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vaccine research: financial conflict of interest is the norm, not the exception

post #1 of 38
Thread Starter 

This isn't really anything we need to debate, but I'm posting it here because it's something we all should know, whether we vaccinate according to the full schedule, on a select/delayed timetable, or not at all.  Please feel free to add other articles, if you find any.  I think that this is only the tip of the iceberg.

 

It's extremely important to know this, because most of us grew up believing that medical research (including vaccine research), as *SCIENCE,* is pure, untouched by corruption, and staffed only with selfless, brave souls who want to save humanity.  The industry itself feeds that myth. There are a lot of well-meaning people who have no idea how pervasive the corruption is, and who passionately defend the entire industry. 

 

The truth is very unsettling, to say the least.  My thanks to MDC member Turquesa for originally finding and posting this on another thread!

 

From 2010: http://www.thenation.com/article/big-pharma-bad-science#

"In June, the New England Journal of Medicine, one of the most respected medical journals, made a startling announcement. The editors declared that they were dropping their policy stipulating that authors of review articles of medical studies could not have financial ties to drug companies whose medicines were being analyzed.

The reason? The journal could no longer find enough independent experts. Drug company gifts and "consulting fees" are so pervasive that in any given field, you cannot find an expert who has not been paid off in some way by the industry. So the journal settled for a new standard: Their reviewers can have received no more than $10,000 from companies whose work they judge. Isn't that comforting?"

 

http://www.theoneclickgroup.co.uk/documents/vaccines/Conflicts%20of%20Interest%20in%20Vaccine%20Safety%20Research%2C%20Gayle%20DeLong.pdf

"Compounding the COls inherent in the business of manufacturing vaccines is the fact that vaccine manufacturers sponsor research. The influence of industry is widespread: It affects individuals as well as institutions and study outcomes as well as research initiatives. In a survey of faculty at top US medical research institutions (Tereskerz et al 2009) found over two-thirds of researchers (338 out of 506) received some support from industry."
 

post #2 of 38

Studies are more likely to be published in prestigious journal when they are industry funded.

 

"Conclusion Publication in prestigious journals is associated with partial or total industry funding, and this association is not explained by study quality or size"

 

http://www.nvic.org/Downloads/Jeffersonetal-BMJ2009.aspx

 

(the link is a download of the study)

 

So, even when non industry funded studies exist, we are unlikely to know about them or be able to access them - as industry related studies are the studies that get press.  

post #3 of 38

From the Independent (UK) today:

 

Drug Giants fined 11bn for Criminal Wrongdoing

 

Quote:
In all, 26 companies, including eight of the 10 top players in the global industry, have been found to be acting dishonestly. The scale of the wrongdoing, revealed for the first time, has undermined public and professional trust in the industry and is holding back clinical progress, according to two papers published in today's New England Journal of Medicine. Leading lawyers have warned that the multibillion-dollar fines are not enough to change the industry's behaviour.
post #4 of 38

Tweeted out by Dr Tenpenny today: 

 

Undue industry influences that distort healthcare research, strategy, expenditure and practice: a review. (pubmed)

RESULTS:We located abundance of consistent evidence demonstrating that the industry has created means to intervene in all steps of the processes that determine healthcare research, strategy, expenditure, practice and education. As a result of these interferences, the benefits of drugs and other products are often exaggerated and their potential harms are downplayed, and clinical guidelines, medical practice, and healthcare expenditure decisions are biased.

CONCLUSION:

To serve its interests, the industry masterfully influences evidence base production, evidence synthesis, understanding of harms issues, cost-effectiveness evaluations, clinical practice guidelines and healthcare professional education and also exerts direct influences on professional decisions and health consumers. There is an urgent need for regulation and other action towards redefining the mission of medicine towards a more objective and patient-, population- and society-benefit direction that is free from conflict of interests.

post #5 of 38
Quote:
Originally Posted by Taximom5 View Post
 

This isn't really anything we need to debate, but I'm posting it here because it's something we all should know, whether we vaccinate according to the full schedule, on a select/delayed timetable, or not at all.  Please feel free to add other articles, if you find any.  I think that this is only the tip of the iceberg.

 

It's extremely important to know this, because most of us grew up believing that medical research (including vaccine research), as *SCIENCE,* is pure, untouched by corruption, and staffed only with selfless, brave souls who want to save humanity.  The industry itself feeds that myth. There are a lot of well-meaning people who have no idea how pervasive the corruption is, and who passionately defend the entire industry. 

 

The truth is very unsettling, to say the least.  My thanks to MDC member Turquesa for originally finding and posting this on another thread!

 

From 2010: http://www.thenation.com/article/big-pharma-bad-science#

"In June, the New England Journal of Medicine, one of the most respected medical journals, made a startling announcement. The editors declared that they were dropping their policy stipulating that authors of review articles of medical studies could not have financial ties to drug companies whose medicines were being analyzed.

