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Healthy Skepticism International News

November 2008

Just an academic bun fight? Or something more?

By Rebecca Warburton and Don Light

Herein lies a tale of an academic bun fight of almost mythic proportions. We think this is one of the better-documented cases of how editors of academic journals should not treat authors.

It started when some authors associated with a research center funded by drug companies wrote (in the Journal of Health Economics, hereafter JHE) the latest in a string of articles saying how expensive it was to develop new drugs. This and earlier papers are widely cited by the industry, when explaining why high prices and long patent protection produce ‘tomorrow’s miracles’.

We wrote a comment on that paper for JHE, explaining our reasons for being skeptical of the conclusions. Key to our skepticism was the use of proprietary (secret) data to produce the paper, and the industry funding of the center, which had not been disclosed in JHE. We had other points as well.

We had an incredible experience attempting to get this critique published, and felt bruised and battered during, and after.

Brief synopsis:

All of our attempts to put the issue of industry funding before JHE readers were suppressed by the three Harvard professors who were editing JHE. We were immediately struck by the style of editing – unilateral deletions or censoring of passages about industry influence, even though basic economics would hold that he who pays the piper calls the tune. Explanations given were minimal and final, what might be called “ultimatum editing.” The editors claims the deleted passages were “personal attacks” on the authors, but readers can decide for themselves because we have documented what they cut.

Our critique was cut ruthlessly. Meanwhile the original authors were shown our paper without our being told about it, and allowed lots more time and length to reply. We were then given little time to respond and told we could not comment on the new material they were allowed to add, or their personal insults about ourselves, only any “errors” we found. In short, the editors exhibited double standards at every point.

Again, further deletions were made and we were told to take them or not get published. The editors then sent the set (our critique, authors’ reply, our response) to Elsevier for editing and setting in page proofs for printing in the next issue. Then the editors pulled the entire set from production altogether with no explanation. After weeks of silence, they sent back the page proofs with more than 80% of our response crossed out and said this was all they would publish. We found a trial lawyer who said he would take the case to court and pay for all expenses himself because of its ethical importance. Under threat, the editors relented, and finally the papers appeared in JHE. But, surprise, the editors secretly went back to the authors and allowed them to write a fourth, acerbic piece as the last word.

So we wrote up our experience, describing exactly what the three JHE editors had done. In the age of email, it is well-documented.

We were able to get our description of what happened accepted by the Harvard Health Policy Review, a journal run by Harvard students, and then the [expletive deleted] hit the fan. Unbeknownst to us, two of the three editors we’d dealt with were actually on the HHPR’s Board!

The Harvard Crimson (Harvard’s student newspaper) wrote an article about ours, and then another about the controversy. We sent our article and related materials to managers of various web sites and journalists. Several international and national web sites made postings, including an excellent synopsis by the noted medical editor, Richard Smith, who played a central role in establishing international standards for editors and is a fearless champion of unbiased research and elimination of commercial interests. Available at http://blogs.bmj.com/bmj/2008/10/21/richard-smith-a-ripping-yarn-of-editorial-misconduct/

The student journal temporarily pulled the entire issue off the web. Other sites picked up our article. Word began to spread…and the journal put the issue back up with a comment.

To see the piece that caused the fuss, go to http://www.hhpr.org/ - click “current issue” and it’s second under “In Focus: Healthcare Reforms”. Or search “ethical” to find it.

Next read an article about all this in the Crimson http://www.thecrimson.com/article.aspx?ref=524767. One of the three Harvard editors told The Scientist that they only removed from our JHE piece “personal attacks” on the first set of authors and called our detailed account of their actions “bullshit.” (see http://www.the-scientist.com/news/display/55101/)

We have written a short piece with the passages that the editors deleted (“Were the Harvard editors fair? Judge for yourself”), to allow readers to decide whether we made personal attacks in our JHE pieces as submitted or sound and relevant points. Download it here to see what was deleted: http://www.thejabberwock.org/blog/pdf/light001.pdf

The JHE article we criticized, our original critique, and all relevant documents can be found at
http://iheaweek.com/2005/iheaweek-2005-no-017-august-31.html (search for “warburton”)

Outside commentary:

These three sites were first to break the news, as far as we can tell:
http://pharmagossip.blogspot.com/2008/10/harvard-health-policy-review-case-of.html
http://ahrp.blogspot.com/2008/10/to-editors-of-journal-of-health.html
http://www.pharmalot.com/2008/10/the-case-of-the-disappearing-journal-article/

Merrill Goozner, author of The $800 Million Pill and a professional watchdog who champions fairness and accuracy wrote two authoritative columns:
http://www.gooznews.com/archives/001223.html
http://www.gooznews.com/archives/001225.html

Vera Hassner Sharav wrote a column, found at
http://ahrp.blogspot.com/2008/10/to-editors-of-journal-of-health.html

After this it becomes harder to determine the order, but there are many sites talking about the case.

Here’s a site with links to many others, including our “Decide for yourself” piece:
http://www.theoneclickgroup.co.uk/news.php?start=2460&end=2480&view=yes&id=3031#newspost

also:
http://brodyhooked.blogspot.com/
http://www.researchethics.ca/blog/2008/10/commercial-influence-on-research-on.html
http://sprint.usatoday.mlogic3g.com/detail.jsp?key=917903
http://www.theoneclickgroup.co.uk/news.php?start=2460&end=2480&view=yes&id=3031#newspost

Less accurate but fiery:
http://alison-bass.blogspot.com/2008/10/exposing-drug-industrys-bogus-800.html

And if you still have time to spare, this page links to the JHE article we criticized, our critique, etc. (search for “warburton”) http://iheaweek.com/2005/iheaweek-2005-no-017-august-31.html

The story is still evolving. To keep up, google these terms together and you hit a home run (kudos to Google): warburton light jhe

 

 

HS Int News index

Page views since 15 March 2010: 5848

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909