MEDICAL JOURNALS PIMP FOR BIG PHARMA
By Jon Christian Ryter
June 19, 2010 NewsWithViews. com
http://www.newswith views.com/ Ryter/jon321.htm
PLoS Medicine a peer review journal for the Public Library of Science claimed in an article that the most respected medical journals have become much too dependent on revenue from the pharmaceutical industry from two sources. First, advertising revenue which, according to PLoS, is the least corrupting form of revenue since the pharmaceutical industry should have the right to reach their potential customers in the periodicals their customers-doctors- read. What is the bigger problem, and what corrupts the integrity of the advertising process in about 25 different medical journals according to PLoS in an article published by the Public Library of Science five years ago (but never read by the general public which does not generally subscribe to it) is the second source of "advertising" revenue. The PR firms hired by the pharmaceutical giants pay fees to the journals to print well-edited capsulated synopsis of the drug trials.
The PR firms know that when the drug trials are published in any medical journal, the drug and the test tacitly carry that journal's stamp of approval simply by appearing in it. According to PLoS, a favorable review in a periodical like the Journal of American Medicine and the British Medical Journal and Lancet which have global distribution is worth thousands of pages of advertising. The PR companies will sometimes pay upwards of a million dollars for reprints of the articles to send to drug distributors, pharmaceutical wholesalers and medical professionals. While the PR firms admit the recipients of the reprints seldom read them, what they rely on is the name of the prestigious journal printing the review of giving a new drug credibility in the marketplace it has not earned from evidence of their curative abilities. The more important the medical journal, the more credibility the drug receives in the eyes of the physicians who receive the reprints.
Many times the whole content of the written clinical tests are not all that favorable to the drug but that, of course, is not reflected in the capsulated, controlled synopsis that appears in the medical journals. In 1994, Dr. Paula Rochon, adjunct scientist for the Kunin-Lunefeld Applied Research Unit and several of her colleagues wrote a paper examining the impact of journals which were paid to publish controlled excerpts of clinical studies had on the medical community's acceptance of the drugs compared to actual medicinal value of the drugs examined. The study focused on one class of drugs only: nonsteroidal anti-inflammatory drugs designed to combat arthritis. They found 56 trials. Not one of the published reports on the clinical studies presented any facts that were detrimental to the drugs tested.
The group came back a decade later, in 2003, and did a follow-up study on the 56 trial drugs to see if the drugs were living up to their clinical claims. The article was published by Richard Smith, the CEO of UnitedHealth Europe. Smith was Editor-in-Chief of the British Medical Journal for 13 years and held that job when the aforementioned study on the new arthritis drug was done. In many cases the reality of the drugs did not match the printed rhetoric of the promises of the clinical study conducted a decade earlier.
The question raised by the Public Library of Science a decade later was: how do pharmaceutical companies get the results they want once the drug is approved and recommended by physicians to their clients. When we go to our HMO or PPO physicians and they prescribe medication, we assume-and have every right and expectation to assume-that the prescription our physician prescribes will relieve or cure whatever the prescription is taken for. According to Smith, the pharmaceutical companies and their PR firms get the results they want not by fudging the facts but by asking the right questions and providing the right answers. This comes from hiring the right PR top guns who know how to stay a step ahead of the peer review groups. They do this by isolating positive parts of the clinical studies and forcing the dialogue into those positive aspects while ignoring negative ones. Or they combine the results from different centers in multiple combinations to obfuscate negative results in some facet or facets of the clinical study.
These strategies, Smith noted, have been exposed in the cases of risperidone and odansetron. However, with the 56 clinical studies the PLoS were attempting to evaluate, there was an impossible amount of work to examine in order to ascertain how many of the trials were truly independent and not biased on behalf of the fees paid by the pharmaceutical company. Clearly, what the Big Pharma wants is their drugs approved and used, and the PR firms they hire are paid to get positive "reviews" from the medical journals and paid advertising and advertorial (paid editorial copy) in the form of capsulated clinical studies.
What it comes down to, if the world's most prestigious medical journals-which medical professionals read as the Bible of the industry-have sold their souls for money, it is no more factually believable than magazines like The Onion or Mad magazine, the satirical comic book most Americans of read as teenagers back in the 1950s and 1960s. Smith further noted that "...Journal editors are becoming increasingly aware of how they are being manipulated and are fighting back. But, I must confess it took me almost a quarter of a century editing for the BMJ to wake up to what was happening... [E]ditors ask for other related data [related to] the studies submitted to them...But editors do not know what other unpublished studies exist."
