Media collection about conflicts of interest in systematic reviews of neuraminidase inhibitors

As usual, I’m keeping a record of major stories in the media related to a recently published paper. I will continue to update this post to reflect the media response to our article in the Annals of Internal Medicine.

When I checked last (1 May 2015), the Altmetric score was 112. Here’s the low-tech way to check that…

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Introducing evidence surveillance as a research stream

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.

Dealing with industry’s influence on clinical evidence

I co-wrote a piece for The Conversation about a new article that was published in the Cochrane Database of Systematic Reviews, written by Andreas Lundh and other luminaries from the research area. The authors showed that industry sponsored clinical trials more often report positive outcomes and fewer harmful side effects.

The most interesting result from the article was that the biases that make industry funded clinical trials more likely to produce positive results could not be accounted for  using the standard tools that measure bias. This is amazing because it gives us a strong hint that industry is an independent source of heterogeneity in the systematic reviews that include them.

Too bad it’s the 12th of the 12th 2012 and the world is about to end. We won’t have time to sort it out.

(Feature image from AAP Image/Joe Castro via The Conversation – click the link)