Dr. Brett Thombs and his McGill graduate students analyzed 509 drug trial reports included in 29 "studies of studies" and found that only 2 of the 29 meta-analyses mentioned who funded the original drug trials. The team identified 7 meta-analyses where every single drug trial included was paid for by the manufacturer of the drug being studied:
Meta-analyses are conducted by experienced experts in the field. Thus, the McGill study finding underscores how easily researchers who analyze drug studies are either duped or complicit in disregarding the bias that permeates their analyses.
We believe that the single most potent factor undermining the veracity of medical research and meta-analyses is imbedded financial conflicts of interest.
SCIENCE DAILY
ScienceDaily (Mar. 11, 2011)
— Hidden financial conflicts-of-interest are sneaking into published drug
research through the back door, warns an international team of investigators,
led by researchers from the Jewish General Hospital's Lady Davis Institute for
Medical Research and McGill University in Montreal.
More and more, policy decisions and what medications doctors prescribe for
their patients are being driven by large "studies of studies," called
meta-analyses, which statistically combine results from many individual drug
trials.
Led by Dr. Brett Thombs and McGill graduate student Michelle Roseman, the
team found that important declarations of financial conflicts-of-interest in
individual drug trials disappeared when those studies were combined in
meta-analyses. Their results will be published in the March 9 issue of the Journal
of the American Medical Association (JAMA).
Roseman, the study's first author, and the rest of the team reviewed 29
recent meta-analyses on a range of drug treatments published in high-impact
medical journals. Those 29 meta-analyses, or "studies of studies,"
included results from 509 drug trials. The team documented the funding sources
and author-industry financial ties of all 509 trials and whether or not the
meta-analyses noted who had funded the trials.
"Only 2 of the 29 meta-analyses even mentioned the issue of who funded
the original drug trials, and even those 2 did it in very obscure places in the
published articles," said Thombs, a psychologist and assistant professor
in the Department of Psychiatry at McGill University. "Not one of the
meta-analyses mentioned whether researchers who conducted the trials were
employed by industry or personally received money from industry."
"Most people want their physicians to make treatment decisions based on
high-quality, unbiased evidence," said Roseman. "Researchers who
conduct meta-analyses should be aware of who funds the trials they review and
they should assess the risk that findings might be biased due to drug company
sponsorship."
The team identified 7 meta-analyses where every single drug trial included
was paid for, at least in part, by the maker of the drug or had investigators
linked financially to drug makers. In 6 of the 7 meta-analyses, however, there
was no mention of who funded the drug trials.
"Consumers can be more confident that drugs actually work if there is
at least 1 independent evaluation that confirms this," said Thombs.
"When all existing studies are financially linked to drug makers, there is
a risk that patients and their physicians may be misled."
"What is surprising is that many researchers who do meta-analyses don't
seem to be aware of these important issues," added Roseman. "We
surveyed the authors of the 29 meta-analyses. Only 7 said that they even
recorded who funded the drug trials they evaluated, and only 2 published this
information. Furthermore, only 2 recorded author-industry financial ties, and
none published this."
Thombs, Roseman and their colleagues have called for changes in policy on
how evidence on drug treatments is reported in meta-analyses. "Unless we
require authors of meta-analyses to provide this information for consumers, it
will be lost," emphasized Thombs. "Patients and doctors want to have
this information, and we believe it is in the best interest of all of us to
make sure it is available."
"Few people would buy a car whose performance and safety had only been
tested by the manufacturer or a house based only on the word of the seller
without an independent inspection," added Thombs. "Yet most drugs
that people take have been evaluated, for the most part, by the companies that
produce them and profit from their sales. At the very least, doctors and their
patients need to know who is evaluating the effectiveness and safety of drugs
that are being prescribed."
The Canadian Institutes of Health Research and the Fonds de la Recherche en
Santé Québec provided funding that supported work on this study. In addition to
Thombs and Roseman, other researchers who contributed to this study were
Katherine Milette, a McGill graduate student; Lisa A. Bero, Ph.D., of the
University of California, San Francisco; James C. Coyne, Ph.D. of the
University of Pennsylvania, Philadelphia and the University of Groningen, the
Netherlands; Joel Lexchin, M.D. of York University, University of Toronto, and
University Health Network, Toronto; and Erick H. Turner, M.D., of the Oregon
Health and Science University, Portland.
Story Source: The above story is reprinted (with editorial adaptations by
ScienceDaily staff) from materials
provided by Jewish General Hospital,
via EurekAlert!, a
service of AAAS.
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