Editors generally do not know if they are doing an honest peer review on one product or on a gigantic clever marketing jigsaw. More than likely one or more editors have commented that the material they get, regardless if it's a precise document or a jigsaw puzzle will always be of high technical quality.
The question raised by Smith and investigators like Dr. Rochon is how do we prevent the most prestigious medical journals in the world from selling their editorial souls for money? How do we prevent them from becoming no more credible than Mad Magazine or The Onion? How do we prevent them from becoming an extension of the marketing arm of the pharmaceutical industry? Smith thinks the editors can demand the right to review the protocols, and insist that all trials be registered; and most of all, demand that all clinical studies are completely transparent.
That won't happen because the journal publishers and shareholders know those clinical studies are worth millions of dollars in revenue, and bring additional millions in print advertising dollars from the pharmaceutical industry to reward them for publishing the clinical studies. Meaning, of course, that the medical journals are not going to risk that revenue. So, if you're a doctor who generally reads the New England Journal of Medicine, the Annals of Internal Medicine, JAMA or BMJ or Lancet in England, Canada or Australia for the latest life saving drugs, you might as well read something that will give you a chuckle.
Mad magazine was my magazine of choice as a kid. Give it a try. You have to say one thing about Mad. If you're older than 8 or 10 years of age, you'll always know when Mad's story line is an out-and-out lie or is colouring the truth. According to Smith and the editors of several other medical journals, you can't tell that from clinical studies published in the medical journals until you read the histories of the drugs about a decade later. By then, for some, it's too late. I guess that's why class action lawsuits are still in vogue.
Showing posts with label Medical Fraud. Show all posts
Showing posts with label Medical Fraud. Show all posts
Tuesday, November 30, 2010
For several years now, reading medical/scientific journals, I came to the conclusion, that science/medicine is dogmatic in their approach and life threateningly flawed. Various research methodologies in statistical analysis, (I studied research methods and various statistical methodology and analysis using SSPS sofware some years ago now), led me to conclude that there were serious flaws in medical research. Its like a disease spreading through academia.
The whole structure of how research is conducted is shockingly flawed. A rebellion last year at Harvard University from medical students - against flawed theories heavily weighed on by Big Pharma. They wanted to study how to heal, not to maim!! A module at Kings College Medical School in London, teaching medical students how to interpret skewed statistical methodologies!!! That does not go far enough. Many of us, with a deep insight and mistrust of science, not only medical is pervasive.
Thanks to scientists such as Dr Ioannidis, making it possible for us, to understand and prevent further health disasters.
I came across this article (below) about a scientist, one of many, articulating succinctly what I found throughout my own hazy research on my quest for health.
My own observations is that most are ill because of medical interventions, and that, we have the an internal healing mechanism. The less it is interfered with, the more healing will take place. Tapping into the healing mechanism through means excluding medical intervention and prevention is of paramount importance. Its a personal choice. We are under constant assault from the time of conception. Parents who took vaccines and meds, environmental toxins, etc.. The mapping of the human genome proving to be a huge white elephant, and bla bla bla. My usual rant here.... ;D Anyhow, read this excellent article which mirrors my own and many of you there, thoughts on science, healing and so forth.
The article below encapsulates my own findings:
Lies, Damned Lies, and Medical Science
By David H. Freedman http://tinyurl.com/26olese
Cont/....
hat question has been central to Ioannidis’s career. He’s what’s known as a meta-researcher, and he’s become one of the world’s foremost experts on the credibility of medical research. He and his team have shown, again and again, and in many different ways, that much of what biomedical researchers conclude in published studies—conclusions that doctors keep in mind when they prescribe antibiotics or blood-pressure medication, or when they advise us to consume more fiber or less meat, or when they recommend surgery for heart disease or back pain—is misleading, exaggerated, and often flat-out wrong. He charges that as much as 90 percent of the published medical information that doctors rely on is flawed. His work has been widely accepted by the medical community; it has been published in the field’s top journals, where it is heavily cited; and he is a big draw at conferences. Given this exposure, and the fact that his work broadly targets everyone else’s work in medicine, as well as everything that physicians do and all the health advice we get, Ioannidis may be one of the most influential scientists alive. Yet for all his influence, he worries that the field of medical research is so pervasively flawed, and so riddled with conflicts of interest, that it might be chronically resistant to change—or even to publicly admitting that there’s a problem.
