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.