Re: Odd Ghostwriting Offer Raises Researcher's Blood Pressure
- From: MarilynMann <mannm@xxxxxxxxxxx>
- Date: Wed, 21 Nov 2007 09:16:52 -0800 (PST)
It kind of looks like they chose the wrong person to contact. Dr.
Sealey seems to be a bit of a critic of pharma influence in medicine:
http://hcrenewal.blogspot.com/search?q=sealey
Wednesday, December 27, 2006
Medical Meeting Spikes Session on Conflicts of Interest
There seems to be a run of stories about academic fora rejecting
discussions of conflict of interest (see most recent post here about
how the New England Journal of Medicine seemingly rejected a
commentary on conflicts of interest by one of its own "national
correspondents.") Now the Boston Globe has published an article by
Christopher Rowland about the cancellation of a session on conflicts
of interest at the American Society of Hypertension (ASH) 2007
meeting. We previously discussed a controversy at the Society over
industry involvement in guidelines it sponsored that featured a
broadened definition of "pre-hypertension," one that seemingly would
include many more patients as candidates for drug treatment. According
to the Globe,
The title of the proposed panel discussion cut straight to the point:
"Conflicts of Interest." But attendees at the American Society of
Hypertension's spring meeting in Chicago won't get to hear what
panelists have to say about financial ties between the drug industry
and medical societies and physicians. The society has rejected the
session, saying it was 'one-sided' and did not meet 'standards for
fair balance and scientific rigor.'
Now, the cancellation itself is causing a conflict, prompting three
prominent drug industry critics from Boston who had been invited to
participate to accuse the society of stifling debate.
'The society is hiding under a rock,' said Dr. Jerome Kassirer, a
former editor of the New England Journal of Medicine, who would have
been a panelist.
The panel about conflicts of interest [would have been lead] by Jean
E. Sealey, a researcher and former president-elect of the American
Society of Hypertension. Sealey has said the drug industry wields too
much influence over the society's activities through its financial
contributions to the group and by paying for honoraria, speakers fees,
grants, and research contracts with individual doctors.
But the society's leadership alleged that Sealey had her own conflicts
of interest: While she served on the society's board, her husband, Dr.
John Laragh , edited one of the society's academic journals.
Sealey agreed to give up her chance to be president, but was allowed
to organize a half-day session for next May's annual meeting.
The group said in a statement that it sent Sealey's panel proposal to
its continuing medical education review committee, which determined
Sealey's plan to limit the panel to three prominent drug industry
critics lacked balance. It suggested adding a Food and Drug
Administration official to the roster, but Sealey refused.
In response to questions from the Globe, the society initially said in
an e-mail that fair balance is required under national standards for
continuing medical education programs, and that its internal
continuing medical education committee was compelled to reject the
panel on those grounds. In a subsequent e-mail, after Kassirer said
there is no such requirement in the national rules, the society said
the expectation of fair balance is 'inherent.'
Sealey said the purpose of her proposed panel was to provide a
counterpoint to the many industry sponsorships and payments to
physicians who are scheduled to present medical information at the
meeting. At last year's meeting, she said, 100 of the 165 presenters
disclosed financial ties to pharmaceutical companies.
Obviously, the American Society of Hypertension has the legal right to
determine what presentations will occur at its national meeting.
However, in my humble opinion, the Society's stated reason for
rejecting this single panel presentation on conflict of interest was
bizarre. As noted above, there is no known requirement that each
individual presentation at a medical meeting must in some way be
"balanced."
Furthermore, the ASH meeting seems to be one of the many medical
meetings in which there is a large amount of industry participation.
ASH itself has 12 corporate members, all pharmaceutical companies. At
the annual meeting, high-powered pharmaceutical advertising is quite
evident, and the meeting web-site includes a pamphlet to promote even
more. It suggests that over 70 commercial exhibitors will participate,
indicates a vast variety of advertising and promotional opportunities,
and claims, "the enthusiastic response to our exhibit area from both
participants and visitors affirms our belief that this is one of the
most productive exhibit showcases available."
