More corruption at UN?

Turns out what most interested observers have been arguing for a long time has been proven correct. The WHO's panic mongering in relation to the swine flu pandemic was just that, panic mongering. The primary beneficiaries were pharmaceutical companies whose products were stockpiled by many countries that responded to WHO recommendations. Finally, in-depth reports accuse WHO of exaggerating the real danger. The reports also note that on the WHO committee writing the report served several scientists who arguably had a conflict of interest (related to their relationships with pharmaceutical companies). The Washington Post wonders whether or not the WHO advert for flu medicines (aka its flu guidance) informed its member countries of these commercial conflicts of interest.

Open Letter to Canadian Health MInister

Dear Ms Leona Aglukkaq:

I am currently on a research assignment in Britain, hence I missed the uproar in Canada about the appointment of a Pfizer VP to the governing council of the CIHR. This open letter is in response to this growing scandal.

I am appalled that anyone should have considered appointing a representative of the pharmaceutical industry to such a position of influence, let alone a representative of Pfizer.

As to the former: Continuing conflicts of interest between the role the Pfizer VP would have to play in order to avoid breaching the fiduciary relationship the company and its employees have to its shareholders, and the public interest are inevitable. His role is to represent the interests of Pfizer and its shareholders, while the CIHR agenda surely is in the Canadian public's interest. There is no reason at all to assume that Pfizer's interests and those of the Canadian public necessarily are identical.

As to the second: Pfizer as a pharmaceutical company is probably the most egregious of the companies involved in terms of continuing breaches of ethics regulations. The company routinely and repeatedly pays out large sums to extricate itself from breaches of ethical guidelines, and frequently the law. I am flabbergasted that, of all companies available, a Pfizer representative should have ever been considered. Are you or your advisers unaware of any of this?

I urge you to intervene before it is too late. The CIHR is at great risk of losing credibility as a biomedical research funder by appointments such as these.

Sincerely,
udo schuklenk

JAMA shenanigans continue

You might recall that I posted various blogposts (the last one being this) about the ongoing shenanigans between JAMA and Jonathan Leo.

Here's how the story continues. I copy below a message I just posted to fellow medical editors of the World Association of Medical Editors via our listserv. It's pretty self-explanatory. This truly boggles the mind!

I will keep you posted in case I get a reply.


Colleagues,

you will recall probably the ongoing forth and back between the JAMA editors and Jonathan Leo.

I want to draw to your attention these two documents:
www.udo-schuklenk.org/files/jamamarch.pdf
www.udo-schuklenk.org/files/jamajuly.pdf

The first document is an on-line publication (incl doi number and all) from March by the JAMA editors. It has been very widely criticized in various fora and condemned pretty much uniformly by everyone with some knowledge of publishing ethics, no least bioethics outlets. What is significant is

a) JAMA has excised its first publication from its website as well as biomedical data-bases (I have no idea how the latter feast was achieved). No retraction notice was published, no erratum of any kind. As one of my colleagues pointed out: what does this mean for the substantial commentary (overhelmingly critical in nature) that was published in various fora on this now non-existent article?

b) My own publisher (Wiley-Blackwell) told me that anything published with a doi number online must not be changed in any print version or on-line without proper errata, withdrawal notes etc.; basically an on-line paper with a doi number ought to be treated just like one would treat a print article. So, one question I have is whether this is simply part of the lex JAMA (continuously revised by the paper's current editors, including seemingly the journal's publication history itself), or whether my publisher has given me false information with regard to the status of on-line publication with doi numbers.

Medical journal primadonnas - the end (not)

I have reported a short while ago (you might want to re-read this before continuing this blog posting) how editorial staff at the Journal of the American Medical Association (JAMA) seemingly bullied Dr Leo after he disclosed in the British Medical Journal (BMJ) an undisclosed conflict of interest of authors of a study JAMA published.

Here now, without further ado, the end of the saga. It's been reported on the websites of the WSJ, JAMAs as well as Dr Leo's. My analysis will make use of content (analysis) provided by subscribers to a bioethics discussion list hosted by the Medical College of Wisconsin.

JAMA's editors have not exactly helped their case. They effectively admit contacting Leo's Dean to complain about his conduct (ie publishing his conflict of interest allegations - 5 months after bringing them to the attention of JAMA's editorial staff) on the BMJ website. They deny having bullied the Dean as well as Leo. However, the Dean confirmed that the gist of the JAMA editors' complaint about Leo contained a threat to the school. Here's an excerpt from said bioethics discussion list: '"In an interview Friday, Dean Ray Stowers said Dr. DeAngelis “flat out” threatened him and attempted to bully him during the conversation. The telephone call was followed by an email exchange. In a March 11 email, Dr. DeAngelis wrote to Dr. Stowers: “As I’ve already expressed to you, I don’t want to make trouble for your school, but I cannot allow Jonathan Leo to continue to seek media coverage without my responding. I trust you have already or soon will speak with him and alert me to what I should expect.” Dr. Stowers responded the next day by saying he couldn’t find any fault in Dr. Leo’s actions and pressed JAMA editors for more specifics on what they believed was wrong with Dr. Leo’s writing or actions. “I think this can be worked out without your continued threats to our institution which are not appreciated and I believe to be below the dignity of both you and JAMA,” he wrote. Dr. Stowers says he has not heard from JAMA since sending that email.'

The JAMA editorial suggests, mistakenly, that Leo was under confidentiality related obligations not to publish his letter to the BMJ until after JAMA had completed its investigation. It's entirely unclear why this should be the case. Leo is perfectly entitled to publish anywhere (as he did) allegations of conflict of interest. After all, everything he reported is a matter of public record (accordingly there were plenty of others who would have been witness to the conflict of interest). What is particularly amusing, perhaps, is that the journal objecting to Leo blowing the whistle on the conflict of interest it omitted to report, had not hesitation to blow the whistle on him (by calling his superior, the Dean of the school). Obviously, one standard for authors, another for editors...

JAMA claims in its editorial that Leo's disclosure of his allegations would hamper its ability to undertake its own investigation. As it happens, however, according to JAMA's own reported timeline, it actually completed its investigation some time before Leo's letter in the BMJ was published. The journal claims, however, that it was unable to publish the subsequent 6 line conflict of interest declaration (even on-line) that it received some time in January until some time in March due to space considerations. Of course, there are no on-line space considerations, as everyone knows. In addition to this, the editors were capable of rushing their above mentioned editorial on-line within about a week. Not overly credible the editorial explanation of space constraints here...

JAMA's new policy on this issue is truly pointless. It aims to enforce censorship on people reporting potential omissions of conflicts of interest declarations to the journal and expects them to keep quiet until it has investigated the matter. Anyone who goes instead directly to the news media would accordingly be in the clear as far as the new JAMA policy is concerned. The solution then would be, instead of waiting for JAMA's breathtakingly long 'investigation' of a simple matter (did you omit to declare a potential conflict of interest?), to issue a press release straightaway, or to write a letter to a different medical journal (as Leo did).

Significantly, the BMJ that published Leo's complaint has refused to withdraw his letter, because, according to the BMJ editor, the complaint was factually accurate.

It is deeply disconcerting that a leading biomedical journal such as JAMA tried to bully an academic as well as a medical school dean for doing nothing other than report the omission of a conflict of interest declaration. A clear abuse of the powers that journal editors are invested with by virtue of the job they hold. This is what really is at issue here!