Viewers may question much of what they hear and read about scientific and medical studies after watching the latest “Full Measure” cover story.
It’s a cautionary note issued by respected industry leaders who say unseen interests are exerting enormous control over research and what is—or isn’t—published. Their startling claim: that a large percentage of articles in prestigious medical journals are simply not to be believed.
We begin with Dr. Marcia Angell of the Harvard Medical School, a pioneer in the medical journal field.
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Marcia Angell: You know any drug I take has got to have been on the market at least five years, because I think that a lot of them are harmful. I think physicians and the public have come to believe that drugs are much better and much safer than they really are.
What makes Angell’s skepticism so remarkable is where she places much of the blame: on researchers and medical journals. That includes the prestigious New England Journal of Medicine, where she worked for 20 years and was its first female editor-in-chief from 1999 to 2000.
Sharyl Attkisson: Most people probably think an article is, in a journal, probably written at a university based on independent study, and that’s that.
Angell: Yeah, it used to be that way, as you describe it, pretty simple. And it began to change as the pharmaceutical industry became richer, more powerful, more influential, and began to take over the sponsorship of probably most clinical research now.
But before we get to that, we begin with a more obvious example of questionable science: the Chocolate Diet. The study was a hoax by a journalist to show how easy it is to get shoddy research published.
A chocolate diet is one thing. But more and more, prestigious journals are getting caught inadvertently publishing false studies.
Attkisson: What’s your view of how much we can trust the articles that appear in these prestigious medical journals?
Dr. Howard Pomeranz: One always has to be aware of the possibility that somebody who is an author or co-author or someone who is consulted to help support the research was a paid consultant by the pharmaceutical industry and that’s not always apparent, when you look at someone’s affiliations as authorship on a paper.
Pomeranz is a neuro-ophthalmologist at the Hofstra Northwell School of Medicine. He has authored dozens of journal articles, and says many studies are written by academic researchers fraught with conflicts of interest.
Attkisson: In some cases, it sounds like it’s nothing more than advertising by an employee that works for a drug company.
Pomeranz: It is, and I think that’s often the way you have to look at it.
It wasn’t always that way. Angell says it used to be that pharmaceutical companies stayed out of the way of the research they paid medical schools and teaching hospitals to do.
Angell: The drug companies did not claim to own the data. They didn’t even see the data, and then the researcher would submit it to whatever journal he wanted to. So, it was pretty much that way.
Attkisson: Independent?
Angell: Pretty much independent.
Angell says that as she applied due diligence to the many studies submitted to the New England Journal of Medicine, it started to feel like a losing battle.
Angell: I would call up and say, ‘OK, you’ve shown that your drug is pretty good. But there’s not a single side effect. Any drug that does anything is going to have some side effects.’ And I had people say, ‘Well, the sponsor won’t let me.’
I began to be extremely distrustful of most of the research that was published. We did our very best, we often rejected things because it was clearly biased, but anything we rejected always ended up in another journal.
Angell left the New England Journal of Medicine in 2000. But she kept her eye on the journal industry, which she says resisted meaningful efforts to rein in conflicts of interest.
The New England Journal of Medicine declined interview requests, b from “Full Measure,” but said: “Since 1984 we have requested author disclosures.”
In 2009, the journal says, it helped pioneer a universal form requesting “that authors report all relevant financial conflicts” during the most recent three years. And it posts the form and study sponsorship.
Besides Angell, another powerful voice is weighing in. The current editor-in-chief of the British journal Lancet, Dr. Richard Horton, wrote a scathing editorial, saying: “Much of the scientific literature, perhaps half, may simply be untrue. Science has taken a turn towards darkness.”
Attkisson: What if there were those who say you are too skeptical? That the pharmaceutical industry has best practices that it uses, that it has its financial stakes at interest, but it also has human interest … at its heart?
Angell: Well, I would say I have a bridge for you …