A terrifically enlightening paper appeared in PloS Medicine showing how drug companies influence the outcomes of research they pay for, and, more importantly, how influential scientific and medical journals are complicit.
Fortunately from the point of view of the companies funding these trialsâ€”but unfortunately for the credibility of the journals who [sic] publish themâ€”these trials rarely produce results that are unfavourable to the companies’ products. Paula Rochon and others examined in 1994 all the trials funded by manufacturers of nonsteroidal anti-inflammatory drugs for arthritis that they could find. They found 56 trials, and not one of the published trials presented results that were unfavourable to the company that sponsored the trial. Every trial showed the company’s drug to be as good as or better than the comparison treatment.
By 2003 it was possible to do a systematic review of 30 studies comparing the outcomes of studies funded by the pharmaceutical industry with those of studies funded from other sources. Some 16 of the studies looked at clinical trials or meta-analyses, and 13 had outcomes favourable to the sponsoring companies. Overall, studies funded by a company were four times more likely to have results favourable to the company than studies funded from other sources. In the case of the five studies that looked at economic evaluations, the results were favourable to the sponsoring company in every case.
How do researchers get away with publishing only data that is favorable to the drug company paying for it? Are the results paid for, as in bribed? Not really, it’s all in how the research question is posed.
The companies seem to get the results they want not by fiddling the results, which would be far too crude and possibly detectable by peer review, but rather by asking the “right” questionsâ€”and there are many ways to do this. Some of the methods for achieving favourable results are listed in the Sidebar, but there are many ways to hugely increase the chance of producing favourable results, and there are many hired guns who will think up new ways and stay one jump ahead of peer reviewers.
The information printed in this article, which is open source and can be read in full online, is, I believe, fairly well know among academics, but never talked about. I’m surprised that it has been published at all.
Because this ability to influence outcomes of research projects and then get them published in prestigious journals, it pays to look at the bottom of the paper to see who paid for the research; if it happens to be the same company whose drug or other product is featured in the paper, the findings are best taken with a grain of salt.