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kwikdriver
Tue, Jul-18-06, 18:50
Just days after announcing a crackdown on researchers who do not disclose drug company ties, the editor of a prestigious medical journal says she was misled again — this time by the authors of a study linking severe migraines to heart attacks in women.

All six study authors have done consulting work or received research funding from makers of treatments for migraines or heart-related problems. Their research appears in Wednesday's Journal of the American Medical Association, a week after the crackdown was announced.

The authors said they did not report their financial ties because they did not believe they were relevant to the study.

Dr. Catherine DeAngelis, JAMA's editor in chief, said journal editors did not know about the ties until The Associated Press brought them to her attention late last week.

"We'll get killed," she said, referring to the potential damage to the journal's reputation.

'Issue of perception'
She said she would have published the authors' associations with drug makers had she known about them. "Let me decide what's pertinent or not," DeAngelis said. "The issue is not what can those companies possibly gain; it is the issue of perception."

Last week, JAMA disclosed that the authors of a depression study failed to report ties to makers of antidepressants. And two months ago, the journal reported similar omissions from authors of a study linking certain arthritis drugs to cancer.

JAMA has long required researchers whose articles it will publish to sign statements disclosing all potential financial conflicts. An editorial last week said JAMA was getting tougher as a result of the recent breaches. JAMA's new policy, effective in January, requires disclosures even before articles are accepted for publication.

Other leading medical journals, including the New England Journal of Medicine, JAMA's main competitor, have disclosure requirements, but DeAngelis said hers are the toughest. Editors say disclosures are necessary to help readers judge the reliability of research.

DeAngelis said a letter from the authors explaining the omissions would be published online and in an upcoming issue of the journal, along with her response.

"Authors should always err on the side of full disclosure," she wrote in her response.

Authors said ties were irrelevant
Dr. Tobias Kurth, the study's lead author, said the researchers were not trying to mislead the journal. He said they believed their financial ties were irrelevant because the study does not promote drug treatment, but rather reports a potential link between women with severe migraines and an increased risk of heart attacks.

"They do not represent a conflict of interest," Kurth, a scientist at Harvard's Brigham and Women's Hospital, said in a telephone interview. Kurth said he has received research funding from the makers of Bayer aspirin, Tylenol and Advil, pain relievers sometimes used to treat migraines.

Co-author Nancy Cook said in an e-mail that she received "minor compensation" for a one-time consulting stint for Bayer, but that she did not think it was relevant to her work on the migraine study.

"I do believe that conflicts sometimes exist and should be disclosed, but I hope this issue does not get overblown by the media," Cook said. "I think that could harm the reputations of honest and well-meaning researchers and lead to public mistrust where none is warranted."

Dr. Frederick Freitag, a Chicago migraine specialist not involved in the study, said the ties should have been reported, even if they had no effect on the research.

"You still owe it as a matter of appropriate disclosure to lay your cards on the table" or risk having somebody ask, "What are you hiding?" he said.

Freitag said he has ties with numerous drug companies because they are the ones that fund important research.

Sloppy work by JAMA?
Dr. Jerome Kassirer, a former New England Journal editor and outspoken critic of drug company influence over doctors, said JAMA editors appear not to have done their homework. "It sounds like they're being sloppy," Kassirer said.

DeAngelis said that the criticism is unfair, and that JAMA lacks the manpower to check every researcher's background. "I'm not God and I'm not the FBI," she said.

She said the publicity probably will make others who haven't disclosed potential conflicts reconsider.

"I suspect we are going to have a whole bunch of disclosures over the next few weeks because authors are going to see how dead serious we are," DeAngelis said.


http://www.msnbc.msn.com/id/13923444/

LC_Dave
Tue, Jul-18-06, 19:49
I think the shock and suprise is not that corporate entities (whose motives are profit) exercise power, persuation, and vested interests in all facits of our society (including the mega billion dollar worldwide health industry),

the real shock and suprise is that there are people who believe the scientific studies are pure and altruistic.

kwikdriver
Tue, Jul-18-06, 19:56
I think the shock and suprise is not that corporate entities (whose motives are profit) exercise power, persuation, and vested interests in all facits of our society (including the mega billion dollar worldwide health industry),

the real shock and suprise is that there are people who believe the scientific studies are pure and altruistic.

The real shock is that there are so many people who don't care that corporations exercise such power, and expect individuals (the average American reads at a 7th grade level, and I doubt it's any better for any other industrialized nation) to somehow see through all that corporate manipulation and persuasion. I'd also like to say it's shocking to see someone shrug off the article posted above along the lines of, "What do you expect? They're corporations," as if the pursuit of profit exempts corporations from social responsibility, but it isn't shocking at all. That's how corporations get and expand their power: relying on a complacent populace.

mike_d
Tue, Jul-18-06, 20:02
I know TV ads for script drugs have more than doubled this summer-- they are way outpacing cars and pizza right now.