In poring over medical journals, he was struck by how many findings of all types were refuted by later findings. Of course, medical-science “never minds” are hardly secret. And they sometimes make headlines, as when in recent years large studies or growing consensuses of researchers concluded that mammograms, colonoscopies, and PSA tests are far less useful cancer-detection tools than we had been told; or when widely prescribed antidepressants such as Prozac, Zoloft, and Paxil were revealed to be no more effective than a placebo for most cases of depression; or when we learned that staying out of the sun entirely can actually increase cancer risks; or when we were told that the advice to drink lots of water during intense exercise was potentially fatal; or when, last April, we were informed that taking fish oil, exercising, and doing puzzles doesn’t really help fend off Alzheimer’s disease, as long claimed. Peer-reviewed studies have come to opposite conclusions on whether using cell phones can cause brain cancer, whether sleeping more than eight hours a night is healthful or dangerous, whether taking aspirin every day is more likely to save your life or cut it short, and whether routine angioplasty works better than pills to unclog heart arteries.
But beyond the headlines, Ioannidis was shocked at the range and reach of the reversals he was seeing in everyday medical research. “Randomized controlled trials,” which compare how one group responds to a treatment against how an identical group fares without the treatment, had long been considered nearly unshakable evidence, but they, too, ended up being wrong some of the time. “I realized even our gold-standard research had a lot of problems,” he says. Baffled, he started looking for the specific ways in which studies were going wrong. And before long he discovered that the range of errors being committed was astonishing: from what questions researchers posed, to how they set up the studies, to which patients they recruited for the studies, to which measurements they took, to how they analyzed the data, to how they presented their results, to how particular studies came to be published in medical journals.
......./
David Gorski, a surgeon and researcher at Detroit’s Barbara Ann Karmanos Cancer Institute, noted in his prominent medical blog that when he presented Ioannidis’s paper on highly cited research at a professional meeting, “not a single one of my surgical colleagues was the least bit surprised or disturbed by its findings.” Ioannidis offers a theory for the relatively calm reception. “I think that people didn’t feel I was only trying to provoke them, because I showed that it was a community problem, instead of pointing fingers at individual examples of bad research,” he says. In a sense, he gave scientists an opportunity to cluck about the wrongness without having to acknowledge that they themselves succumb to it—it was something everyone else did.
......../
If a study somehow avoids every one of these problems and finds a real connection to long-term changes in health, you’re still not guaranteed to benefit, because studies report average results that typically represent a vast range of individual outcomes. Should you be among the lucky minority that stands to benefit, don’t expect a noticeable improvement in your health, because studies usually detect only modest effects that merely tend to whittle your chances of succumbing to a particular disease from small to somewhat smaller. “The odds that anything useful will survive from any of these studies are poor,” says Ioannidis—dismissing in a breath a good chunk of the research into which we sink about $100 billion a year in the United States alone.
....../
And so it goes for all medical studies, he says. Indeed, nutritional studies aren’t the worst. Drug studies have the added corruptive force of financial conflict of interest. The exciting links between genes and various diseases and traits that are relentlessly hyped in the press for heralding miraculous around-the-corner treatments for everything from colon cancer to schizophrenia have in the past proved so vulnerable to error and distortion, Ioannidis has found, that in some cases you’d have done about as well by throwing darts at a chart of the genome. (These studies seem to have improved somewhat in recent years, but whether they will hold up or be useful in treatment are still open questions.) Vioxx, Zelnorm, and Baycol were among the widely prescribed drugs found to be safe and effective in large randomized controlled trials before the drugs were yanked from the market as unsafe or not so effective, or both.
“Often the claims made by studies are so extravagant that you can immediately cross them out without needing to know much about the specific problems with the studies,” Ioannidis says. But of course it’s that very extravagance of claim (one large randomized controlled trial even proved that secret prayer by unknown parties can save the lives of heart-surgery patients, while another proved that secret prayer can harm them) that helps gets these findings into journals and then into our treatments and lifestyles, especially when the claim builds on impressive-sounding evidence. “Even when the evidence shows that a particular research idea is wrong, if you have thousands of scientists who have invested their careers in it, they’ll continue to publish papers on it,” he says. “It’s like an epidemic, in the sense that they’re infected with these wrong ideas, and they’re spreading it to other researchers through journals.”
