Health Impact News Editor Comments

Although this article is now 10 years old, not much has changed in 10 years. It is worth republishing and bringing to the attention of our readers.

by Richard Smith

PLOS Medicine

Excerpts:

“Journals have devolved into information laundering operations for the pharmaceutical industry”, wrote Richard Horton, editor of the Lancet, in March 2004. In the same year, Marcia Angell, former editor of the New England Journal of Medicine, lambasted the industry for becoming “primarily a marketing machine” and co-opting “every institution that might stand in its way.”

Medical journals were conspicuously absent from her list of co-opted institutions, but she and Horton are not the only editors who have become increasingly queasy about the power and influence of the industry. Jerry Kassirer, another former editor of the New England Journal of Medicine, argues that the industry has deflected the moral compasses of many physicians, and the editors of PLoS Medicine have declared that they will not become “part of the cycle of dependency…between journals and the pharmaceutical industry”.

Something is clearly up.

Examples of Methods for Pharmaceutical Companies to Get the Results They Want from Clinical Trials

Conduct a trial of your drug against a treatment known to be inferior.

Trial your drugs against too low a dose of a competitor drug.

Conduct a trial of your drug against too high a dose of a competitor drug (making your drug seem less toxic).

Conduct trials that are too small to show differences from competitor drugs.

Use multiple endpoints in the trial and select for publication those that give favourable results.

Do multicentre trials and select for publication results from centres that are favourable.

Conduct subgroup analyses and select for publication those that are favourable.

Present results that are most likely to impress—for example, reduction in relative rather than absolute risk.

Read the full article here.