I’ve taken a little while to get this post done because I’ve been waiting for my recently-published article to go from online-first to being citeable with volume and page numbers.
Last year, I was asked to write an editorial on the topic of industry influence on clinical evidence for the Journal of Epidemiology & Community Health, presumably after I published a few articles on the topic in early 2012. It’s an area of evidence-based medicine that is very close to my heart, so I jumped at the offer.
It took quite a bit of time to find a way to set out the entire breadth of the evidence process – from the design of clinical trials all the way through to the uptake of synthesised evidence in practice. In the intervening period, I won an NHMRC grant to explore patterns of evidence and risks of bias in much more detail, and the theme of evidence surveillance as an entire stream of research started to emerge.
Together with Florence Bourgeois and Enrico Coiera, we reviewed nearly the whole process of evidence production, reporting and synthesis, identifying nearly all the ways in which large pharmaceutical companies can affect the direction of clinical evidence.
It’s a huge problem because industry influence can lead to the widespread use of unsafe and ineffective drugs, as well as the more subtle problems associated with ‘selling sickness’. Even if 90% of the drugs taken from development to manufacture and marketing are safe, useful and improve health around the world, there’s still that 10% that in hindsight should never have been approved in the first place.
My aim is to find them, and to do so faster than has been possible in the past. It’s what we’ve started to call evidence surveillance around here (thanks Guy Tsafnat), and that’s also what we proposed in the last section of the article.
Note: If you can’t access the full article via the JECH website, you can always have a look at the pre-print article available here on this website. It’s nearly exactly the same as the final version.
adam g. dunn 