Ghostwritten Medical Articles Cast Doubt on Reliability of Drugs

The New York Times reported on Wednesday that Wyeth, the drug company that made Premarin used in estrogen replacement therapy, commissioned 26 ghostwritten articles that appeared in major medical journals. The articles hyped the value of estrogen replacement and downplayed the negatives. Eventually, this therapy was discontinued as a routine way of treating menopausal women because of the dangers involved. The ghostwritten articles were actually not written by the doctors whose names appeared on the articles, and for the most part those doctors seemed to have played no major roles in the production of these articles other than endorsing a paycheck. Further, the journals were not informed that those doctors whose names appeared did not write these works,

This fact is a scandal in itself, but the idea of ghostwriting articles has been well documented earlier. Particularly in the hype around Prozac and similar SSRI's, scholars have called our attention to the fact that many articles were ghost written and published in prestigious journals to make it seem as if those drugs were incredibly effective in treating depression, OCD, and other difficult to treat disorders. The early days of Prozac were euphoric, with statistics indicating that over 70 per cent of people taking those drugs were helped dramatically. While there were very few randomized, double-blind experiments with such drugs, anecdotal and other types of articles appeared that touted these high rates of cure. Instrumental in this mix were the ghost-written articles with the names of well-known experts in the field published in significant and prestigious journals.

Now that the dust has settled, The New York Times and other journals have pointed out that the early estimates of the efficacy of SSRI's was skewed by over-eager researchers. The actual efficacy rates for Prozac-like drugs is more like 37 percent, a thirty percent drop from the initially enthusiastic rates. It's worth noting that 37 percent is only four points above the placebo effect, which is generally agreed on as being about 33 per cent effective. This fact, of course, doesn't discount the beneficial effects of SSRI's to those individuals for whom they work.

My point is that we need to be extremely careful when we read that "experts have said" or that "experiments have shown" -- particularly when we are looking at difficult-to-treat affective disorders. Even when we note that articles have been peer-reviewed (and all these ghostwritten articles had been peer-reviewed) we are still dealing with human being capable of making flawed judgments. Herd mentality exists not just in bovine groups but even in academic and scholarly ones as well. Some studies have shown (caveat emptor) that almost 50 per cent of peer-reviewed articles eventually turn out of be wrong. Science attempts to reach certainty, but certainty never attempts to reach science.

Follow Lennard Davis on Twitter: www.twitter.com/lendavis

Comments

[tompoe]

" . . . the journals were not informed that those doctors whose names appeared did not write these works,"

Excuse me, but medical journals never publish without thorough, exhaustive due diligence. That's their entire reason for existing.

[Squeezer55]

Another practical illustration was the advocating of cardiac drugs for treating serious cardiac arrythmias as well as cardiac arrest in code blue situations. When I first studied Advanced Cardiac Life Support in the mid '80's , there was a huge number of drugs required for treating each problem arrythmia. Several years ago, some bright bulbs reviewing specific drug efficiencies in cardiac outcomes decided to look at the studies that advocated their use and promotion to the JAMA and the American Heart Foundation.
Many of the drugs adoption into national protocols by JAMA ( Journal of the American Medical Assoc.) were based on studies that were actually paid for by the cardiac drug manufacturers. Many further unbiased studies were undertaken and showed that a lot of the drugs had little effectiveness in determining outcomes and were subsequently dropped from the protocols. Today emergency cardiac care uses a lot fewer drugs and depends more on early intervention and defibrillation than the drugs being huckstered by the pharma guys.

[noneIn2008]

Pharma is good at ghost writing. Just look at the proposed health care bills they have written, introduced by they stooges in Congress.

[itsmyparty]

Ya think?Duh!

[RMankovitz]

This seems to be a new high in peer-review corruption - 26 phony articles . The old title, announced a few months ago, went to Scott Reuben, paid by Merck, Pfizer and Wyeth to falsify the data in 21published studies, including faking the patients, reporting on non-existent trials, and listing co-authors without their knowledge or consent. These faked studies supported Bextra, Celebrex, and Lyrica, as well as the all time favorite (pain)killer Vioxx.

I belong to a small group of scientists and researchers that periodically read peer-reviewed studies, and come to personal conclusions as to whether we think they are fake or not. Of course, they hide the ball so well we cannot be sure, but we are comfortable following our instincts. I would guess that somewhere around 80% of the studies supporting drug efficacy fail our informal veracity test, while close to 100% of the studies showing either lack of efficacy and/or adverse drug effects pass our veracity test. Common sense might predict such an outcome.

I also self-fund university research that often results in publication of the results in peer-reviewed journals. In my opinion, peer-review, which was once a model for vetting research, has now ended up as a prize available to the highest bidder.

None of the above should be much of a surprise, coming from the establishment that has the distinction of being the third leading cause of death in the US.

Roy Mankovitz, Director
http://www.MontecitoWellness.com

[TryToBeFlexible]

The next big scandal, statin drugs will be shown to be extremely dangerous, but have no real benefit.