A Failure To Disclose

For several years now, medical journals have insisted that authors who report on their scientific studies include financial conflicts of interest alongside the results. The reasoning behind the policy is based on science. Study after study has shown that clinical trials that are funded by drug companies are much more likely to show positive results than trials funded by government or independent sources.

Unfortunately, journalism has lagged far behind the medical journals in adopting enlightened policies on reporting the conflicts of interest of quoted sources. The Washington Post has a policy encouraging the reporting of such conflicts in their science stories, but it is often ignored by reporters. The New York Times, which routinely ignores obvious conflicts of interest in its reporting, is working on a policy. The medical hype that spices up the pages of Newsweek, Time and U.S. News almost never includes information about the financial self-interest of their quoted sources.

Another flagrant failure to report conflicts of interest was contained in yesterday’s Science Times. Reporter Anahad O’Connor reported on a possible method of identifying autoimmune diseases like rheumatoid arthristis long before they begin to wear down the body. She quoted two scientists from the University of Oklahoma medical school, R. Hal Scofield and John B. Harley, who recently published articles in the New England Journal of Medicine and Lancet touting the new biomarkers, which are called autoantibodies. They expressed the hope that autoantibodies will one day be used in tests for the early spotting of diseases.

By doing a little digging, I found out that the market for autoimmune testing is already $6.6 billion a year. Coming up with an early screening test would expand that market exponentially. By doing a little more digging, I found out that the two quoted scientists co-owned a host of patents on the earlier generation of biomarkers for identifying autoimmune diseases. One also served on the board of Ivax Diagnostics, the company that markets the tests. It’s likely they’ve filed for patents on autoantibodies.

They’re clearly using the pages of the Times to tout the next generation of tests without revealing their conflicts of interest.

If proven useful, would these tests be a good use of health care dollars? I’m skeptical. Does it make sense to screen millions of people to reassure them they haven’t yet started developing degenerative diseases like rheumatoid arthritis, when even if you do have raised levels of the biomarker, you may not get the disease and if you do get the disease, there isn’t much medicine can do about it?

The saddest part of this story is that the Lancet article that triggered the Times story ended in a lie. Scofield wrote that “I have no conflict of interest to declare.” No conflicts of interest information was included in the New England Journal of Medicine article last fall, either.

Excuse me. If owning patents on the first generation of biomarkers for a set of diseases and serving on the board of a company that markets it aren’t conflicts of interest, what are?

We’ve reached a point in the crass commercialization of medicine that academic entrepreneurs are flouting the rules of medical journal reporting and manipulating reporters to get into print what are essentially ads for their next private venture. Maybe those journal editors should take a second look at their science and their claims to its usefulness.