{"id":43023,"date":"2014-01-11T17:29:44","date_gmt":"2014-01-11T22:29:44","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=43023"},"modified":"2014-01-12T21:22:29","modified_gmt":"2014-01-13T02:22:29","slug":"top-down-problem","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2014\/01\/11\/top-down-problem\/","title":{"rendered":"top down problem&#8230;"},"content":{"rendered":"\n<ul>\n<li><a href=\"http:\/\/www.huffingtonpost.com\/david-j-kupfer-md\/gaming-disorder_b_4480794.html\" target=\"_blank\">How the Official Psychiatric Guidebook Deals With the Internet<\/a><\/li>\n<li><a href=\"http:\/\/www.google.com\/url?sa=t&#038;rct=j&#038;q=&#038;esrc=s&#038;source=newssearch&#038;cd=2&#038;cad=rja&#038;ved=0CCsQqQIoADAB&#038;url=http%3A%2F%2Fwww.post-gazette.com%2Fnews%2Fhealth%2F2013%2F12%2F17%2FMysteries-of-the-Mind-Doctors-don-t-fully-understand-biology-of-depression&#038;ei=BHvRUqTaJIykkQe4_IHoCQ&#038;usg=AFQjCNEc6GBoDPQAVYpWbTpCt-3MBWURrQ&#038;sig2=xnbN87PbtUeABO96dJqqSA&#038;bvm=bv.59026428,d.eW0\" target=\"_blank\">Doctors don&#8217;t fully understand biology of depression<\/a><\/li>\n<li><a href=\"http:\/\/www.necn.com\/12\/21\/13\/Mind-Mysteries-Docs-seek-to-understand-d\/landing_scitech.html?&#038;apID=cabba81c99db42679470e9146b700154\" target=\"_blank\">Mind Mysteries: Docs seek to understand depression<\/a><\/li>\n<\/ul>\n<p align=\"justify\">When I <em>Google<\/em> David Kupfer under <em>News<\/em>, I find these three articles near the top, all from December. But I don&#8217;t find anything about this: <\/p>\n<blockquote>\n<div align=\"center\" class=\"big\"><a href=\"http:\/\/archpsyc.jamanetwork.com\/article.aspx?articleid=1780020\" target=\"_blank\">Failure to Report Financial Disclosure Information<\/a><\/div>\n<div align=\"center\" class=\"middle\">by <strong><font color=\"#200020\">Robert D. Gibbons, PhD, David J.Weiss, PhD, Paul A. Pilkonis, PhD, Ellen Frank, PhD, and  David J. Kupfer,MD.<\/font><\/strong><\/div>\n<div align=\"center\" class=\"middle\"><strong><font color=\"#990000\">JAMA Psychiatry<\/font><\/strong>. Published Online: November 20, 2013. doi:10.1001\/jamapsychiatry.2013.3888<\/div>\n<div align=\"center\" class=\"middle\">[<a href=\"http:\/\/archpsyc.jamanetwork.com\/article.aspx?articleid=1780020\" target=\"_blank\">full text on-line<\/a>] <\/div>\n<p>     <\/p>\n<div align=\"justify\">To the Editor: We apologize to the editors and  readers of JAMA Psychiatry for our failure to fully disclose our  financial interests in an article1 that reported a diagnostic tool, the  Computerized Adaptive Test for Depression [CAT-DI]. Following acceptance  of the paper, we disclosed that &ldquo;The CAT-DI will ultimately be made  available for routine administration, and its development as a  commercial product is under consideration.&rdquo; The company that owns the  rights to CAT-DI and several related tests is Psychiatric Assessments,  Inc [PAI], which uses the trade name of Adaptive Testing Technologies  [ATT] on a website describing these tests. Lead author Robert D.  Gibbons, PhD, is the president and founder of PAI,which was incorporated  in Delaware in late 2011, then registered to do business in Illinois in  January 2012. Dr Gibbons awarded &ldquo;founder&rsquo;s shares in PAI&rdquo; to us, yet  all 5 of us failed to report our financial interests in connection with  our article and again in a Reply to Letters to the Editor regarding the  article. Neither PAI nor ATT has released the CAT-DI test [or any other  test] for commercial or professional use, but our ownership interests  were relevant to the research article and Reply we submitted and should  have been disclosed to the editors. Our submitted disclosure lacked  transparency, and we regret our omission.<\/div>\n<\/blockquote>\n<div align=\"justify\">or this:<\/div>\n<blockquote>\n<div align=\"center\" class=\"big\"> <a href=\"http:\/\/hcrenewal.blogspot.com\/search?updated-max=2013-11-22T12:16:00-05:00&#038;max-results=20&#038;start=7&#038;by-date=false\" target=\"_blank\">WHEN IS DISCLOSURE NOT DISCLOSURE?