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17. Februar 2011

Knowledge of ghostwriting and financial conflicts-of-interest reduces the perceived credibility of biomedical research

Die Offenlegung von Interessenkonflikten ist nicht nur theoretisch wichtig, sondern hat praktische Komsequenzen für die Verschreibungspraxis, denn sie trägt zur Skepsis bei. Das zeigt dieser kleine Versuch von Lacasse und Leo. Eine Schlussfolgerung der Autoren: "For industry [...] our results suggest that decreased disclosures are preferable" ist dann wohl auch eher als Warnung zu verstehen.

While the impact of conflicts-of-interest (COI) is of increasing concern in academic medicine, there is little research on the reaction of practicing clinicians to the disclosure of such conflicts. We developed two research vignettes presenting a fictional antidepressant medication study, one in which the principal investigator had no COI and another in which there were multiple COI disclosed. We confirmed the face validity of the COI vignette through consultation with experts. Hospital-based clinicians were randomly assigned to read one of these two vignettes and then administered a credibility scale.

Jeffrey R Lacasse, Jonathan Leo
Knowledge of ghostwriting and financial conflicts-of-interest reduces the perceived credibility of biomedical research
BMC Research Notes 2011, 4:27
www.biomedcentral.com/1756-0500/4/27

The Inverse Benefit Law: How Drug Marketing Undermines Patient Safety and Public Health

Der Artikel, dessen Schwerpunkt die Ursachen irrationaler Verschreibung ist, weist besonders auf die Rolle von Interessenkonflikten bei der Erstellung von Leitlinien und deren Folgen hin.

Recent highly publicized withdrawals of drugs from the market because of safety concerns raise the question of whether these events are random failures or part of a recurring pattern.
The inverse benefit law, inspired by Hart’s inverse care law, states that the ratio of benefits to harms among patients taking new drugs tends to vary inversely with how extensively the drugs are marketed. The law is manifested through 6 basic marketing strategies: reducing thresholds for diagnosing disease, relying on surrogate endpoints, exaggerating safety claims, exaggerating efficacy claims, creating new diseases, and encouraging unapproved uses.

Howard Brody, MD, PhD, and Donald W. Light, PhD
The Inverse Benefit Law: How Drug Marketing Undermines Patient Safety and Public Health
Am J Public Health 2011
http://ajph.aphapublications.org/cgi/content/abstract/101/3/399