Follow the Money Trail! Part 2

We always want to be the best, the most handsome, the richest, whatever the superlative.  And as physicians, we like to think that we're better & more skilled than the average physician and more independent of external (financial) influence than the rest.  Yet, when I now look back upon some (all?) of my writings & presentations, the sad truth is that perhaps I was only fooling myself into seeing what I wanted to see.

In a follow up to yesterday's post, I stumbled upon a review published in PLoS Medicine last month in which authors with industry affiliations were more than twice as likely to promote continued use of hormone therapy after publication of the Women's Health Initiative study than those without such financial ties.  The good news is that regardless of affiliation, most of the articles reviewed were scientifically accurate.  The bad news?  Almost two thirds of the articles reviewed were also promotional in nature.

Granted it's always a good idea to be critical of new study outcomes that contradict the accepted, but when study after study thereafter comes to the same conclusion, perhaps it's time to accept a new course direction. Yet, of the 32 articles supporting & promoting the continued use of peri-menopausal hormone therapy, 30 were authored by those with potential conflicts of interest, eg financial ties to Big Pharma as evidenced by payment for research, speaking, and/or consulting.

And of the 18 studies that were non-promotional in nature, 11 were authored by those without industry ties.  The fact that 3 of the authors with industry ties had large blocks of text self-plagiarized repeatedly without acknowledging or citing the original source makes one suspect medical/scientific ghost writing, which has been another major issue of late.

Now I'm sure (or at least I'd like to believe) that none of these authors put pen to paper thinking explicitly that they needed to put a positive spin on the hormone controversy to continue to receive research money, speaking fees, and/or consulting honoraria.  But isn't it ironic that those not beholden to Big Pharma were less promotional, even critical?

As I noted yesterday, we need full disclosure of any and all potential and real conflicts of interest.  Just because there is a potential conflict of interest doesn't mean that it will manifest itself.  But the public, our patients, needs to make that judgement, that decision, for themselves.  It's time we stopped hiding on top of our (academic) pedestals.