Doctors Are Concerned About Funding Bias in Medical Research

Concerns about funding bias in academic research are widespread, and a growing number of trusted health experts are sharing their concerns.

Dr. Marion Nestle has been keeping track of this issue in the nutrition field.

Last week, NPR highlighted this problem within the context of medical literature.

Highlights:

• “For many years, meta-analyses and systematic reviews seemed to solve a big problem. Doctors who had once relied on each other’s expert opinions to select the best treatments gradually turned to careful scientific studies instead.”

• “But the number of studies mushroomed and often came to different conclusions. So in the 1990s, doctors and medical advisory committees started relying on studies that combined results from many different research projects to streamline the search for answers.”

• “These kinds of studies are “extremely important,” says Dr. John Ioannidis, a professor of medicine health research and policy at Stanford University. He has conducted many of these types of studies over the course of his career. “They’re trying to make some sense out of a very convoluted scientific and medical literature.”

• “But Ioannidis says unfortunately things have gotten out of hand. First, “the problem is that there are just too many meta-analyses,” Ioannidis says. What’s worse, they’re increasingly being generated by scientists who have financial interests in the outcome, Ioannidis found.”

• “Ioannidis says the drug industry has started using meta-analysis for commercial purposes, rather than as a disinterested look at the evidence.”

• “They can get the results or at least the interpretation that fits their needs. So you have the most powerful and most prestigious design in current medical evidence, and it can be easily manipulated as an advertisement, as a marketing tool.”

• “Peter Kramer, a clinical professor emeritus at Brown University and author of Listening to Prozac, took a deep dive into meta-analyses when he was writing his latest book, Ordinarily Well. He found the situation even worse than Ioannidis suggests. “In some ways my doubts are stronger than his,” Kramer told NPR Shots.”

• “And the problems he found aren’t simply commercial conflicts of interest. For example, he saw biases among academics who were wedded to the notion that placebos are just as good as actual drugs for depression.”

• “The influence of funders is a concern, says Dr. Alfred Berg, a professor emeritus of family medicine at the University of Washington who chaired one of the committees. It’s reasonable to suggest that scientists with clear financial conflicts of interest should not be producing these studies. “Is it going to happen in my lifetime?” Berg says. “Probably not!”

• “Fortunately, scientific journals are starting to do a better job of making sure researchers disclose their financial interests. It’s up to readers now to take heed.”