This is pretty funny.
My only comment is that Seth sees this as a problem with “academic psychiatry–and perhaps all academic medicine,” but I don’t think there’s anything particularly bad about academia here–certainly this sort of thing happens in the business world all the time, right? It’s just that Seth worked in academia for many years and so its problems particularly annoy him.
I don't find this funny. From reading the BMJ posting by Leo and the editorial by JAMA, I think JAMA is (more) in the right and that Leo should have taken more due diligence in his actions. It is fine to escalate your actions if no response is being taken in a matter such as undisclosed conflicts of interest, but you should make sure that no response is actually being taken.
JAMA exercised due diligence in conducting their own independent investigation of the conflicts of interest which actually found more conflicts than Leo knew about. This was reported in JAMA along with an apology from the authors and a correction of the original article. From my perspective and the perspective of the journal, this seems reasonable and appropriate.
Of course, not all actions of JAMA were ideal.
Bottom line: Conflicts of interest are important in interpreting scientific results and analyses.
It seems like both parties didn't exactly act in an ideal manner — but no matter what, JAMA is going to come off looking terribly. If they hadn't contacted the Dean, just published the apology a few days later with an note stating the investigation was ongoing — this whole thing would have gone pretty much unnoticed. The high-handed actions are what really made this into a story.
From what I understand, Leo actually contact JAMA privately about the COI shortly after the original article was disputed and he received no reply.
http://scienceblogs.com/insolence/2009/03/catheri…
Good point. I was considering their reactions to the conflict of interest part, not their handling of Leo.
Actually clinical research probably handles conflicts of interest better than most areas
but only a little over 10 years ago many clinical researchers/journals thought there was little need to disclose conflicts of interest
http://content.nejm.org/cgi/content/abstract/338/…
and such a survey study would be unethical by todays standards as published authors were "coerced" into responding …
How so? I don't see the coercion (or "coercion", if you mean a misperception on the part of the ethics bureaucracy). Participation seems voluntary, though anonymity might be somewhat compromised.
BrendanH
> Participation seems voluntary
Note the high response rate and very low refusal rate.
With today's fully informed consent and the participant's right to refuse without any possible consequences – researchers would be unlikely to achieve such a high response rate.
On the other hand journalists, I believe, can still report on who declines respond …
"I don't think there's anything bad about academia here." The problem is academic medicine, not all academia, and it's a serious problem because academic doctors control what doctors do. Nemeroff, for example, pioneered the childhood diagnosis of bipolar disorder. Thus causing thousands of kids, if not more, to be given dangerous poorly-tested drugs.
"This sort of thing happens in the business world all the time." With business you have more of a choice — I may or may not buy an X or a Y — and there is less opportunity for long-term damage. Whereas the parents of a child with so-called bipolar disorder are scared by doctors into giving their child dangerous drugs. Thanks to Nemeroff.
How is Leo fault here? He is under no obligation to wait 6 months for JAMA to say what it should have said in the first place. Leo had a legitimate criticism, and he was right to make it.
The JAMA editors look really bad here.
Seth,
I'm not trying to defend academic medicine, or academia, here. I'm just suggesting that, as someone who worked in academia, you're particularly sensitive to its problems. Regarding the failures of business and government: we didn't get much of a choice about the current recession, either. There's a lot more to the effects of business than the choice of which breakfast cereal to buy.
The consequences of poor research practices does seem more salient in academic medicine …
An account of tens of thousands of unneccesary deaths due to the failure to seek replication of results is given in – The lethal consequences of failing to make full use of all relevant evidence about the effects of medical treatments: the importance of systematic reviews. Iain Chalmers in Rothwell P, ed. Treating Individuals – From randomized trials to personalized medicine in routine practice. London: The Lancet
But failures of business and goverment (i.e. the climate) are perhaps just underappreciated
Keith