The reason? The journal could no longer find enough independent experts. Drug company gifts and "consulting fees" are so pervasive that in any given field, you cannot find an expert who has not been paid off in some way by the industry. So the journal settled for a new standard: Their reviewers can have received no more than $10,000 from companies whose work they judge. Isn't that comforting?"

 

 

From the New England Journal of Medicine website : 

 

"

Financial Associations/Conflict of Interest

NEJM is committed to publishing the highest quality research and reliable, authoritative review articles that are free from commercial influence.

For all research articles we publish, NEJM lists study sponsorship and relevant financial information as disclosed by the authors. The disclosure forms of all authors are available online with the full text of each article. Additional information about the contributions of authors may also appear in the Methods section of research articles.

A separate policy applies to Review Articles and editorials, which comment on published articles but do not present new research. NEJM expects that authors of such articles not to have any significant financial interest in any biomedical company relevant to the topics and products discussed in the article. When a prospective author does have financial ties to disclose, the editors decide whether they are relevant to the topic and whether they are de minimus.

NEJM's policy is that none of the NEJM editors should have any financial relationship with any biomedical company.

For more information:

Integrity Safeguards 

Uniform Format for Disclosure of Competing Interests in ICMJE Journals (November 5, 2009)

Financial Associations of Authors (our current conflict of interest policy; June 13, 2002)

Full Disclosure and the Funding of Biomedical Research (April 24, 2008)  " 

 

http://www.nejm.org/page/about-nejm/editorial-policies

 

As was said in another thread, COI must be stated in the paper itself.  Anyone can easily choose to just ignore studies with a COI disclosed if they wish. There are still many many many studies available that don't have any ties to "big pharma". 


Edited by teacozy - 10/11/13 at 1:35pm
post #6 of 38

Also, the part you quoted says "The editors declared that they were dropping their policy stipulating that authors of review articles of medical studies could not have financial ties to drug companies whose medicines were being analyzed."

 

Review articles are different. Per the NEJM quote review articles " ... comment on published articles but do not present new research." 

 

http://www.nejm.org/page/about-nejm/editorial-policies

 

Another source " 

What’s a “Review Article?”

Not to be confused with a “peer reviewed journal,” Review articles are an attempt by one or more writers to sum up the current state of the research on a particular topic. Ideally, the writer searches foreverything relevant to the topic, and then sorts it all out into a coherent view of the “state of the art” as it now stands. " 

 

http://www.lib.utexas.edu/lsl/help/modules/review.html

post #7 of 38

Sorry, to be more clear : A review article is not a research study.  It is an article that reviews all the current studies that exists to keep the reader updated on the current status of the literature.  So this has nothing to do with the authors of the STUDIES that are done.  It just has to do with those who are trying to bring the studies together into one article.


Those with SIGNIFICANT ties to drug companies still can't write even review articles.  What financial ties are allowed?  $10,000 or less over two years.  Since most researchers make on the order of $60,000 or more a YEAR, that's a rather small tie.

 


Edited by teacozy - 10/11/13 at 2:52pm
post #8 of 38

"Most U.S. clinical trials are funded by industry. Opportunities exist for sponsors to influence research in ways that jeopardize research objectivity. The purpose of this study was to survey U.S. medical school faculty to assess financial arrangements between investigators and industry to learn about investigators' first hand knowledge of the effects of industry sponsorship on research. Here we show first-hand knowledge that compromises occurred in: research participants' well-being (9%), research initiatives (35%), publication of results (28%), interpretation of research data (25%), and scientific advancement (20%) because of industry support. Financial relationships with industry were prevalent and considered important to conducting respondents' research."

 

http://www.ncbi.nlm.nih.gov/pubmed/19353387

post #9 of 38

http://www.thenation.com/article/big-pharma-bad-science#

 

From the first link in the OP:

 

"The <NEJM> standard announced in June was only for the reviewers. The actual authors of scientific studies in medical journals are often bought and paid for by private drug companies with a stake in the scientific results. While the NEJM and some other journals disclose these conflicts, others do not. Unknown to many readers is the fact that the data being discussed was often collected and analyzed by the maker of the drug involved in the test. An independent 1996 study found that 98 percent of scientific papers based on research sponsored by corporations promoted the effectiveness of a company's drug. By comparison, 79 percent of independent studies found that a new drug was effective. "

post #10 of 38
Quote:
Originally Posted by kathymuggle View Post
 

"Most U.S. clinical trials are funded by industry. Opportunities exist for sponsors to influence research in ways that jeopardize research objectivity. The purpose of this study was to survey U.S. medical school faculty to assess financial arrangements between investigators and industry to learn about investigators' first hand knowledge of the effects of industry sponsorship on research. Here we show first-hand knowledge that compromises occurred in: research participants' well-being (9%), research initiatives (35%), publication of results (28%), interpretation of research data (25%), and scientific advancement (20%) because of industry support. Financial relationships with industry were prevalent and considered important to conducting respondents' research."

