Articles, PSQH August 5, 2009

Following Lance’s Lead – No Cheating

by Barry P Chaiken, MD

Post Update: Here is the latest article in the NY Times describing Senator Grassley’s effort to address this issue. Senator Moves to Block Medical Ghostwriting

Haven’t we had enough of cheating? According to the NYTimes (Medical Papers by Ghostwriters Pushed Therapy, 8/5/09), medical journals published articles written by ghostwriters paid for by Wyeth, the pharmaceutical company, to promote the use of Wyeth’s hormone replacement therapy for women. Further independent studies showed that the therapy promoted by these biased ghostwriters was harmful to menopausal women increasing their risk of heart disease, cancer, and dementia. Perhaps industry influence on medical literature is much more widesperead than previously known.

The cycling world has been rocked with numerous scandals where cheating seemed more the norm than the exception. This year’s Tour de France ended clean, with Lance Armstrong leading the way with frequent but negative doping tests. Isn’t it about time we figure out how to stop the cheating in medical literature? Cheating in sports is , well, just cheating in sports. No lives are lost. Cheating in the medical literature harms people. There is no place for it in science and especially in medicine. So, let’s figure out how to put a stop to it.

The use of comparative effectiveness research to identify those procedures and treatments that produce the best outcomes depends upon honest, unbiased scientific study. The effective use of clinical information tehcnology, in turn, depends on the application of trusted clinical knoweldge. So, if we expect to transform healthcare to make it safer, higher quality, and more efficient, we better be sure that the science we apply is as close to the truth as we can make it.

About two years ago I wrote an article about cheating in the medical literature. It seems that nothing has changed in the intervening time.  Here is the link to Anti-doping of Clincial IT and below are excerpts from my article that appeared in the November/December 2006 issue of Patient Safety and Quality Healthcare.

“As doping is fundamentally contrary to the spirit of sport, dishonesty in research is contrary to the spirit of medical research. An “anti-doping” policy modeled loosely upon that created for sport by the World Anti-Doping Agency must be developed for clinical research published in peer review journals. Of course, clinical research and IT issues are far removed from the factors that impact sports, but the key tenets are the same: ethics, excellence, and fairness.

“The decade-long drop in crime in the United States, according to law enforcement officials, is due mostly to deterring crime rather than catching more criminals. To reduce the prevalence of cheating in research, journals require a powerful deterrence factor that motivates authors to police themselves. To be effective, this deterrence factor requires cooperation from the research institutions, as employers and supporters of these investigators. Any anti-doping research policy must allow researchers to maintain relationships with various funding sources and influential partners. At the same time, the policy must strongly motivate the researchers to accurately and fully disclose all conflicts of interest to journal editors, peer reviewers, and readers.”

Excerpts from: Anti-doping of Clinical IT, PSQH, November/December, 2006

Comments 1
  • Excellent commentary. The developed world needs to improve it’s ethics; it’s gotten out of hand. What with orthopedic fraudulent studies (Medtronic), steroids in major league baseball and other sports, super-suits in swimming, the list just goes on and on. Not to mention the investment/finance community. It’s harder and harder to stay honest, but we have to for the sake of the future. Or else we’ll be just like “them,” whoever you choose to see as “them.”

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