One of the aims of drbriffa.com is to expose the how the food and pharmaceutical industries can sometimes act as a barrier to you getting accurate health information and advice. My experience is that industry funding and involvement can seriously bias the ‘conclusions’ drawn from scientific studies. Sound cynical? Well, researchers and scientists have in recent years begun to compare the reliability of industry-funded with independently-funded studies, and the results of these assessments make for some pretty revealing reading.

The most recent of such reviews was published in the British Medical Journal this week [1]. In it, Danish researchers compared the results of industry-funded reviews of drugs with the results of those coming from a body known as the Cochrane Collaboration – a group of scientists taken to be both independent and impartial. The researchers found that the Cochrane reviews were more ‘transparent’ than industry funded research. Cochrane reviews also tended to draw attention to the potential for bias which might pervert study findings. On the other hand, industry-funded reviews were found to always recommend the drug being reviewed, and without reservation.

This is not the only evidence that industry funding can seemingly affect research results. One of the ways this can happen is for the industry to effectively ‘bin’ the results of studies they don’t like the look of. This practice (termed ‘publication bias’), is well known to occur, and is a major cause of bias. One piece of research, for instance, found that studies sponsored by pharmaceutical companies were more than four times more likely to have favourable outcomes than studies with other sponsors [2].

Another potential cause of bias is the sometimes intimate relationship pharmaceutical companies have with medical journals. There is no doubt that many journals rely heavily on the pharmaceutical industry for survival. Not only do the journals get much-needed advertising revenue from this source, but these drug companies can do much to boost journal finances by buying considerable amounts of reprints of favourable studies. This year, the BMJ published an analysis of the ways in which the pharmaceutical industry can affect what ends up getting published in journals [3]. The summary points of this analysis were that:

• Most general and clinical medical journals do not have policies on conflicts of interest for their editors

• Articles published in sponsored journal supplements bring in substantial revenue for the publishers of journals

• Non-profit making doctors’ organisations may receive more revenue from advertising in journals than from members’ fees

• Journals do not seem to be able to survive without advertising

• Articles in medical journals that criticise the drug industry can result in substantial loss of advertising revenue

• Systematic research is needed to determine whether commercial interests influence the decisions of journal editors and owners

And if that were not convincing enough of a an unhealthy relationship between the industry and medical journals, a former editor of the BMJ, Dr Richard Smith, wrote an article last year entitled “Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies” click here.

So, if at times I seem a little sniffy about some piece of science and its veracity, then this is due not only to my general scepticism regarding the influence of industry in our lives, but also the body of evidence which shows considerable potential for conflict of interest and bias in the area of medical research and publishing.

References:

1. Jorgensen AW, et al. Cochrane reviews compared with industry supported meta-analyses and other meta-analyses of the same drugs: systematic review. BMJ 2006;333:782-5

2. Lexchin J, et al. Pharmaceutical industry sponsorship and research outcome and quality: systematic review. BMJ 2003 326(7400):1167-1170.

3. Lexchin J, et al. Commercial influence and the content of medical journals BMJ 2006; 332:1444-1447

4. Smith R. Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies. PLOS Medicine May 2005 [click here]

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