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Is scientific research really independent?

ONE of the good old faithful debates that turns up again and again in science circles is the one about funding research. Does it skew research when the private sector is the funder?

It’s cropped up yet again because of an almighty ruckus that’s bust out around one of the world’s oldest and most respected medical journals. “The BMJ [was the British Medical Journal] announced it would be withdrawing statements from two articles, one a study by Harvard clinician John Abramson and colleagues, and the other a comment piece by Dr Malhotra, which claimed that 20% of patients suffered side effects” from statins.

Fair enough – it was pointed out that those statements were a little rocky. This sort of correction is part of the way science works, nothing to see here, move on please. Especially in this case, where the errors really had nothing to do with the main thrust of the articles.

What caused a real uproar was that the professor who pointed out these statements also demanded that both articles be retracted. Retraction is a serious matter, usually reserved for papers that have been shown to be undeniably false or suspect when it comes to their main premise – not the case here.

Both articles contributed to an ongoing debate about a call to prescribe statins, not just for those who have heart disease, but to those who have a 20% (or even lower) RISK of heart disease – perfectly healthy men and women who just might get heart disease later.

Now without getting into any debate about whether or not that’s correct, if a country like Britain adopts a policy of prescribing statins for healthy people as well as those with existing heart disease, it expands the use of the drug quite incredibly, and that is going to do no harm at all to the bottom line of statin manufacturers.

And guess what? The research involved has apparently received massive funding from just such pharmaceutical companies. “There is a concern underlying [Abramson and Malhotra’s] critique that will be familiar to BMJ readers,” writes the editor, Fiona Godlee.

“It is that all of the trials included in the CTT meta-analysis were funded by the manufacturer of the statin being studied. [The authors] list the various ways in which these trials might have exaggerated the benefits of statins and minimised the harms, and they summarise what low risk patients need to know. Top of the list is the benefit of lifestyle change, something that the dominance of industry sponsored clinical trials too often obscures."

We’ve known for a long time – and it makes intuitive sense – that industry-funded research is more likely to favour industry – four times more likely, in fact (BMJ. 2003 May 31;326(7400):1167-70: Pharmaceutical industry sponsorship and research outcome and quality: systematic review, Lexchin J et al.)

Private funding has been a mainstay of research for – well, forever. From gentlemen scientists who paid for their research out of their own estates a couple of hundred years ago, to research paid for by modern philanthropists like the Bill Gates Foundation, private money has been crucial.

And even industry money has played a role – the people who will benefit from finding out about the metal fatigue of a new alloy are the ones most likely to pay for a scientist to investigate. We’ve learned a lot through this kind of research.

But the role of private sector money can be troublesome: not only is it four times more likely to yield a result the funder wants, favourable research is twice as likely to get published as unfavourable research – which is often simply withheld and allowed to sink like a stone.

In January this year, the UK’s Public Accounts Committee said “it was of ‘extreme concern’ that about half of all trial results for medicines available on the global market were not subject to public and independent scrutiny.

“Warning that doctors and patients are being ‘undermined’ in their ability to make informed decisions on treatment, the committee called on the government to act to ensure that the results of all clinical trials of every medicine currently being prescribed are made available… Critics have accused ‘Big Pharma’ of systematically putting profit before patients, withholding data that might undermine confidence in their blockbuster drugs.” (The Independent, 3 January 2014) Interestingly, apparently the raw data that the Cholesterol Treatment Trialists’ (CTT) Collaboration (headed by Sir Rory Collins, the prof who wants a retraction) holds has not been made available to other researchers and scientists.

So there’s a thing that we as the lay public and potential patients/guinea pigs can do to ensure that science does its job properly: we can call/lobby/advocate for the publication of all decent research, favourable or not, as long as it passes peer review; and for the sharing of all data so that other researchers can interrogate the science that is published from a position of full knowledge.

It may sound like an arcane and obscure little argument, but it has massive ramifications, huge commercial impact, and very personal meaning: the lack of transparency, the skewing of publication noted above can lead to big profits made off less-than-convincing research – and mean the end-user is getting less effective results than he or she has a right to expect.

- Fin24

*Mandi Smallhorne is a versatile journalist and editor. Views expressed are her own.

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