.../
Though scientists and science journalists are constantly talking up the value of the peer-review process, researchers admit among themselves that biased, erroneous, and even blatantly fraudulent studies easily slip through it. Nature, the grande dame of science journals, stated in a 2006 editorial, “Scientists understand that peer review per se provides only a minimal assurance of quality, and that the public conception of peer review as a stamp of authentication is far from the truth.” What’s more, the peer-review process often pressures researchers to shy away from striking out in genuinely new directions, and instead to build on the findings of their colleagues (that is, their potential reviewers) in ways that only seem like breakthroughs—as with the exciting-sounding gene linkages (autism genes identified!) and nutritional findings (olive oil lowers blood pressure!) that are really just dubious and conflicting variations on a theme.
Most journal editors don’t even claim to protect against the problems that plague these studies. University and government research overseers rarely step in to directly enforce research quality, and when they do, the science community goes ballistic over the outside interference. The ultimate protection against research error and bias is supposed to come from the way scientists constantly retest each other’s results—except they don’t. Only the most prominent findings are likely to be put to the test, because there’s likely to be publication payoff in firming up the proof, or contradicting it.
..........That we’re not routinely made seriously ill by this shortfall, he argues, is due largely to the fact that most medical interventions and advice don’t address life-and-death situations, but rather aim to leave us marginally healthier or less unhealthy, so we usually neither gain nor risk all that much.
Read the whole article here: http://tinyurl.com/26olese
The whole structure of how research is conducted is shockingly flawed. A rebellion last year at Harvard University from medical students - against flawed theories heavily weighed on by Big Pharma. They wanted to study how to heal, not to maim!! A module at Kings College Medical School in London, teaching medical students how to interpret skewed statistical methodologies!!! That does not go far enough. Many of us, with a deep insight and mistrust of science, not only medical is pervasive.
Thanks to scientists such as Dr Ioannidis, making it possible for us, to understand and prevent further health disasters.
I came across this article (below) about a scientist, one of many, articulating succinctly what I found throughout my own hazy research on my quest for health.
My own observations is that most are ill because of medical interventions, and that, we have the an internal healing mechanism. The less it is interfered with, the more healing will take place. Tapping into the healing mechanism through means excluding medical intervention and prevention is of paramount importance. Its a personal choice. We are under constant assault from the time of conception. Parents who took vaccines and meds, environmental toxins, etc.. The mapping of the human genome proving to be a huge white elephant, and bla bla bla. My usual rant here.... ;D Anyhow, read this excellent article which mirrors my own and many of you there, thoughts on science, healing and so forth.
The article below encapsulates my own findings:
Lies, Damned Lies, and Medical Science
By David H. Freedman http://tinyurl.com/26olese
Cont/....
hat question has been central to Ioannidis’s career. He’s what’s known as a meta-researcher, and he’s become one of the world’s foremost experts on the credibility of medical research. He and his team have shown, again and again, and in many different ways, that much of what biomedical researchers conclude in published studies—conclusions that doctors keep in mind when they prescribe antibiotics or blood-pressure medication, or when they advise us to consume more fiber or less meat, or when they recommend surgery for heart disease or back pain—is misleading, exaggerated, and often flat-out wrong. He charges that as much as 90 percent of the published medical information that doctors rely on is flawed. His work has been widely accepted by the medical community; it has been published in the field’s top journals, where it is heavily cited; and he is a big draw at conferences. Given this exposure, and the fact that his work broadly targets everyone else’s work in medicine, as well as everything that physicians do and all the health advice we get, Ioannidis may be one of the most influential scientists alive. Yet for all his influence, he worries that the field of medical research is so pervasively flawed, and so riddled with conflicts of interest, that it might be chronically resistant to change—or even to publicly admitting that there’s a problem.
In poring over medical journals, he was struck by how many findings of all types were refuted by later findings. Of course, medical-science “never minds” are hardly secret. And they sometimes make headlines, as when in recent years large studies or growing consensuses of researchers concluded that mammograms, colonoscopies, and PSA tests are far less useful cancer-detection tools than we had been told; or when widely prescribed antidepressants such as Prozac, Zoloft, and Paxil were revealed to be no more effective than a placebo for most cases of depression; or when we learned that staying out of the sun entirely can actually increase cancer risks; or when we were told that the advice to drink lots of water during intense exercise was potentially fatal; or when, last April, we were informed that taking fish oil, exercising, and doing puzzles doesn’t really help fend off Alzheimer’s disease, as long claimed. Peer-reviewed studies have come to opposite conclusions on whether using cell phones can cause brain cancer, whether sleeping more than eight hours a night is healthful or dangerous, whether taking aspirin every day is more likely to save your life or cut it short, and whether routine angioplasty works better than pills to unclog heart arteries.
