ASCO Abstracts Came With Strings Attached
2 CommentsBy Ed Silverman // August 23rd, 2007 // 5:18 pm
Conflicts of interest are all the rage these days. And for good reason. Understanding the factors influencing decisions - which finding may be emphasized, which paper gets published, which medication is endorsed - is increasingly of concern. So a handful of researchers, with NIH backing, measured financial ties on display at two meetings of the American Society of Clinical Oncology.
They perused 3,529 abstracts and 25,416 authors in 2004 and 3,556 abstracts and 26,181 authors in 2005. Their findings, which were published in the Journal of Clinical Oncology: In 2004 and 2005, 23 percent of abstracts had one or more authors with a personal financial interest. More than 75 percent of all personal financial interests were valued at less than $10,000.
On one hand, 23 percent may be seen as high or, perhaps, unsurprising. And some may argue that financial interests less than $10,000 isn’t very much. Then again, perceptions can differ. As an accompanying editorial notes, “the absolute amount of monetary involvement should be compared with overall income or wealth. Psychology research shows that a $100,000 reward to a millionaire may have less utilitarian value than $100 to a person with no income.”
Unfortunately, the ASCO conflict of interest policy states that “disclosure of the conflicting or potentially conflicting interest will itself suffice to protect the integrity of the subject activity.” In other words, a potential conflict can be resolved by the mere fact that disclosure took place, but without regard to the value of the financial stake involved. That isn’t good enough.
For more results, please keep reading…
More than 90 percent of financial interests of more than $100,000 were employment related. Fewer than 3.5 percent of authors with personal financial interests had interests valued at more than $100,000. Overall, 6.3 percent (in 2004) and 2.9 percent (in 2005) of abstracts only had research funding, whereas 7.3 percent (in 2004) and 6.9 percent (in 2005) had only commercial employment.
In 2005, 60 percent of plenary sessions compared with 23.1 percent in general poster sessions and 17.3 percent for publish-only abstracts reported financial ties. Personal financial interests were more common among US authors compared with non-US authors - 9.2 percent vs. 4.2 percent.
Cary
A conflict of interest cannot be resolved by simply releasing a waiver. To me, any amount of money an individual has tied up in a decision he or she is making will influence that decision. It is human nature. The FDA is a prime example.
Until the government separates the funding for the FDA from big pharma, and doctors that work for the big pharma don’t sit on the product review board for a drug that was produced by their company, there will always be conflict of interest.
Gregory D. Pawelski
Selling cancer chemotherapy with concessions creates conflicts of interest for oncologists
http://www.healthyskepticism.org/news/2007/Jun.php
A precursor to the modern Chemotherapy Concession going on in the United States had been forbidden in Germany since the 13th century, as a result of a very visionary German ruler, Frederick II of Hohenstaufen, Emperor of the Holy Roman Empire of the Germanic Nation, and his visionary law (Edict of Salerno) regarding the separation of the professions of Physician and Pharmacist.
His 1241 Edict of Salerno (sometimes called Constitution of Salerno) made the first legally fixed separation of the occupations of physician and apothecary. Physicians were forbidden to double as pharmacists and the prices of various medicinal remedies were fixed. This became a model for regulation of the practice of pharmacy throughout Europe.
Medical oncologists should be taken out of the retail pharmacy business and force them to be doctors again.