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Doctors Aren't Being Candid About the Money They Get From Big Pharma
Physicians who get paid extra by pharmaceutical and medical device companies often aren't forthcoming about the money in their research papers, according to a study [open, DOI: 10.1001/jamasurg.2018.2576] [DX] out Wednesday in JAMA Surgery. It found that many of the doctors who receive the most in industry payments only occasionally disclose their potential financial conflicts when publishing relevant research.
[...] In 2013, as part of the Affordable Care Act, the federal government established the Open Payments Database, which tracks reported payments, funding, and ownership stakes the pharmaceutical industry gives to physicians and hospitals. [Mehraneh Jafari of the University of California] and her team pored through the data from 2015, isolating the top 100 doctors who had gotten paid that year by surgical and medical device companies. They then searched through all of those doctors' papers published in 2016, scrutinizing the COI disclosure sections.
The doctors had collectively been paid more than $12 million in 2015, with the median payment coming in at just under $100,000. Of those 100 doctors, 64 published research the next year. About half of the 412 articles published by them concerned research that should have merited a disclosure of the payments, such as from a medical device company whose products were used in the study. But only a third of the 225 papers flagged by Jafari and her team actually did. Worse still, 85 percent of the authors had at least one paper where they failed to list their conflicts.
Despite the findings, Jafari doesn't think it's a matter of sinister intent on the doctors' part. "You can't really blame the physicians—it's the system that's broken," she said. "There's different guidelines from different journals, and it's hard, especially if you're a prolific researcher, to keep track of them."
(Score: -1, Spam) by Anonymous Coward on Saturday August 18 2018, @02:26AM
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(Score: 3, Insightful) by Anonymous Coward on Saturday August 18 2018, @03:05AM (3 children)
WTF? She's making excuses for these lying doctors?
It's pretty easy to keep track of the following concept: if you got money from any company that is even remotely or tangentially related to a research project you are involved in, report it.
(Score: 2) by AthanasiusKircher on Saturday August 18 2018, @04:28AM (1 child)
Agreed. The excuse is bizarre. The next sentence in TFA after what you quoted from the summary continues: "Thanks to the varying guidelines surrounding COIs, Jafari added, doctors might not always understand whether a specific industry payment should be considered a conflict."
I suppose there might very occasionally be a really ambiguous case where a doctor received money for something completely different, and maybe didn't realize that money came from the same source indirectly as something in the study... But from the description in TFA, it doesn't sound like that's what's going on in most cases in this study.
It should be very simple, if these researchers care at all about SCIENCE: If you receive money from a company who has a direct interest in the outcome of the research, you report it. Ij fact, any significant sources of funding for research should always be transparent public knowledge if you expect to publish in a reputable journal. You shouldn't have to depend on journal's policy to tell you to do so. You REPORT IT. ALWAYS. EVERY TIME. End of story.
Science can't function otherwise. Because even careful researchers with integrity can suffer from unintentional confirmation bias, and that can unintentionally lead to decisions in study design, data collection practices, data analysis, final decisions on how to interpret and write up results, etc.
It doesn't mean a conflict of interest always leads to bad research. But it does mean a reader should always be a little more skeptical and that confirmation studies should be performed as follow-ups by researchers with less of a conflict.
I can and do blame the physicians here... And ANY researcher who doesn't disclose their sources of funding. They are systematically undermining the scientific process, and it's disturbing that the author here refuses to call them out for it.
(Score: 2) by bzipitidoo on Saturday August 18 2018, @12:28PM
I used to think of Capitalism as a brilliant way of harnessing human greed for the good of all. Over the years, I've become aware of more and more Conflicts of Interest, corruption, favoritism, cronyism, nepotism, graft, kickbacks, media bias, propaganda campaigns, and more recently, science denialism. Our society is riddled with that. It warps everything. Add money in the form of prizes or whatever to any game in which money is not part of the game, and the unscrupulous will come crawling out of the sewers to work every angle they can think of, in the scramble to win that prize money. There are the sandbaggers who purposely threw a bunch of games to lower their ratings just enough to qualify for an easier section, in timed events there's the inherent conflict of interest in allowing one of the players to provide the time keeping equipment, and so on. We deal with the "home field advantage" by playing the game several times, in different places. Want to know Why, for so many things? Follow the Money.
This particular Conflict of Interest being in the medical research field plays straight into science deniers' and quacks' hands. The muck in medicine is very deep. I know of no other area that has such insane billing practices that routinely inflates everything to well over 100x the actual value, with such pathetically weak justifications. Like, "don't worry about the cost, insurance will cover it" and "we have to charge such high prices to cover our other expenses and those patients who don't pay their bills", and, as certain Big Pharma price gougers claimed, they plow the profits back into research. Yeah, what does get spent on research is for bribing the researchers to, uh, be good (to them, hint, hint). They get away with all kinds of dirty pool that is not allowed in any other line of business. If ever there's a swamp that needs draining, medicine is a contender for the deepest. Marketing is bad too, but they know that naked lying is going too far, resorting instead to manipulation and weaseling. Even finance with their "too big to fail" crap may be cleaner.
(Score: 0) by Anonymous Coward on Saturday August 18 2018, @08:54PM
I agree that you can't blame them.
But we should hold them accountable. Once there are rules, and punishments, then we can blame them. At that time, not only should they know better, the enforcement will serve as a reason to demonstrate that those that don't will be punished.
the punishment I have in mind is fining them lots and lots of money. and forcing them to take the same drugs they got their clients addicted to (opiods), then cut them off and their authority to write prescriptions.
make them experience what happens when people trusted them, and make them pay for the experience--just as their patients have.
(Score: 0) by Anonymous Coward on Saturday August 18 2018, @01:49PM
When paycheck Trumps [sic] the truth.