Conflicts of Interest

The editor of a prominent medical journal duped!

Conflicts of interest are unfortunately the rule not the exception in medical research. Consider the following discussion of medical progress from Medscape.

“Dr. Beer: A couple of presentations pertained to this issue, adding to the growing body of evidence from TAX 327 suggesting that modern chemotherapy can be effective for some patients. One analysis, for example, indicated that pain response is an independent predictor of survival, which is not surprising, but is interesting nonetheless.

“Another analysis from TAX 327 evaluated the effect of treatment on quality of life in patients with minimal symptoms. Those researchers found that quality of life improved to a greater extent following treatment with docetaxel plus prednisone compared with mitoxantrone plus prednisone for all patients, as well as for patients with minimal symptoms. We previously learned that survival was better and that prostate-specific antigen (PSA) response rates were greater with docetaxel, but in some patient subsets, toxicity was higher with docetaxel-based chemotherapy. And so it is reassuring to see that docetaxel-based chemotherapy was associated with a higher quality of life than mitoxantrone/prednisone and that the toxicity burden was not so excessive that the benefits were outweighed by side effects.

On the other hand — looking at the numbers critically — more patients experienced a deterioration in quality of life than an improvement, and I think that is a reminder that a lot more work needs to be done.” (italics medicynic’s)

Contrast the time and detail given to extolling the virtues of the treatment (docetaxel) versus the bare minimum of detail disclosing that most patients don’t respond and experience deterioration while on treatment. The fact that the survival benefit is barely two months is not all disclosed. It’s not surprising that the discussant is a paid consultant for the drug company manufacturing docetaxel.

At the bottom of the article in a location that is easy to overlook it states: “Disclosure: Tomasz M. Beer, MD, FACP, has disclosed that he owns stock, stock options, or bonds and is an inventor with rights to intellectual property created for Novacea. Dr. Beer has disclosed that he has received grants for clinical research from sanofi-aventis and Novartis. Dr. Beer has also disclosed that he has received grants for educational activities from sanofi-aventis.”

Can a paid consultant offer unbiased, unspinned information? Is disclosure enough? Medicynic doubts it.

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