Wednesday, December 31, 2008

Would you trust a drug company to approve its own drugs?

That question, essentially whether I would trust an industry to police its own products, came to me as I perused several of the new blogs I normally check in the morning. I came upon this quote in Kevin Drum over at Mother Jones. From Marcia Angell, former editor of the highly respected medical journal The New England Journal of Medicine,

"It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines."

Following the link provided, I came upon this article, describing, with disgusting repetition, a series of research psychiatrists who took money from drug companies while simultaneously doing research on products provided by those companies. The researchers, universities and drug companies did not see this as a conflict of interest, although the researchers were often replaced after this arrangement came to light, "to avoid confusion" or for some other artificial reason.

Obviously this piqued my interest, being a scientist I would like to know that many of the papers I read and base my research on are 'trustable', and would also like to think that when I publish, people will be able to read my work and trust me. Furthermore, it is the particular perogative of science to monitor and test the safety and efficacy of all the scientific breakthroughs that occur daily and impact all of our lives.

Though the article describes mostly psychiatric research, this article highlights a scary trend in science, experimenter bias in research resulting from the intermixing of private, profit-driven research with academic, ivory-tower science. This article on the health benefits of various drinks discusses this exact problem. Ideally, academic science should be performed in an environment where no particular results are desired, where hypotheses can be right or wrong with impunity, and researchers feel no external pressure to achieve some particular result. Of course this is ideal and impossible, the money for research has to come from somewhere and generally research has a goal, which is often why the money was provided in the first place. In the past, much of the money in academics had come largely from the government, and while it requires progress reports and peer review, it is, in theory, divorced the desire for a particular outcome.

As more and more clinical and even basic research studies are funded by sponsors with particular results in mind (the US governments obsession with denying climate change over the last eight years comes to mind) the risk of experimenter bias based on desired expectation is increasing. It is easy to see how a scientist, confronted with data that do not exactly conform to the expectations or previous results, might be tempted to loosen their scientific rigor. Not to falsify data or lie about results, this is truly abhorrent and I would like to think that only the most corrupt or glory-seeking scientists do this. But to apply some logical or valid reason, which might be applied to a different situation accurately and completely correctly, to discount some results that do not conform to the expected answer.

While this practice might have little effect on the research overall, it is amazing how changing tiny pieces of data can alter the entire picture painted by a study. And although this is wrong, it is easy to see how external pressure might convince someone to stray from their ethical model. If an individuals job or lab or personal finances depend on a particular result, and their is a 'valid' reason to exclude or include data that might bring one closer to that result, the temptation might be strong.

Recognizing this, it is important to know who or what study recommends particular drugs, health practices and other new scientific breakthroughs that effect our daily lives. There is a tremendous amount of research bias and twisted interpretation in many of the research studies that are out there (the testimony of Jeffery Wigand about the tobacco industry speaks to this exact point), and only through knowledge and understanding can we protect ourselves from it.This is why, I believe, things like peer-review and open source publications are crucial to the advancement of human knowledge, because unbiased hypothesis driven research and data evaluation are essential for the accurate understanding of the mysteries of our world. Publicly funded research, which is goal oriented but not beholden to a particular program or result, is the only way for this to happen, and it is important that we recognize this and continue to support politicians and policies that will sustain this model.

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