The New England Journal of Medicine Can Do Much Better
I thought this was interesting. I saw it on Twitter from someone by the name of Bogdan Enache. It seems a new antibiotic is being researched and the study was in the New England Journal of Medicine. It’s called Omadacycline, for community acquired pneumonia. Bogdan went on to pose these questions:
The company:
- Designed – conducted – prepared the statistical analysis
- Analyzed & interpreted the data (in conjunction w/ the authors)
- Hired a medical writer to write the paper
Wow. Thoughts from you researchers out there. Is there where science is going?
The NEJM used to be the standard bearer, but has long since lost its way. In 2010 “Acupuncture for Chronic Low Back Pain” they endorsed acupuncture although there was no activity greater than placebo. In contrast July 2002 “A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee” neither the article nor the accompanying editorial recommended arthroscopy because there was
no activity greater than placebo. Somewhere in between they decided that level 1 evidence could be ignored when politically expedient. They now support doctors and institutions that promote and profit by selling unscientific medical treatment, instead of advocating medical treatment based upon the best available science. Only the King of Medicine remains as a voice of reason.
– Sir Geon of Bones
The concern here is the obvious conflict of interest (COI) the pharma company has, correct?
All private companies (driven by profit) will have COI issues when doing research. If the solution is to not allow private companies to do research, then how does it get done? Most research done in academic centers are being by funded by NIH grants. Two days ago on this blog, your partner Pat Conrad argued for dissolving the NIH. So, take away private companies and government monies and what are we left with for research- nothing.
The presence of COIs doesn’t mean anything has been done wrong. COIs are defined as situations, not actions. They occur all the time in all of our professional daily lives. If I order a test or schedule a follow-up visit there is a COI if I personally benefit (make money) from the test or visit. That’s not a problem as long as I don’t prioritize my personal benefit above the needs of the patient.
COIs can however lead to bad actions called breaches of loyalty. If I order an unnecessary test because I put my personal benefit above the need of the patient then there is a breach of loyalty.
Despite the obvious COI, if Paratek’s research had no breach of loyalty then it is legit to publish.
It’s not where science is going. It’s been here for 20+ years. Look at the way scientific theories and opposing data are discussed in the press. Science is hard.