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Commentary

Mere Magazines
Thomas P. Stossel, M.D., Wall Street Journal, 12-30-05

Stossel, a physician, complains that medical journals have been quick to disparage research by pharmaceutical companies while exaggerating their own importance in conveying medical information.

Recently I was working in a Zambian orphanage when a young woman with worsening shortness of breath and chest pain asked me for help. Armed only with a stethoscope, I could do nothing other than diagnose a probable lethal tuberculous infection of the heart. Without devices and drugs developed by companies, doctors are not very useful.

It was therefore discouraging to return to my Boston-based medical center and witness leading medical journals sanctimoniously demonizing not only the technologies developed by drug companies but also the companies themselves. The Journal of the American Medical Association has declared industry-sponsored research categorically untrustworthy, and, to publish it, demands that an academic researcher be an author and take responsibility for its integrity, and also that an independent academic statistician analyze its data.

The message in all this is clear: Medical academics are saints—devoted selflessly to patient care—and corporate people are sinners, morally blinded by greed. But having worked in academic medicine for over 35 years and consulted for companies, this Manichean duality is inconsistent with my experience and a woeful distortion of reality.

And no description of medical research in a medical journal comes close to the detail level or intense scrutiny imposed by the FDA on companies' documentation of drug or device development before approval. Space constraints for readability and cost-savings preclude journals from publishing detailed information on the order of what companies file with the FDA, and unpaid journal peer reviewers, not to mention practicing doctors, would never read it anyway. The recent Korean cloning fiasco, in which the leading science journals published blatantly fraudulent papers, wasn't the first such incident to afflict prestige journals, and it could never happen under conditions of FDA review. Indeed, doctors should take all studies published in "prominent medical journals" with "skeptical caution."

Stossel points out the irony that companies face enormous regulatory scrutiny, not just the peer review that medical journals use to screen articles. They also face potentially harsh legal sanctions if they knowingly distort product data. All-in-all, this makes company-bashing particularly unseemly, especially from journals that pretend to be objective purveyors of information.



Project FDA.
  
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