TOP MEDICAL JOURNAL ADMITS ETHICS BREACH

Some Drug Reviews Had Financial Support

The world's most influential medical journal has admitted to an
extraordinary betrayal of its own ethics, saying that nearly half of
the drug reviews published since 1997 were written by researchers with
undisclosed financial support from companies marketing the drugs.

The New England Journal of Medicine, in an unusual internal probe
published in today's edition, found that 19 out of about 40 drug
therapy reviews violated its famously tough conflict-of-interest
policy. The policy bars researchers with ties to pharmaceutical
companies from writing reviews or editorials about company products.

Journal editors conducted the audit in response to reports last fall
in the Los Angeles Times identifying eight drug therapy articles that
broke the journal's conflict-of-interest rules. In a terse letter,
the journal confirmed those findings and cited 11 additional articles
that violated the policy.

The authors of the 19 offending articles had disclosed their
drug-company support to journal editors, who disregarded their own
guidelines.

"We regret our failure to apply our policy correctly," said the letter
signed by editor in chief Dr. Marcia Angell, deputy editor Dr. Robert
Utiger, and the editor of the drug therapy reviews, Dr. Alastair J.J.
Wood.

"We were careless," Angell said. The editorial staff now has
"heightened vigilance" to the problem and has implemented new
disclosure policies to guard against it, she said.

The latest revelations will probably further embarrass the prestigious
188-year-old weekly, which has positioned itself as a leading voice in
medical ethics and even goaded other publications to adopt standards
as high as its own.

"They set up an admirable policy, and it's a pity they didn't follow
up on it," said Dr. Drummond Rennie, an editor at the Journal of the
American Medical Association who has written on ethical dilemmas in
publishing.

For a premier journal to err on a basic matter of editorial integrity
raises questions about the quality of medical data in lesser
publications. In fact, most medical journals would not consider the
violations identified by the New England Journal to be a problem.

The ethical breach also shows the deep inroads that commercial
sponsorship has made into academic research and publishing.

"It's symptomatic of where the money comes from nowadays to do
research in medicine," said Mildred Cho, a research scholar at the
Stanford University Center for Biomedical Ethics.

That poses a challenge to readers and editors alike because authors
with a drug company's financial support are more inclined to be
favorable toward its products than are authors lacking such support,
studies have shown.