Journal "pharmascolds" skew policy, says study

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Medical journal coverage of the question of physician-industry relationships is “unbalanced” and may be skewing public policy towards ever-more restrictive safeguards against industry influence.

That's the finding of a trio of researchers – one of them Harvard's Tom Stossel, MD, the industry-friendly founder of the Association of Clinical Researchers and Educators – in a study published in Nature Biotechnology. They looked at 108 journal articles, including original research, reviews, editorials and other commentaries, published over the past quarter-century and dealing with the topic of industry-physician relationships.

“Publications on this topic began to appear in the 1980s and peaked around 2000,” write the study's authors, who plotted the topic's trajectory through keyword searches on terms like “conflict of interest,” “CME” and “physician-industry relationships.” Earlier papers, they found, mainly concerned research relationships, while later papers explored a variety of possible avenues of influence including marketing to physicians, commercial support of CME and “ghost writing” of journal articles.

Nearly all of the articles they looked at (89%) “unambiguously emphasized risks” of industry-physician contact. Very few considered possible benefits of industry-physician interaction, and most speculated industry-physician contact hurt patient care outcomes – absent supporting evidence.

“In our view, the dominance of risk-emphasizing papers and the low prevalence of opposing viewpoints in those papers have contributed to the evolution of policies concerning academia-industry relationships,” wrote the authors, arguing that the brickbats from medical journals have fed a “conformity cascade” among ill-informed lawmakers. They called for journal editors to bring in “a broader and more inclusive diversity of voices when considering articles on academic-industry relationships.”   
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