THE BLOG
08/23/2006 01:29 pm ET | Updated May 25, 2011

Pulling Punches at JAMA

The Journal of the American Medical Association has been
making news lately, and not always for its publication of
pathbreaking medical studies. After learning from readers about
several incidents of failures by authors to disclose conflicts of
interest with companies with a stake in the outcome of their
research, editor-in-chief Catherine DeAngelis tightened the journals
disclosure rules and asked deans at the offending researchers'
institutions - including the famed Mayo Clinic College of Medicine -
to beef up their ethics training.

Conflict-of-interest disclosure isn't the only area where the editors
at JAMA have felt compelled to tighten their oversight of
researchers who work for for-profit firms. The editors also now
require industry-funded studies to hire an independent outside data
analyst to give its peer reviewers an extra layer of comfort with the
presentation of information contained in articles submitted for
publication.

In today's issue of JAMA, Dr. DeAngelis offered a sober
editorial summing up and defending her responses to the past year's
events. The "The Influence of Money on Medical Science," contains
some fascinating new revelations. Without naming names, she reported
that some companies are insisting that their academic researchers
avoid submitting studies to JAMA because of the rules
requiring independent data analysis. One set of authors even withdrew
their study and submitted it to another (unnamed) journal, which
promptly published it and won "much media coverage" for its contents.

I'd like to know what study that was and where it appeared. Did those
media reports reveal that it had been withdrawn from JAMA
because its authors did not want to submit its data to independent
analysis? Alas, she did not say.

DeAngelis also revealed that the dean of the Harvard Medical School,
Joseph B. Martin, has informed her that he will send the 8,000
faculty members at that prestigious institution copies of JAMA's new disclosure rules, as well as those from the New England
Journal of Medicine
. The three incidents of failures to disclose
conflicts of interest to JAMA that made national headlines
this year all involved HMS faculty.

But the editorial stopped short of breaking new ground. She once
again rejected advice I offered two years ago, when a study I conducted
for the Center for Science in the Public Interest pointed out that
JAMA, like the three other journals studied, had a small but
persistent pattern of authors failing to disclose their financial
ties to firms with a stake in the outcome of the studies being
published. That study recommended that journal editors ban authors
from publishing for at least three years when such incidents are
brought to their attention, as they often are, by readers. Here's her
latest response:

Leveling sanctions against an author who fails to
disclose financial interests by banning publication of his or her
articles for some time period would only encourage that author to
send his or her articles to another journal; it cleans our house by
messing others. So what about all editors, or at least a group, such
as the International Committee of Medical Journal Editors, agreeing
to share the information and jointly to ban the offending authors?
Those who suggest this approach have not considered the risk of an
antitrust suit.

This antitrust argument repeats comments she made to a Times reporter a few weeks ago. It's a red herring. I wrote a
letter to the Times, which they chose not to publish. Here's
the argument.

If full disclosure of potential conflicts of interest is crucial to
"ensuring that physicians and patients can properly interpret and
more important trust, what they read" in journals, then isn't failure
to disclose conflicts of interest a form of scientific fraud? And
don't editors have a right to collectively protect themselves against
fraud?

She says that getting academic deans to "intervene" with mandatory
ethics training is a more effective method of sensitizing industry-
paid researchers to their ethical responsibilities than sanctions
that might violate some lawyer's notion of antitrust law. If
newspaper editors had the same attitude, then Jayson Blair would
still be working - after his mandatory ethics training, of course.