JAMA says docs misled over industry ties

LINDSEY TANNER, "JAMA says docs misled over industry ties", Houston
Chronicle, July 18, 2006,
Link: http://www.chron.com/disp/story.mpl/ap/health/4055561.html

Just days after announcing a crackdown on researchers who do not
disclose drug company ties, the editor of a prestigious medical journal
says she was misled again _ this time by the authors of a study linking
severe migraines to heart attacks in women.

All six of the study's authors have done consulting work or received
research funding from makers of treatments for migraines or
heart-related problems. Their research appears in Wednesday's Journal
of the American Medical Association, a week after the crackdown was
announced.

The authors said they did not report their financial ties because they
did not believe they were relevant to the study.

Dr. Catherine DeAngelis, JAMA's editor in chief, said journal editors
did not know about the ties until The Associated Press brought them to
her attention late last week.

"We'll get killed," she said, referring to the potential damage to the
journal's reputation.

She said she would have published the authors' associations with drug
makers had she known about them. "Let me decide what's pertinent or
not," DeAngelis said. "The issue is not what can those companies
possibly gain; it is the issue of perception."

Last week, JAMA disclosed that the authors of a depression study failed
to report ties to makers of antidepressants. And two months ago, the
journal reported similar omissions from authors of a study linking
certain arthritis drugs to cancer.

JAMA has long required researchers whose articles it will publish to
sign statements disclosing all potential financial conflicts. An
editorial last week said JAMA was getting tougher as a result of the
recent breaches. JAMA's new policy, effective in January, requires
disclosures even before articles are accepted for publication.

Other leading medical journals, including the New England Journal of
Medicine, JAMA's main competitor, have disclosure requirements, but
DeAngelis said hers are the toughest. Editors say disclosures are
necessary to help readers judge the reliability of research.

JAMA posted a letter online Tuesday from the authors explaining the
omissions, DeAngelis' response and a correction. DeAngelis said they
would also be published in an upcoming print edition of the journal.

"Authors should always err on the side of full disclosure," she wrote
in her response.

Dr. Tobias Kurth, the study's lead author, said the researchers were
not trying to mislead the journal. He said they believed their
financial ties were irrelevant because the study does not promote drug
treatment, but rather reports a potential link between women with
severe migraines and an increased risk of heart attacks.

"They do not represent a conflict of interest," he said in a telephone
interview.

Kurth, a scientist at Harvard's Brigham and Women's Hospital, said he
has received research funding from the makers of Bayer aspirin, Tylenol
and Advil _ pain relievers sometimes used to treat migraines.

Co-author Nancy Cook said in an e-mail that she received "minor
compensation" for a one-time consulting stint for Bayer, but that she
did not think it was relevant to her work on the migraine study.

"I do believe that conflicts sometimes exist and should be disclosed,
but I hope this issue does not get overblown by the media," Cook said.
"I think that could harm the reputations of honest and well-meaning
researchers and lead to public mistrust where none is warranted."

Dr. Frederick Freitag, a Chicago migraine specialist not involved in
the study, said the ties should have been reported, even if they had no
effect on the research.

"You still owe it as a matter of appropriate disclosure to lay your
cards on the table" or risk having somebody ask, "What are you hiding?"
he said.

Freitag said he has ties with numerous drug companies because they fund
important research.

Dr. Jerome Kassirer, a former New England Journal editor and outspoken
critic of drug company influence over doctors, said JAMA editors appear
not to have done their homework. "It sounds like they're being sloppy,"
he said.

DeAngelis said that the criticism is unfair, and that JAMA lacks the
manpower to check every researcher's background. "I'm not God and I'm
not the FBI," she said.

She said the publicity probably will make others who haven't disclosed
potential conflicts reconsider.

"I suspect we are going to have a whole bunch of disclosures over the
next few weeks because authors are going to see how dead serious we
are," DeAngelis said.

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