Finance close to heart of drug research

MEDICAL researchers in Canada have found a strong association with authors' published positions on the safety of a specific drug and their financial relationships with pharmaceutical manufacturers.

A team of four researchers associated with the University of Toronto's faculty of medicine examined the positions of authors of 70 medical articles. Leading investigator Allan Detsky said the study provided an opportunity to study financial conflicts of interest as the pharmaceutical industry provides substantial support for research and medical education.

The articles, published between March 1995 and September 1996, assessed various brands of a heart medicine called calcium channel antagonists. Authors' positions were then classified as either supportive, neutral or critical. Financial questionnaires were then sent out to authors, with the purpose of learning more about their relationship with the different manufacturers of the drug.

The investigators found that 96 per cent of the supportive authors had financial relationships with the manufacturers of the calcium channel antagonists they had assessed, compared to 60 per cent of the neutral authors and 37 per cent of the critical authors. One hundred per cent of the supportive authors were found to have at least one relationship with a pharmaceutical company, as opposed to 67 per cent of neutral authors and 43 per cent of those who were critical.

"Physicians and researchers simply need to disclose their financial relationships," said Professor Detsky, who teaches in Toronto's departments of health administration and medicine, and is physician-in-chief at Mount Sinai Hospital. "Editors of journals need to be more specific in their determination of any potential bias when requesting editorial material."

This potential bias in medical writing is not being ignored by medical journal editors. John Hoey, editor of the Canadian Medical Association Journal, believes the Toronto study produced some unsettling findings. His journal was aware of potential conflicts of interest before the study came out and, since January of last year, has required authors of scientific papers and editorials that mention a drug or device to complete a form similar to the one used in the study.

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