Medical Journals on The Take

[Guest guest]

These are the type of shenanagans that we want our vitamins and

supplements to go through?? NONE of this is really for

our 'benefit'... Just their pockets...

 

Other comments?

Misty L. Trepke

http://www..com

 

Medical Journals on the `Take'

 

New England Journal Changes Rules and Says Its OK to Payoff Its

Reviewers

 

http://www.mercola.com/2002/jun/26/nejm.htm

 

Editors at The New England Journal of Medicine, one of the most

prestigious medical journals in America, announced on June 12 a

change in journal policy that would allow experts to comment on the

effectiveness of a drug or device, even when that expert has a

financial tie to the maker of the product under review.

 

The move could leave the journal open to criticism that drug

companies and other private entities could wield more influence in

the publication process.

 

The new rules do not apply to " original articles " -- articles

presenting new data on the causes or treatments of various

conditions.

 

In those cases, the journal discloses the study's funding and the

financial interests of the researchers, and that won't change.

 

But they are changing rules applying to " review articles, " where

noted

experts in a particular field provide commentary on new study

findings, and editorials, in which experts are asked to comment on

new findings.

 

The policy has now been changed to read that the authors of these

types of articles will not have any " significant " monetary ties to

private companies that might stand to gain from a review article in

the Journal.

 

And the editors base their definition of " significant financial

interest " on guidelines issued by the US National Institutes of

Health and the Association of American Medical Colleges, which set

the amount at $10,000 or more in any given year.

 

The New England Journal of Medicine 2002;346:1901-1902

 

- - - - - - -

 

DR. MERCOLA'S COMMENT:

 

Just terrific. The entire June 5, 2002 issue of JAMA was on the major

conflict of interest with the peer review system and the next week we

find that NEJM decides to loosen its grip on the conflict of interest

in the journal.

 

Of course, this is all for our benefit.

 

Seems that they just couldn't find any expert who was not being paid

off by the drug companies.

 

So rather than addressing the real problem, the drug companies

influence on physician behavior, NEJM just capitulates and says we

will now change the rules, it is just fine for someone to be paid off

by the drug companies as long as they don't give them more than

$10,000.

 

Makes perfect sense (at least from the drug company's perspective).

To me this should be a headline story in the major periodicals, but

it

never made it to major media.

 

This would not have happened under the former editor of the journal,

Marcia Angell, MD. You can find links to her brilliant editorials

from two years ago below.

 

= = = = = = = = = = = = =

 

Peer Review System for Journals Can Get You Into Trouble

By Lawrence K. Altman, M.D.

 

http://www.mercola.com/2002/jun/26/peer_review.htm

 

Medical journals are the prime source of information about scientific

advances that can change how doctors treat patients in offices and in

hospitals. And to ensure the quality of what journals publish, their

editors, beginning 200 years ago, have increasingly called on

scientific peers to review new findings from research in test tubes

and on animals and humans.

 

The system, known as peer review, is now considered a linchpin of

science.

 

Editors of the journals and many scientists consider the system's

expense and time consumption worthwhile in the belief that it weeds

out shoddy work and methodological errors and blunts possible biases

by scientific investigators. Another main aim is to prevent authors

from making claims that cannot be supported by the evidence they

report.

 

Yet for all its acclaim, the system has long been controversial.

 

Despite its system of checks and balances, a number of errors,

plagiarism and even outright fraud have slipped through it. At the

same time, the system has created a kind of Good Housekeeping Seal of

Approval that gets stamped on research published in journals.

Although most research is solid, and in some cases groundbreaking,

problems have persisted.

 

A particular concern is that because editors and reviewers examine

only what authors summarize, not raw data, the system can provide

false reassurances that what is published is scientifically sound.

 

After a series of problems, about 20 years ago, journal editors came

under pressure to better document claims for the system's merits. To

do that, a number of editors began their own primary research into

the way the peer review system worked, what was wrong and how it

could be fixed.

 

A leader has been The Journal of the American Medical Association,

which has held four meetings on research on peer review since 1989

under the direction of Dr. Drummond Rennie, a deputy editor..

 

Researchers reported considerable evidence that many statistical and

methodological errors were common in published papers and that

authors

often failed to discuss the limitations of their findings.

 

Even the press releases that journals issue to steer journalists to

report peer reviewed papers often exaggerate the perceived importance

of findings and fail to highlight important caveats and conflicts of

interest.

 

Under the system, authors submit manuscripts to journals whose

editors

send the most promising ones to other experts (peers) in academic

medicine to solicit their unpaid advice.

 

The peers check for obvious errors, internal inconsistencies, logic,

statistical legitimacy, reasonableness of conclusions and many other

factors, and make suggestions that editors use in deciding whether to

ask for revisions, publish the paper or return it marked " rejected. "

 

There is general agreement that an overwhelming majority of " weak "

papers will survive initial rejections to find acceptance somewhere

among the thousands of medical and scientific journals that each year

publish an estimated two million new research articles, mostly paid

for by the public through government grants. Despite improvements in

peer review, " there still is a massive amount of rubbish " in the

journals, Dr. Rennie said.

 

In recent years, editors have used the importance of peer review to

justify imposing punitive restrictions on authors who disclose

information to the press before the paper's publication in their

journals. By linking peer review and publication date, critics say,

editors have increased the news value of their journals, a step that

has slowed the free flow of information and helped some journals

raise subscriptions, advertisement rates and profits.

 

While many editors and others have defended the system, they

acknowledge that it is unlikely to detect fraud and is prone to

abuse.

One reason is that the secrecy involved in the system can be unfair

to

authors. While the names of authors are generally known to reviewers,

the reviewers' names are not disclosed to the authors. Because the

anonymous peers chosen to review manuscripts are often the authors'

scientific competitors, jealousies and competitive advantage can

become factors in the reviews.

 

Occasionally, reviewers have been caught publishing information they

lifted from other researchers' manuscripts. Further, little is known

about the quality of the reviewers or what training they need to do a

good job.

 

" The available evidence, " wrote Fiona Godlee of BioMed Central in

London, " gives no indication that anonymous peer review achieves

better scientific results than open review. "

 

Apparently, few journals have adopted the open system. Ms. Godlee

said she looked forward to the day when signed reviews were posted on

the Internet along with published articles.

 

The peer review system also tends to set a very high barrier for

authors to publish truly novel findings.

 

In 1796, a peer reviewed journal in England rejected Dr. Edward

Jenner's report of his development of the world's first vaccine,

against smallpox.

 

The vaccine was used to eradicate the viral disease nearly two

centuries later, and it may be needed again if bioterrorists release

smallpox virus in an attack.

 

In recent decades, at least two Nobel Prizes were awarded to

scientists who received rejection slips from one journal before

another published their papers.

 

One paper concerned what turned out to be the hepatitis B virus. The

other concerned a radio-immunoassay technique that can detect trace

amounts of substances in the body and that is now used every day

throughout the world.

 

Another recent problem, critics say, is that many editors have not

moved quickly enough to use newer methods to judge the merits of

manuscripts.

 

One example is the growing importance of statistics to measure the

safety and effectiveness of new therapies and to compare them with

older ones.

 

Yet research on peer review has found that many studies are conducted

without the benefit of adequate consultation with statisticians,

sometimes because none were available.

 

Reasons for errors also include the practice of consulting

statisticians after the research project has been completed, not at

the most critical time, when the study was being designed.

 

Once statistical errors are published, it is hard to stop them from

spreading and being cited uncritically by others.

 

The New York Times

 

JAMA June 5, 2002 Volume 287 No. 21

 

Fidyl

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