals to promote its licensed use and other uses, sometimes omitting cases of myocardial infarction in patients taking the drug. More generally, the dishonesty in the research literature on non-steroidal anti-inflammatory drugs is legion and has resulted in the deaths of hundreds of thousands of patients, many of whom didn’t even need the drug. 
Another dire example is antipsychotics. Many recent drug industry crimes are related to off-label promotion of antipsychotics, and in the United States they were the most sold drugs in 2009. However, they are so dangerous that just one of them, olanzapine (Zyprexa), has probably caused 200 000 deaths.
By way of rebuttal, current BMJ Head of Research Trish Groves doesn't make much of an attempt at defending pharma-funded studies, in fact she agrees they are often deeply flawed. Instead, her argument appears to boil down to - in short - their liking pharma companies a bit more than tobacco ones.

And, of course, that the BMJ's reluctance to be even-handed is certainly not "because our journals receive advertising, reprint, and some sponsorship income from the drug industry". Oh no, absolutely not. Couldn't be further from the truth.

Understandably, Trish takes a bit of a kicking in the rapid responses section (comments, to you and me), and a poll running on their home page currently shows a majority of around 55% in favour of a ban on pharma research too.

It's tobacco control in a nutshell, isn't it? Full of pointless ideas, and with no foresight as to the unintended consequences.

You gotta laugh.


Ivan_Denisovich said...

I don't think that this is about the money. The BMJ editorial team are simply inflicting their ethically challenged ideology on the rest of us. According to Trish Groves, even a tiny contribution to research funding from a tobacco company makes in unreliable and unworthy of publication but it is perfectly OK to reference the works of demonstrably dishonest and partisan tobacco control activists in order to make that claim. The BMJ appears to value ideological conformity above quality in selecting articles for publication. I often disagree with Richard Smith but I do respect him and I believe that the the BMJ was more honest when he edited it.

Xopher said...

Ideological conformity comes before truthful reporting in all media.
BUT - cash is important - They mustn't upset their paymasters.
BBC funding is controlled by Government idealism. Commercial broadcasters and publications don't want to upset pharmaceuticals or government who provide a large proportion of their essential advertising revenue. Without income their jobs are gone.

Unfunded bloggers like yourself are the life-blood of truth (- Thank you Dick)

Michael J. McFadden said...

I had an extended letter on exactly this sort of thing published in the Edmonton Journal back in April 2007, although it concerned the U. of Alberta rather than a med journal. The problems are the same however. See:

About a week after that was published the paper allowed an Anti to slam me with a counter article that pretty much wrote me off as a Big Tobacco shill. I objected strongly to the paper and asked for at least a short response space to clear my name but they never gave it to me.


Longrider said...

Hoist with their own petard. It had to happen sooner or later. These people are so extreme that eventually it would catch up with them.