Ghostbusters' work is never done

The most credible scientific information often doesn’t get published — not only is it shut out from mainstream media, as this author learned after years of effort (hence this blog, because people deserve to know the science), but it’s also blocked from professional journals — if it might go against the interests of the sponsors, an advertiser or powerful entity in the profession.

This was brought home in a powerful expose that’s been investigated and followed by Dr Aubrey Blumsohn at Scientific Misconduct. He shared a report just published in the International Journal of Occupational and Environmental Health describing how Elsevier Science refused to review or publish a study of occupational health of IBM workers that had been commissioned by the company. Whether the study described in this manuscript is great science or not isn’t the issue. What is, is that the paper was rejected for reasons other than science. The journal article describes efforts to suppress the unfavorable information from getting to the public, denigrate the study, debase the commitment of the researchers, and intimidate the publisher. During two years of legal delays, the company and its consulting researchers conducted and published favorable studies, and presented them to the public to challenge the credibility in the eyes of consumers of the study they were attempting to block. These efforts went on for years.

As Dr. Blumsohn wrote:

The publication is timely. We know that several scientific journals have recently rejected manuscripts following legal threats. We also know that several manuscripts have been rejected on the grounds that “we feel we don't have the resources for the legal work required to check it all". Rejected manuscripts commonly contain information perceived to be against the interests of a corporate sponsor, an advertiser, or powerful colleagues within the scientific discipline....Although journals sometimes claim legitimate fear of litigation, such fear cannot extend to mere publication of the fact of intimidation...The failure of journals and editors to publicize and condemn such threats would seem to me to suggest complicity.

As the journal authors reported, private commercial funding of university research has expanded dramatically over the past decades. “Such funding has grown to more than $2 billion annually, making U.S. universities more dependent on private commercial funding than ever before.” The extent of corporate-funded science is troubling, they said, because industry funding is accompanied by a “substantial tradition of manipulation of evidence, data, and analysis, ultimately designed to maintain favorable conditions for industry, at both the material and ideological levels.”

And the industry pays for a substantial portion of occupational health research, the authors wrote. “OEH journals often reflect the dominance of industry influence on research in the papers they publish, sometimes withdrawing or modifying papers in line with industry and advertising agendas. Although such practices are widely recognized, no fundamental change is supported by government and industry or by professional organizations.”

The problem is mind-bogglingly larger in the field of pharmaceutical research and obesity, as JFS has been attempting to illustrate. The relationship that’s grown between universities and the pharmaceutical industry has become complex and increasingly compromises the integrity of the science. There are so many trillions of dollars at stake, academic researchers and publications can ill afford to resist. Research centers are dependent on drug companies for increasingly larger amounts of their research budgets and a mindset takes hold in academic centers that is blind to the conflicts. It’s estimated about 80% of clinical research is now funded by industry.

For those readers unfamiliar with Dr. Blumsohn and why he is an expert on this, you’ll want to read this article by Jennifer Washburn entitled “Rent-a-Researcher.” It describes what Dr. Blumsohn encountered as senior medical professor at Sheffield University in Britain who blew the whistle on major scientific misconduct between the university and Proctor & Gamble Pharmaceuticals. In turn, they attempted to bribe him with a $252,000 payoff to leave and not make “any detrimental or derogatory statements” about the university or its employees. He had been informed that the company’s medical ghostwriter would write up the manipulated research data to be submitted for publication. When he complained to university officials about the misconduct, he was high enough up the food chain and had been carefully documenting everything, so they tried to buy him off. As this author quickly learned, lowly medical writers who dare to blow the whistle about misconduct at university research centers simply find themselves out of a job.

Yet, plenty of writers do sell out and industry-paid ghostwriting is all too common in the medical literature and in mainstream media. A recent article in Skeptical Investigations reported on the tricks of the trade of ghostwriters. “People with scientific backgrounds — often, with PhDs — are paid to stay in the shadows and crank out favorable reports for drug companies,” it revealed. These are the papers that get published in journals and turned into press releases that are repeated verbatim in mainstream media. Norman Bauman wrote of the role of medical writers in the illegal marketing of pharmaceutical interests. “Typically, a pharmaceutical company will hire a PR firm to find a writer who will go to a medical meeting, hear a doctor report on a new indication for a drug, write a story about the meeting, and place the story in the trade press to promote an unapproved indication that the pharmaceutical company couldn't promote directly. That's why they pay [these] writers so much money.”

The internet is similarly rife with paid ghostwriters, as has been reviewed previously. The industry especially recruits hungry university PhD students who know just enough science to sound credible and pays them to go onto internet sites, or create blogs. They’ll spend months establishing themselves as trusted entities to give unsuspecting visitors false medical information, create doubt and impugn those who threaten their sponsor’s interests. You’ll find a number of companies even openly advertising for paid trolls for all sorts of interests. It has never been more critical for both professionals and consumers to understand the proliferation of paid trolls and to be skeptical of anything said on the web by an entity that isn’t writing under their real name, with verifiable credentials and funding.

That’s why the voluntary program established by medical professionals, Heathcare Bloggers Code of Ethics seal, can help protect you. To receive this accreditation, medical bloggers’ credentials are verified by a medical review board, they are confirmed not to be selling anything, all funding sources are openly revealed; and their blog content is peer reviewed by doctors for many months before they're allowed to display the seal, and they are followed thereafter to retain the accreditation. JFS is one of the medical blogs that has been awarded this accreditation.

Not all medical writers, editors and researchers are doing questionable stuff as in this recent report. Dr. Jerome Kassirer, a former editor of the New England Journal of Medicine and a professor at Tufts University School of Medicine in Boston, said that “medical editors and legitimate science writers have actually been at the forefront of the attempt to expose and limit industry ghostwriting.” In a recent article examining ghostwriting and ghostbusting for the American Association for Justice, he wrote:

In the dozen or so years in which concern about the practice has escalated, medical journal editors have issued tougher requirements for authors.... It is disheartening that examples of ghostwriting continue to emerge and that editors must remain constantly alert to it, implementing ever more restrictive policies that affect all authors. The ties between industry and the authors of medical studies, review articles, and editorials are strong, pervasive, and dangerous. Physicians must work harder to prevent bias from creeping into the medical literature. Academic medical centers must help them negotiate contracts with industry that keep test data pristine and prevent manipulation of results.

Don’t miss this latest saga as synopsized by Dr. Blumsohn or the detailed journal report. It is a troubling and enlightening look into why we often don’t hear the science that threatens financial or political interests. The authors concluded their report saying that this situation points to the need for non-industry funded studies and “a wider commitment of all journals, editors and publishers to ensure that important research that may affect public health or social justice reach both the scientific community and the public as rapidly as possible.”

I would add healthcare professionals.

© 2007 Sandy Szwarc