Cancer society’s messages on screening conflict
Filed under: Conflicts of interest, Hot Health Headline, Public health
The New York Times‘ Gina Kolata reports that the American Cancer Society, a longtime defender of early detection and cancer screening, is planning to release an online message next year “to emphasize that screening for breast and prostate cancer and certain other cancers can come with a real risk of overtreating many small cancers while missing cancers that are deadly.”
“We don’t want people to panic,” said Dr. Otis Brawley, chief medical officer of the cancer society. “But I’m admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated.”
The ACS’ change of heart on breast and prostate screening was inspired, in part, by a recent analysis published in JAMA.
In it, researchers report a 40 percent increase in breast cancer diagnoses and a near doubling of early stage cancers, but just a 10 percent decline in cancers that have spread beyond the breast to the lymph nodes or elsewhere in the body. With prostate cancer, the situation is similar, the researchers report.
In an interesting side note, Kolata includes a quote from Colin Begg, a biostatistician at Memorial Sloan-Kettering Cancer Center in New York, that shows a different perspective on media coverage of the screening debate.
“I am concerned that the complex view of a changing landscape will be distilled by the public into yet another ‘screening does not work’ headline,” Begg said. “The fact that population screening is no panacea does not mean that it is useless,” he added.
Kolata’s story was published on Tuesday. On Wednesday, the ACS released a statement from Brawley in which he says the organization stands by its screening recommendations. In the statement, Brawley says ACS “stands by its recommendation that women age 40 and over should receive annual mammography” and that its recommendation that men consult with their doctors to “make an informed decision about whether or not prostate cancer early detection testing is right for them. ”
The LA Times‘ Booster Shots blog has more, as does NPR’s health blog.
Journals pay for cracking down on industry funding
Filed under: Conflicts of interest, Health journalism, Hot Health Headline, Studies
Paul Basken reports in the Chronicle of Higher Education that major medical journals, whose financial viability often depends heavily upon industry support, are faced with an “inherent conflict of interest” when it comes to filtering possible industry bias from their articles.
Basken’s report relies on an analysis of industry-funded studies presented at the International Congress on Peer Review and Biomedical Publication in Vancouver. Once the Journal of the American Medical Association introduced an independent verification requirement for industry-funded studies in 2005, Basken reported, it “saw the percentage of industry-supported studies in its pages drop 21 percent, from more than 60 percent of its published trials to 47 percent. Lancet, however, saw a growth of 17 percent, and The New England Journal of Medicine had an increase of 11 percent, the group reported.”
Ghostwriting: Journals’ dirty, not-so-little secret
Filed under: Conflicts of interest, Health data, Health journalism, Hot Health Headline, Studies
The New York Times‘ Duff Wilson and Natasha Singer reported the results of a Journal of the American Medical Association study showing that, in an anonymous survey of contributors to six major medical journals, 7.8 percent “acknowledged contributions to their articles by people whose work should have qualified them to be named as authors on the papers but who were not listed.”
Reuters Health’s Brendan Borrell describes the lengths one editor goes to when trying to track down ghostwriters and disclose them in his journal’s articles.
Meanwhile, an editorial in the nonprofit open-access Public Library of Science’s PLoS Medicine calls upon journals to “get serious” in the war against ghostwriting.
Grassley digs into journal ghostwriting practices
Filed under: Conflicts of interest, Hot Health Headline
Ben Comer of Medical Marketing & Media reports that Iowa Republican Senator Chuck Grassley sent a letter to eight prominent medical journals, asking them to share their editorial policies regarding the disclosure third parties involved in the creation of journal articles, as well as the penalties they have set for authors who don’t follow those policies. Grassley asked the journals to respond by July 22. Read the senator’s press release here.
JAMA drops gag rule for whistle-blowers
Disclosure of potential conflicts in health care always seems like a great idea until people start asking questions about you.
The editors at JAMA, the Journal of the American Medical Association, found the tables turned when they sought to keep people who bring complaints about conflicts of study authors from going public with the allegations while the journal investigates. (To read the back story and the online JAMA editorial about the change, see this post from The Wall Street Journal Health Blog.)
Well, the JAMA editors have relented and an editorial published in the current issue of the journal drops the gag language while affirming the other elements of conflict policing.
In April, the Association of Health Care Journalists weighed in with a letter to JAMA calling the
policy “counterproductive” because “it could discourage potential whistle-blowers from coming forward with crucial information that physicians and the general public urgently need to make informed decisions about medical care.”
AHCJ objects to JAMA policy on whistle-blowers
The Association of Health Care Journalists has sent a letter to the editor of the Journal of the American Medical Association stating its objection to JAMA’s new policy that seeks to keep whistle-blowers from revealing information.
From the letter:
In an editorial (PDF) published March 20, JAMA said it will inform anyone filing a complaint about a potential conflict of interest that they “should not reveal this information to third parties or the media while the investigation is under way.”
JAMA also said it would require whistle-blowers to provide a “written detailed explanation of the unreported conflicts of interest and provide documentation to support the allegation.”
JAMA’s policy is counterproductive. It could discourage potential whistle-blowers from coming forward with crucial information that physicians and the general public urgently need to make informed decisions about medical care.
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