 

http://www.ncbi.nlm.nih.gov/pubmed/19353387

 

Right. So the vast majority do not. 

post #11 of 38
Quote:
Originally Posted by kathymuggle View Post
 

http://www.thenation.com/article/big-pharma-bad-science#

 

From the first link in the OP:

 

"The <NEJM> standard announced in June was only for the reviewers. The actual authors of scientific studies in medical journals are often bought and paid for by private drug companies with a stake in the scientific results. While the NEJM and some other journals disclose these conflicts, others do not. Unknown to many readers is the fact that the data being discussed was often collected and analyzed by the maker of the drug involved in the test. An independent 1996 study found that 98 percent of scientific papers based on research sponsored by corporations promoted the effectiveness of a company's drug. By comparison, 79 percent of independent studies found that a new drug was effective. "

 

There was no source provided for this independent 1996 study that I saw. That is almost 18 years ago.  Again, in most respectable medical journals a COI must be disclosed. If you don't trust studies that have a COI, then don't use them in your determination. There are many many many studies on vaccines that do not have COIs that you can look at.

 

To argue that the only studies on vaccines have pharma ties is simply not true. I am not sure if that is your argument, but it seems to be because that point seems to still be attacked.  Because some vaccine studies have COI doesn't mean every study on vaccine safety is useless. That's throwing the baby out with the bath water. There are plenty that are pharma-tie free. 

post #12 of 38

And they pick and chose which studies are published based on results.  So how many of these non-pharm studies actually make it anywhere as public knowledge?  Nowhere near as many as the pharm studies.  And when they do?  Pro-vaxxers bash them to no end and do everything they can to discredit the author or study.  Meanwhile when you pay someone to write a favorable article about studies having been done on your product that's not exactly convincing.....

post #13 of 38
Quote:
Originally Posted by teacozy View Post
 

 

Right. So the vast majority do not. 

Wrong.  They said "most US clinical trials are industry funded."  

post #14 of 38
Quote:
Originally Posted by kathymuggle View Post
 

Wrong.  They said "most US clinical trials are industry funded."  

 

Thats not what the results of the study showed. You do know how to do basic math right?  You can look at the percentages yourself. 

post #15 of 38
Quote:
Originally Posted by teacozy View Post
 

 

There was no source provided for this independent 1996 study that I saw. That is almost 18 years ago.  Again, in most respectable medical journals a COI must be disclosed. If you don't trust studies that have a COI, then don't use them in your determination. There are many many many studies on vaccines that do not have COIs that you can look at.

 

1996 was awhile ago.  I will see if I can dig up something more recent.  My point was that that this study showed that industry funded studies tended to come to more positive conclusions about their product than independent studies.  Re quoting:

 

"An independent 1996 study found that 98 percent of scientific papers based on research sponsored by corporations promoted the effectiveness of a company's drug. By comparison, 79 percent of independent studies found that a new drug was effective. "

 

To argue that the only studies on vaccines have pharma ties is simply not true. I am not sure if that is your argument, but it seems to be because that point seems to still be attacked.   I have never said that all studies have pharma ties.  You said the vast majority of studies were not tied to pharmaceutical companies,  I asked you for links supporting this, as it is contrary to what I have read.  From this thread alone:

 

 "In a survey of faculty at top US medical research institutions (Tereskerz et al 2009) found over two-thirds of researchers (338 out of 506) received some support from industry."  (post one)

 

"Most U.S. clinical trials are funded by industry…"  (post 8).

 

In any event, I am not really attacking the point.  I believe most studies have pharmaceutical ties, and you have shown me nothing that dissuades me from that viewpoint.  I have moved on.  I am now focusing on what are the repercussions of industry funding are. Both of the links I posted above discussed the negative consequences of industry funding. 

 

 

 

 

 

 

post #16 of 38
Quote:
Originally Posted by teacozy View Post
 

 

Thats not what the results of the study showed. You do know how to do basic math right?  You can look at the percentages yourself. 

I think you need to reread the quote carefully.  The percentages are about how industry funded trials affect research.  The quote (below) does not specify the percentage of studies that are industry funded, all it says is "most."   

 

From what I quoted:

 

Most U.S. clinical trials are funded by industry. (That is clear, right? ) Opportunities exist for sponsors to influence research in ways that jeopardize research objectivity. The purpose of this study was to survey U.S. medical school faculty to assess financial arrangements between investigators and industry to learn about investigators' first hand knowledge of the effects of industry sponsorship on research. ( They want to study how industry sponsorship might affect research  )Here we show first-hand knowledge that compromises occurred in: research participants' well-being (9%), research initiatives (35%), publication of results (28%), interpretation of research data (25%), and scientific advancement (20%) because of industry support. Financial relationships with industry were prevalent and considered important to conducting respondents' research."