Dodger
Tue, Jul-18-06, 20:59
It's amazing how professionals can be brainwashed to think that receiving lots of money from a drug company cannot influence their analysis of a study.

ceberezin
Tue, Jul-18-06, 21:53
The researchers corporate ties are only the tip of the iceberg. The real scandal is that these researchers accept the idea that the primary point of research is to produce drugs for profit, that they see disease as a marketing opportunity. In their minds, since somebody is going to make a bundle developing a drug from research, it might as well be themselves. So the entire research community is corrupted by the the quest for the designer molecule. Disclosing particular corporate ties is merely a band-aid on a running sore.

LC FP
Tue, Jul-18-06, 22:17
My 2c. I read the study yesterday and actually it highligted a link between women (this was another part of the massive Women's Health Study) who have migraine with aura (1/3 of migraineurs) and a doubled risk of cardiovascular disease. I thought it was very interesting, and it probably is just one more study that shows one inflammatory disease is linked to another.

BTW if you have migraine without aura (2/3 of migraineurs), your risk is not increased.

I don't want to sound like I'm sticking up for the indignant-sounding authors of this study (especially on this board!) but I can't see how this particular study is tainted by the industry. It wasn't looking at any drugs, and didn't look at any migraine treatment changing the odds for CV disease. And that line of thought wasn't mentioned by the authors.

Of course the overly-indignant Dr. DeAngelis's crack editorial staff of Dr. Richard Lipton and Dr. Marcelo Bigal in their obligatory editorial comment are quick to claim that:

"For patients with migraine with aura, clinicians should have heightened vigilance for modifiable cardiovascular risk factors, such as hypertension, hyperlipidemia, and smoking. Ultimately it will be important to detrmine whether migraine with aura is itself a modifiable risk factor for CVD. Future studies should investigate the possibility that preventive medications for migraine or antiplatelet therapy might reduce the risk of CVD in patients with migraine with aura."

Maybe Dr. DeAngelis should check these guy's industry ties?

LC FP
Tue, Jul-18-06, 22:22
Disclosing particular corporate ties is merely a band-aid on a running sore.

ce, you're right. It's rare to see a study published nowadays in a major journal where the authors don't disclose industry ties.

But, hey, it's the American way! The profit motive has given us the advanced civilization we all enjoy!

Nancy LC
Wed, Jul-19-06, 10:14
I think the issue is that the readers should at least be aware of those ties. It shouldn't be up to the article submitter to decide whether or not to disclose them. Disclose them and let the readers decide for themselves.

I used to get migraines with auras but haven't for years and years. They started when I was in grade school.

I know a lot of the gluten sensitive people I talk to cured theirs by a gluten free diet. It is amazing how many neurological issues gluten sensitivity can cause.

The real shock is that there are so many people who don't care that corporations exercise such power, and expect individuals (the average American reads at a 7th grade level, and I doubt it's any better for any other industrialized nation) to somehow see through all that corporate manipulation and persuasion.
Yeah, but how many of them are reading JAMA?

kwikdriver
Wed, Jul-19-06, 11:01
Yeah, but how many of them are reading JAMA?

Journalists read JAMA. Some people read journalists. Many people watch journalists on TV. And so whether people actually read JAMA or not, they are getting the information that JAMA puts out -- information that is, as we are seeing, subject to certain influence$.

Nancy LC
Wed, Jul-19-06, 11:13
Unfortunately I think some of those journalists have 7th grade reading skills too. No wait... 7th grade thinking skills. Yeah, that's the ticket!

catfishghj
Wed, Jul-19-06, 11:27
What is an aura?

ceberezin
Wed, Jul-19-06, 11:32
Some migraine sufferers get an ophthalmic precursor to a migraine. Sometimes it's dots of light that move across the field of vision, called scintillatinig scitomata. I get the aura without the headaches.

goatfarmer
Wed, Jul-19-06, 12:25
I get the aura without the headaches.

Me too. Some years more than others. I went to the dr and the eye dr to see if something was wrong, but never did find anything.

Nancy LC
Wed, Jul-19-06, 12:46
I used to get aura + headache, occassionally aura without the headache. I also had numbness in my tongue (usually just half), cheek, maybe a few fingers. The last migraine I had I didn't have an aura at all. I haven't had one since I quit eating wheat but they had gotten as scarce as only one once every few years.

It is extremely genetic in my family. All the females get them, grandmother, mother and sister and me. For me they're hormonal and/or related to extreme stress. I have a sister that gets them triggered by heat.

HairOnFire
Wed, Jul-19-06, 15:12
The real shock is that there are so many people who don't care that corporations exercise such power, and expect individuals (the average American reads at a 7th grade level, and I doubt it's any better for any other industrialized nation) to somehow see through all that corporate manipulation and persuasion. I'd also like to say it's shocking to see someone shrug off the article posted above along the lines of, "What do you expect? They're corporations," as if the pursuit of profit exempts corporations from social responsibility, but it isn't shocking at all. That's how corporations get and expand their power: relying on a complacent populace

Preach it, kwikdriver. I agree completely. We've been like frogs dropped in cold water with the heat slowly turned up to boil. It'll be too late when people start paying attention, if they ever do. Corporate power combined with a government that aids and abets corporate control with their policies, judicial decisions, and tax breaks will surely strangle our democracy. Can you say "fascism?"