Op-Ed
Tallahassee Democrat
(Tallahassee, FL)
New London Day
(New London,Connecticut)
Op-EdPublished in Tallahassee Democrat
Jul. 22, 2003
Published in New London Day
Jul. 31, 2003
Medical research: We get what they pay for
By Jessie C. GrumanWhen a health researcher submits a paper to the New England Journal of Medicine or any of a number of prestigious, peer-reviewed scientific journals, she may be asked to declare her "conflicts of interest" in the final publication.
In practice, this means identifying the source of funding and any financial arrangements that might be related to the research, warning readers of potential biases and allowing them to take the paper's conclusions with a grain of salt (or the standard two aspirin) if necessary. Scientists generally report at least a few federal grants when asked about their funding, but an increasing number of them also reel off a list of sponsors that looks like the NASDAQ ticker.
These public-private collaborations have been fruitful partnerships in many cases, but prominent implosions of trust from hazy tobacco research, the mass prescription of hormone replacement therapy and the disastrous overuse of Fen-phen have raised fears that formerly independent clinical researchers have become well-compensated cheerleaders for industry. Participants at a recent Washington conference on "conflicted science" repeatedly sounded this alarm, with many concluding that the only solution is complete separation of public and private funding.
But if a clinical researcher - the one who is trying to bring laboratory discoveries to a patient's bedside - wants to forsake the golden handcuffs of corporate money, then who would pay for that freedom?
Applied clinical research, along with systematic research reviews and studies of health outcomes, are funded at the barest minimum at the federal level. Because this investment is so low, the corporate world is likelier than ever to pay for the trials that might actually improve people's health. And there is a price to pay for that.
Clinical studies are exactly what corporations are interested in, since they represent the final leg in the research relay and have implications for a new treatment's success or failure and the company's potential bottom line. So their money — and its complications — fit neatly into the void left by public funding.
Although the case of tobacco company corruption of research is an extreme one, the power of corporate money to influence science can be seen clearly in its example. For instance, University of California, San Francisco researcher Lisa Bero has concluded that studies of the health effects of secondhand smoke are 90 times more likely to conclude that secondhand smoke does not pose a serious risk if the studies are funded by a tobacco company.
Cynics will be forgiven for their lack of surprise, but the astonishingly high number testifies to the myriad ways that clinical research can be manipulated. Interested parties can handpick study populations, design less rigorous studies, fund only "sure things" and repress findings that conflict with a desired conclusion. Publicly funded scientists can use the same tricks, of course, but they risk their reputations for less reward if shoddy work slips through a rigorous process of peer review, which does not even exist in all corporate-sponsored research.
Certainly, individuals and institutions should abide by ethical and professional standards in their work, no matter where their money comes from. But if we're serious about scientific objectivity, we ought to reshape the nation's research portfolio as we would our own financial portfolio - accept some risk with corporate high-fliers, but balance that risk with higher-grade government securities.
Jessie C.Gruman is a social psychologist and president of the Washington-based Center for the Advancement of Health, a nonprofit institute dedicated to translating research into practice and policy.