But beyond the headlines, Ioannidis was shocked at the range and reach of the reversals he was seeing in everyday medical research. “Randomized controlled trials,” which compare how one group responds to a treatment against how an identical group fares without the treatment, had long been considered nearly unshakable evidence, but they, too, ended up being wrong some of the time. “I realized even our gold-standard research had a lot of problems,” he says. Baffled, he started looking for the specific ways in which studies were going wrong. And before long he discovered that the range of errors being committed was astonishing: from what questions researchers posed, to how they set up the studies, to which patients they recruited for the studies, to which measurements they took, to how they analyzed the data, to how they presented their results, to how particular studies came to be published in medical journals.
......./
David Gorski, a surgeon and researcher at Detroit’s Barbara Ann Karmanos Cancer Institute, noted in his prominent medical blog that when he presented Ioannidis’s paper on highly cited research at a professional meeting, “not a single one of my surgical colleagues was the least bit surprised or disturbed by its findings.” Ioannidis offers a theory for the relatively calm reception. “I think that people didn’t feel I was only trying to provoke them, because I showed that it was a community problem, instead of pointing fingers at individual examples of bad research,” he says. In a sense, he gave scientists an opportunity to cluck about the wrongness without having to acknowledge that they themselves succumb to it—it was something everyone else did.
......../
If a study somehow avoids every one of these problems and finds a real connection to long-term changes in health, you’re still not guaranteed to benefit, because studies report average results that typically represent a vast range of individual outcomes. Should you be among the lucky minority that stands to benefit, don’t expect a noticeable improvement in your health, because studies usually detect only modest effects that merely tend to whittle your chances of succumbing to a particular disease from small to somewhat smaller. “The odds that anything useful will survive from any of these studies are poor,” says Ioannidis—dismissing in a breath a good chunk of the research into which we sink about $100 billion a year in the United States alone.
....../
And so it goes for all medical studies, he says. Indeed, nutritional studies aren’t the worst. Drug studies have the added corruptive force of financial conflict of interest. The exciting links between genes and various diseases and traits that are relentlessly hyped in the press for heralding miraculous around-the-corner treatments for everything from colon cancer to schizophrenia have in the past proved so vulnerable to error and distortion, Ioannidis has found, that in some cases you’d have done about as well by throwing darts at a chart of the genome. (These studies seem to have improved somewhat in recent years, but whether they will hold up or be useful in treatment are still open questions.) Vioxx, Zelnorm, and Baycol were among the widely prescribed drugs found to be safe and effective in large randomized controlled trials before the drugs were yanked from the market as unsafe or not so effective, or both.
“Often the claims made by studies are so extravagant that you can immediately cross them out without needing to know much about the specific problems with the studies,” Ioannidis says. But of course it’s that very extravagance of claim (one large randomized controlled trial even proved that secret prayer by unknown parties can save the lives of heart-surgery patients, while another proved that secret prayer can harm them) that helps gets these findings into journals and then into our treatments and lifestyles, especially when the claim builds on impressive-sounding evidence. “Even when the evidence shows that a particular research idea is wrong, if you have thousands of scientists who have invested their careers in it, they’ll continue to publish papers on it,” he says. “It’s like an epidemic, in the sense that they’re infected with these wrong ideas, and they’re spreading it to other researchers through journals.”
.../
Though scientists and science journalists are constantly talking up the value of the peer-review process, researchers admit among themselves that biased, erroneous, and even blatantly fraudulent studies easily slip through it. Nature, the grande dame of science journals, stated in a 2006 editorial, “Scientists understand that peer review per se provides only a minimal assurance of quality, and that the public conception of peer review as a stamp of authentication is far from the truth.” What’s more, the peer-review process often pressures researchers to shy away from striking out in genuinely new directions, and instead to build on the findings of their colleagues (that is, their potential reviewers) in ways that only seem like breakthroughs—as with the exciting-sounding gene linkages (autism genes identified!) and nutritional findings (olive oil lowers blood pressure!) that are really just dubious and conflicting variations on a theme.
