Research, Statistics and Who Paid Who?

July 28, 2010

I felt I really had to return to a topic that I had hoped was a very dead and buried and that is the controversial question of whether research can any longer be trusted. You may have seen a report in the Independent newspaper which stated that more than 90 percent of researchers who have published studies favourable to the controversial diabetes drug Avandia had a financial stake in the issue.

My first question when I an sent studies — as I frequently am– is to find out two questions: first how many participants and second who has funded the research. This latest revelation comes from a study conducted by researchers from the Mayo Clinic, one of the few research organizations in the United States that does not accept corporate funding.

Sales of GlaxoSmithKline’s bestselling drug Avandia plunged in 2007, after evidence emerged linking the drug to an increased risk of heart attack and death. These reports sparked a debate over the drug’s safety that continues to this day. In an analysis of more than 200 studies, articles, editorials and letters published in scientific journals since 2007, Mayo Clinic researchers have concluded that financial conflict of interest continues to play a major role in that debate.

If someone is expressing a positive view of a product you are entitled to ask if they are gaining any benefit from it — and no, I do not receive any payment or benefits on any of the products I mention in healthy news other than accepting a sample for trial purposes so I can report back from practical experience and not just rely on other people’s evidence.

What has emerged is that 87 percent of all authors who expressed positive views about Avandia had financial ties to GlaxoSmithKline, while another 7 percent had ties to other pharmaceutical companies involved with diabetes. Not surprisingly, among authors with financial conflicts of interest, only 30 percent “expressed unfavorable views” of the drug and authors who were critical of Avandia were “largely free of identifiable conflicts of interest,” the researchers said.

Sadly, this does not mean that they were all squeaky clean either as of the 29 authors who recommended the drug Actos as a safer alternative to Avandia, 25 had ties to that drug’s maker, Eli Lilly.

I think we have to accept that there is a large amount of financial and self interest going on in medical research, and if that is disclosed I can live with it. What I find more disturbing is that this research uncovered that while 47 percent of all authors surveyed had a financial stake in the diabetes drug debate, 23 percent failed to disclose these links. Most of these authors merely remained silent about their conflicts of interest, while three actually lied and said they had none.

Could it be time for some legislation, as we allegedly have with our MPs, to declare a conflict of interest so the least we are warned and can make up our own minds as to their impartiality? I would like to think so, but don’t hold your breath.


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