 

I did a little further digging beyond the abstract to see if they spelled out what they meant by "most" in terms of their study, and they did:

 

"Sixty-six percent of respondents indicated that they have received some form of industry support"  Males were more likely to have industry funding than females, and researchers with 11 plus years of experience were more likely than inexperienced researchers to have industry funding.  

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2758529/


Edited by kathymuggle - 10/11/13 at 7:52pm
post #17 of 38

As 1996 was awhile ago….

 

From 2012 (Cochrane)

 

http://www.ncbi.nlm.nih.gov/pubmed/23235689

 

"Sponsorship of drug and device studies by the manufacturing company leads to more favorable results and conclusions than sponsorship by other sources. Our analyses suggest the existence of an industry bias that cannot be explained by standard 'Risk of bias' assessments."

post #18 of 38
dbl post
post #19 of 38
Quote:
Originally Posted by kathymuggle View Post
 

I think you need to reread the quote carefully.  The percentages are about how industry funded trials affect research.  The quote (below) does not specify the percentage of studies that are industry funded, all it says is "most."   

 

From what I quoted:

 

Most U.S. clinical trials are funded by industry. (That is clear, right? ) Opportunities exist for sponsors to influence research in ways that jeopardize research objectivity. The purpose of this study was to survey U.S. medical school faculty to assess financial arrangements between investigators and industry to learn about investigators' first hand knowledge of the effects of industry sponsorship on research. ( They want to study how industry sponsorship might affect research  )Here we show first-hand knowledge that compromises occurred in: research participants' well-being (9%), research initiatives (35%), publication of results (28%), interpretation of research data (25%), and scientific advancement (20%) because of industry support. Financial relationships with industry were prevalent and considered important to conducting respondents' research."

 

I did a little further digging beyond the abstract to see if they spelled out what they meant by "most" in terms of their study, and they did:

 

"Sixty-six percent of respondents indicated that they have received some form of industry support"  Males were more likely to have industry funding than females, and researchers with 11 plus years of experience were more likely than inexperienced researchers to have industry funding.  

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2758529/

 

If you look at the survey in Appendix A, you will see that the definition of "support" is very broad (it included gifts of $100 value). 
 
And what is the result of this supposed support?  As the study says, "Only 4% reported that a sponsor had ever asked them to withhold research results from publication, but 13% said they had been asked to delay publication of research results.  Nearly 8% have been asked by a sponsor to present research results in a way that favors the sponsor’s drug or product. About 7% have been asked by an industry sponsor to keep the research results secret."  
 

Once again, these results clearly tell us that even when you define "support" ridiculously broadly, it has virtually no effect on the research, as the largest percentage there is 13%.  Thus, even when you define support ridiculously broadly, 87% of those who received the support felt no pressure at all.

post #20 of 38
Quote:
Originally Posted by kathymuggle View Post
 

As 1996 was awhile ago….

 

From 2012 (Cochrane)

 

http://www.ncbi.nlm.nih.gov/pubmed/23235689

 

"Sponsorship of drug and device studies by the manufacturing company leads to more favorable results and conclusions than sponsorship by other sources. Our analyses suggest the existence of an industry bias that cannot be explained by standard 'Risk of bias' assessments."

 

 The second study you linked supports my argument.  When the RR is 1, there is no effect.  When the RR is 2, that means the effect is twice as likely under the circumstance.  As an example, when measles outbreaks occur in a school, unvaccinated children are 22.2 times more likely to get measles than the vaccinated children (Feikin DR, et al. "Individual and Community Risks of Measles and Pertussis Associated with Person Exemptions to Immunization." JAMA, 2000; 284:3145-3150.)  Thus, the relative risk (RR) of getting measles when you are not vaccinated is 22.2. 
 

Now let's look at the study you linked.  It says "Industry sponsored studies more often had favorable efficacy results, risk ratio (RR): 1.24"  That means they were 24% more likely to have positive results if they were sponsored by industry.  That's a very low risk.  It means that for 100 industry-sponsored studies, only 24 have results skewed to support the industry.  Thus, the vast majority of studies, *even when they are industry sponsored*, aren't compromised.
   
Also, you need to think a bit more clearly about what this study actually means.  In the study, they compare industry-sponsored research to non-industry-sponsored research.  If the drug companies are so all-powerful that they control the medical studies, how did these authors find studies that were NOT industry-sponsored?  If the medical research shows that vaccines are safe and effective only because the industry sponsors the research, why doesn't the non-industry-sponsored research (which you admit exists by using this study) show that vaccines aren't safe and effective?

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