Most journal editors don’t even claim to protect against the problems that plague these studies. University and government research overseers rarely step in to directly enforce research quality, and when they do, the science community goes ballistic over the outside interference. The ultimate protection against research error and bias is supposed to come from the way scientists constantly retest each other’s results—except they don’t. Only the most prominent findings are likely to be put to the test, because there’s likely to be publication payoff in firming up the proof, or contradicting it.
..........That we’re not routinely made seriously ill by this shortfall, he argues, is due largely to the fact that most medical interventions and advice don’t address life-and-death situations, but rather aim to leave us marginally healthier or less unhealthy, so we usually neither gain nor risk all that much.
Read the whole article here: http://tinyurl.com/26olese
Monday, July 5, 2010
Watch this vid: http://video.google.com/videoplay?docid=-2502546838698762400#
Still wanna reach for your little candies?
MEDICAL JOURNALS PIMP FOR BIG PHARMA
By Jon Christian Ryter
June 19, 2010 NewsWithViews. com
http://www.newswithviews.com/Ryter/jon321.htm
PLoS Medicine a peer review journal for the Public Library of Science claimed in an article that the most respected medical journals have become much too dependent on revenue from the pharmaceutical industry from two sources. First, advertising revenue which, according to PLoS, is the least corrupting form of revenue since the pharmaceutical industry should have the right to reach their potential customers in the periodicals their customers-doctors- read. What is the bigger problem, and what corrupts the integrity of the advertising process in about 25 different medical journals according to PLoS in an article published by the Public Library of Science five years ago (but never read by the general public which does not generally subscribe to it) is the second source of "advertising" revenue. The PR firms hired by the pharmaceutical giants pay fees to the journals to print well-edited capsulated synopsis of the drug trials.
The PR firms know that when the drug trials are published in any medical journal, the drug and the test tacitly carry that journal's stamp of approval simply by appearing in it. According to PLoS, a favorable review in a periodical like the Journal of American Medicine and the British Medical Journal and Lancet which have global distribution is worth thousands of pages of advertising. The PR companies will sometimes pay upwards of a million dollars for reprints of the articles to send to drug distributors, pharmaceutical wholesalers and medical professionals. While the PR firms admit the recipients of the reprints seldom read them, what they rely on is the name of the prestigious journal printing the review of giving a new drug credibility in the marketplace it has not earned from evidence of their curative abilities. The more important the medical journal, the more credibility the drug receives in the eyes of the physicians who receive the reprints.
Many times the whole content of the written clinical tests are not all that favorable to the drug but that, of course, is not reflected in the capsulated, controlled synopsis that appears in the medical journals. In 1994, Dr. Paula Rochon, adjunct scientist for the Kunin-Lunefeld Applied Research Unit and several of her colleagues wrote a paper examining the impact of journals which were paid to publish controlled excerpts of clinical studies had on the medical community's acceptance of the drugs compared to actual medicinal value of the drugs examined. The study focused on one class of drugs only: nonsteroidal anti-inflammatory drugs designed to combat arthritis. They found 56 trials. Not one of the published reports on the clinical studies presented any facts that were detrimental to the drugs tested.
The group came back a decade later, in 2003, and did a follow-up study on the 56 trial drugs to see if the drugs were living up to their clinical claims. The article was published by Richard Smith, the CEO of UnitedHealth Europe. Smith was Editor-in-Chief of the British Medical Journal for 13 years and held that job when the aforementioned study on the new arthritis drug was done. In many cases the reality of the drugs did not match the printed rhetoric of the promises of the clinical study conducted a decade earlier.
The question raised by the Public Library of Science a decade later was: how do pharmaceutical companies get the results they want once the drug is approved and recommended by physicians to their clients. When we go to our HMO or PPO physicians and they prescribe medication, we assume-and have every right and expectation to assume-that the prescription our physician prescribes will relieve or cure whatever the prescription is taken for. According to Smith, the pharmaceutical companies and their PR firms get the results they want not by fudging the facts but by asking the right questions and providing the right answers. This comes from hiring the right PR top guns who know how to stay a step ahead of the peer review groups. They do this by isolating positive parts of the clinical studies and forcing the dialogue into those positive aspects while ignoring negative ones. Or they combine the results from different centers in multiple combinations to obfuscate negative results in some facet or facets of the clinical study.