So it seems that one panel on conflicts of interest featuring critics
of the pharmaceutical industry would likely be completely over-
balanced by the tremendous amount of industry participation elswhere
at the meeting.
This case seems to be yet another in our catalog of examples of the
anechoic effect. Criticisms of the role of commercial vested interests
in medical science are considered impolite in certain venues,
particularly venues that unquestioningly feature a large amount of
industry support. Such impoliteness is unwelcome, as it might trouble
those who are otherwise happy to let the good times roll.
Medical societies, however, ought to think of what they may have sold
to finance their continued rolling.
posted by Roy M. Poses MD at 4:13 PM | 1 comments
Links to this post
Monday, May 22, 2006
New Dispute Over Industry Involvement with a New Definition of
Hypertension: "Monetarization of Medicine?"
Almost a year ago we discussed a dispute that had broken out within
the American Society of Hypertension (ASH) about the role of industry
in and conflicts of interesting affecting the society's work.
The New York Times has followed-up with another story, this one
highlighting the society's role in a new and more expansive definition
of hypertension. This definition included some people with "pre-
hypertension," previously defined as a blood pressure between 120/80
and 139/89, within a newly defined "state 1 hypertension" group. This
expanded definition appeared in an article whose lead author was the
current President of ASH (Giles GD, Berk BC, Black HR, Cohn JN, Kostis
JB, Izzo JL Jr, Weber MA. Expanding the definition and classification
of hypertension. J Clin Hypertens 2005; 7: 505-512.) The Times noted
that "of the seven doctors who wrote the proposed new definition, six
have said they served as consultants and speakers for pharmaceutical
companies that make blood pressure medications. The seventh is a
consultant and stockholder in a company that markets a diagnostic
method to measure damage to blood vessels."
The Times also noted "the work of the group that developed it was
financed by $75,000 in unrestricted drug industry grants from Merck,
Novartis and Sankyo...." Furthermore, a society staffer "confirmed
that the dinners [to discuss the new guidelines] were financed by
$700,000 in grants, also unrestricted, from the same companies."
Internal critics within the society criticized the process. "This is
about the monetarization of medicine," said former society President
Dr Michael H Alderman, who had withdrawn from the group which proposed
the new hypertension definitions. Furthemore, he noted, "all this has
got the ring of seeming to be of great benefit to the pharmaceutical
industry without clear evidence that it's going to be the same benefit
to the public." Dr Curt D Furberg, from Wake Forest University, also
withdrew from the group. He charged that "its work was not evidence-
based, ... [and] 'the industry wants to sell drugs and to as many
people as possible.'" Jane E Sealey, who had been President-Elect of
the society, said, "the truth of the matter is that we have many
members who are leaders in our society who are making well into the
six figures from their pharmaceutical-company-supported activities."
Dr Sealey immediately resigned her presidency at the society's annual
meeting, according to theHeart.org.
ASH President Giles countered that "the organization had always
maintained a firewall between its activities and industry funding. 'We
don't take money that has strings attached to it.'" One of the authors
of the new hypertension definition, Dr Joseph L Izzo of the University
of Buffalo, said "there are those who accuse us of being nothing more
than shills of industry: a lot of us take pretty great offense at
that."
This seems to be another example of how disease definitions get
expanded, often with some degree of participation by pharmaceutical
companies who have interests in increasing the market for their
products. Note also that the sorts of possible conflicts of interest
described may have largely unconscious effects on those affected, as
we have discussed. So the indignation of people who are not conscious
"shills of industry" is real, but perhaps misplaced.
Furthermore, this is another case that suggests physicians and
patients need to be increasingly skeptical about the apparently
authoritative guidelines that now rain down on us.
Finally, the Times also reported that Dr Steven E Nissen, new
president of the American College of Cardiology, "suggested that the
medical profession had become addicted to industry money just as the
nation was addicted to foreign oil." Maybe it's time to kick the
habit.
posted by Roy M. Poses MD at 1:02 PM | 0 comments
* * *
Marilyn
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