These strategies, Smith noted, have been exposed in the cases of risperidone and odansetron. However, with the 56 clinical studies the PLoS were attempting to evaluate, there was an impossible amount of work to examine in order to ascertain how many of the trials were truly independent and not biased on behalf of the fees paid by the pharmaceutical company. Clearly, what the Big Pharma wants is their drugs approved and used, and the PR firms they hire are paid to get positive "reviews" from the medical journals and paid advertising and advertorial (paid editorial copy) in the form of capsulated clinical studies.
What it comes down to, if the world's most prestigious medical journals-which medical professionals read as the Bible of the industry-have sold their souls for money, it is no more factually believable than magazines like The Onion or Mad magazine, the satirical comic book most Americans of read as teenagers back in the 1950s and 1960s. Smith further noted that "...Journal editors are becoming increasingly aware of how they are being manipulated and are fighting back. But, I must confess it took me almost a quarter of a century editing for the BMJ to wake up to what was happening... [E]ditors ask for other related data [related to] the studies submitted to them...But editors do not know what other unpublished studies exist."
Editors generally do not know if they are doing an honest peer review on one product or on a gigantic clever marketing jigsaw. More than likely one or more editors have commented that the material they get, regardless if it's a precise document or a jigsaw puzzle will always be of high technical quality.
The question raised by Smith and investigators like Dr. Rochon is how do we prevent the most prestigious medical journals in the world from selling their editorial souls for money? How do we prevent them from becoming no more credible than Mad Magazine or The Onion? How do we prevent them from becoming an extension of the marketing arm of the pharmaceutical industry? Smith thinks the editors can demand the right to review the protocols, and insist that all trials be registered; and most of all, demand that all clinical studies are completely transparent.
That won't happen because the journal publishers and shareholders know those clinical studies are worth millions of dollars in revenue, and bring additional millions in print advertising dollars from the pharmaceutical industry to reward them for publishing the clinical studies. Meaning, of course, that the medical journals are not going to risk that revenue. So, if you're a doctor who generally reads the New England Journal of Medicine, the Annals of Internal Medicine, JAMA or BMJ or Lancet in England, Canada or Australia for the latest life saving drugs, you might as well read something that will give you a chuckle.
Mad magazine was my magazine of choice as a kid. Give it a try. You have to say one thing about Mad. If you're older than 8 or 10 years of age, you'll always know when Mad's story line is an out-and-out lie or is colouring the truth. According to Smith and the editors of several other medical journals, you can't tell that from clinical studies published in the medical journals until you read the histories of the drugs about a decade later. By then, for some, it's too late. I guess that's why class action lawsuits are still in vogue.
Still wanna reach for your little candies?
MEDICAL JOURNALS PIMP FOR BIG PHARMA
By Jon Christian Ryter
June 19, 2010 NewsWithViews. com
http://www.newswithviews.com/Ryter/jon321.htm
PLoS Medicine a peer review journal for the Public Library of Science claimed in an article that the most respected medical journals have become much too dependent on revenue from the pharmaceutical industry from two sources. First, advertising revenue which, according to PLoS, is the least corrupting form of revenue since the pharmaceutical industry should have the right to reach their potential customers in the periodicals their customers-doctors- read. What is the bigger problem, and what corrupts the integrity of the advertising process in about 25 different medical journals according to PLoS in an article published by the Public Library of Science five years ago (but never read by the general public which does not generally subscribe to it) is the second source of "advertising" revenue. The PR firms hired by the pharmaceutical giants pay fees to the journals to print well-edited capsulated synopsis of the drug trials.
The PR firms know that when the drug trials are published in any medical journal, the drug and the test tacitly carry that journal's stamp of approval simply by appearing in it. According to PLoS, a favorable review in a periodical like the Journal of American Medicine and the British Medical Journal and Lancet which have global distribution is worth thousands of pages of advertising. The PR companies will sometimes pay upwards of a million dollars for reprints of the articles to send to drug distributors, pharmaceutical wholesalers and medical professionals. While the PR firms admit the recipients of the reprints seldom read them, what they rely on is the name of the prestigious journal printing the review of giving a new drug credibility in the marketplace it has not earned from evidence of their curative abilities. The more important the medical journal, the more credibility the drug receives in the eyes of the physicians who receive the reprints.
Many times the whole content of the written clinical tests are not all that favorable to the drug but that, of course, is not reflected in the capsulated, controlled synopsis that appears in the medical journals. In 1994, Dr. Paula Rochon, adjunct scientist for the Kunin-Lunefeld Applied Research Unit and several of her colleagues wrote a paper examining the impact of journals which were paid to publish controlled excerpts of clinical studies had on the medical community's acceptance of the drugs compared to actual medicinal value of the drugs examined. The study focused on one class of drugs only: nonsteroidal anti-inflammatory drugs designed to combat arthritis. They found 56 trials. Not one of the published reports on the clinical studies presented any facts that were detrimental to the drugs tested.
The group came back a decade later, in 2003, and did a follow-up study on the 56 trial drugs to see if the drugs were living up to their clinical claims. The article was published by Richard Smith, the CEO of UnitedHealth Europe. Smith was Editor-in-Chief of the British Medical Journal for 13 years and held that job when the aforementioned study on the new arthritis drug was done. In many cases the reality of the drugs did not match the printed rhetoric of the promises of the clinical study conducted a decade earlier.
The question raised by the Public Library of Science a decade later was: how do pharmaceutical companies get the results they want once the drug is approved and recommended by physicians to their clients. When we go to our HMO or PPO physicians and they prescribe medication, we assume-and have every right and expectation to assume-that the prescription our physician prescribes will relieve or cure whatever the prescription is taken for. According to Smith, the pharmaceutical companies and their PR firms get the results they want not by fudging the facts but by asking the right questions and providing the right answers. This comes from hiring the right PR top guns who know how to stay a step ahead of the peer review groups. They do this by isolating positive parts of the clinical studies and forcing the dialogue into those positive aspects while ignoring negative ones. Or they combine the results from different centers in multiple combinations to obfuscate negative results in some facet or facets of the clinical study.
These strategies, Smith noted, have been exposed in the cases of risperidone and odansetron. However, with the 56 clinical studies the PLoS were attempting to evaluate, there was an impossible amount of work to examine in order to ascertain how many of the trials were truly independent and not biased on behalf of the fees paid by the pharmaceutical company. Clearly, what the Big Pharma wants is their drugs approved and used, and the PR firms they hire are paid to get positive "reviews" from the medical journals and paid advertising and advertorial (paid editorial copy) in the form of capsulated clinical studies.
What it comes down to, if the world's most prestigious medical journals-which medical professionals read as the Bible of the industry-have sold their souls for money, it is no more factually believable than magazines like The Onion or Mad magazine, the satirical comic book most Americans of read as teenagers back in the 1950s and 1960s. Smith further noted that "...Journal editors are becoming increasingly aware of how they are being manipulated and are fighting back. But, I must confess it took me almost a quarter of a century editing for the BMJ to wake up to what was happening... [E]ditors ask for other related data [related to] the studies submitted to them...But editors do not know what other unpublished studies exist."
Editors generally do not know if they are doing an honest peer review on one product or on a gigantic clever marketing jigsaw. More than likely one or more editors have commented that the material they get, regardless if it's a precise document or a jigsaw puzzle will always be of high technical quality.
The question raised by Smith and investigators like Dr. Rochon is how do we prevent the most prestigious medical journals in the world from selling their editorial souls for money? How do we prevent them from becoming no more credible than Mad Magazine or The Onion? How do we prevent them from becoming an extension of the marketing arm of the pharmaceutical industry? Smith thinks the editors can demand the right to review the protocols, and insist that all trials be registered; and most of all, demand that all clinical studies are completely transparent.
That won't happen because the journal publishers and shareholders know those clinical studies are worth millions of dollars in revenue, and bring additional millions in print advertising dollars from the pharmaceutical industry to reward them for publishing the clinical studies. Meaning, of course, that the medical journals are not going to risk that revenue. So, if you're a doctor who generally reads the New England Journal of Medicine, the Annals of Internal Medicine, JAMA or BMJ or Lancet in England, Canada or Australia for the latest life saving drugs, you might as well read something that will give you a chuckle.
Mad magazine was my magazine of choice as a kid. Give it a try. You have to say one thing about Mad. If you're older than 8 or 10 years of age, you'll always know when Mad's story line is an out-and-out lie or is colouring the truth. According to Smith and the editors of several other medical journals, you can't tell that from clinical studies published in the medical journals until you read the histories of the drugs about a decade later. By then, for some, it's too late. I guess that's why class action lawsuits are still in vogue.
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