<\/a> <\/div>\n<div align=\"center\" class=\"big\"><strong><font color=\"#200020\">Hint: When it is made by the Chairman of the DSM-5 Task Force.<\/font><\/strong><\/div>\n<div align=\"center\" class=\"big\"><strong><font color=\"#0066ff\">Healthcare Renewal<\/font><\/strong><\/div>\n<div align=\"center\" class=\"middle\">by Bernard Carroll<\/div>\n<div align=\"center\" class=\"small\">November 21, 2013<\/div>\n<div align=\"center\" class=\"middle\">[<a href=\"http:\/\/hcrenewal.blogspot.com\/search?updated-max=2013-11-22T12:16:00-05:00&#038;max-results=20&#038;start=7&#038;by-date=false\" target=\"_blank\">full text online<\/a>]<\/div>\n<p align=\"center\"><img loading=\"lazy\" decoding=\"async\" height=\"18\" width=\"66\" border=\"0\" src=\"http:\/\/1boringoldman.com\/images\/snip.gif\" \/><\/p>\n<p align=\"justify\"> As I am not a person who suffers fools or insults  gladly, their evasive response caused me to do some checking. I quickly  learned that the gang of five are shareholders in a private corporation.  Before their paper was accepted by JAMA Psychiatry, the corporation was  incorporated in Delaware and soon after registered to do business in  Illinois. Those facts were not disclosed in the original report or in  the published letter of Reply to me. These omissions were acknowledged  in the notice of Failure to Report that appeared on-line today.<\/p>\n<p align=\"justify\"> It gets worse. Other things that I learned &ndash; and  that I communicated to the journal &ndash; make it clear that the corporate  train had left the station in advance of the letter of Reply. For  instance, a professional operations and management executive [Mr. Yehuda  Cohen] had joined the corporation. He had established the corporate <a href=\"http:\/\/www.adaptivetestingtechnologies.com\/\">website<\/a>,  where he was featured as a principal, along with the gang of five. The  website also displayed a professionally crafted Privacy Policy, dated  ahead of the letter of Reply. This document identified what appears to  be a commercial business address for the corporation. The notice of  Failure to Disclose is silent on these facts.<\/p>\n<div align=\"center\"><img loading=\"lazy\" decoding=\"async\" height=\"18\" width=\"66\" border=\"0\" src=\"http:\/\/1boringoldman.com\/images\/snip.gif\" \/><\/div>\n<\/blockquote>\n<div align=\"justify\">I weighed in too:   <\/div>\n<ul>\n<li><a href=\"http:\/\/1boringoldman.com\/index.php\/2013\/11\/21\/41793\/\" target=\"_blank\">careful watching&hellip;      <\/a><\/li>\n<li><a href=\"http:\/\/1boringoldman.com\/index.php\/2013\/12\/29\/insider-trading\/\" target=\"_blank\">insider trading&hellip;<\/a> <\/li>\n<li><a href=\"http:\/\/1boringoldman.com\/index.php\/2014\/01\/03\/dsm-5-retrospective-i\/\" target=\"_blank\">DSM-5 retrospective I&hellip;<\/a> <\/li>\n<li><a href=\"http:\/\/1boringoldman.com\/index.php\/2014\/01\/03\/dsm-5-retrospective-ii\/\" target=\"_blank\">DSM-5 retrospective II&hellip;<\/a> <\/li>\n<li><a href=\"http:\/\/1boringoldman.com\/index.php\/2014\/01\/03\/dsm-5-retrospective-iii\/\" target=\"_blank\">DSM-5 retrospective III&hellip;<\/a><\/li>\n<li><a href=\"http:\/\/1boringoldman.com\/index.php\/2014\/01\/06\/royalty\/\" target=\"_blank\">royalty?&hellip;         <\/a><\/li>\n<\/ul>\n<div align=\"justify\">As did Dr. Phil Hickey on <em>Behaviorism and Mental Health<\/em> [<a href=\"http:\/\/www.behaviorismandmentalhealth.com\/2013\/12\/23\/dsm-5-dimensional-diagnoses-more-conflicts-of-interest\/\" target=\"_blank\">DSM-5 &ndash; Dimensional Diagnoses &ndash; More Conflicts of Interest?<\/a>]. But that&#8217;s about that. It has been all quiet since then. Back during the DSM-5 process, there was much to be said about the industry influence among the task force members, particularly after Cosgrove&#8217;s and Krimsky&#8217;s damning article in PLoS Medicine [see <a href=\"http:\/\/1boringoldman.com\/index.php\/2012\/03\/15\/must-be-crazy\/\" target=\"_blank\">must be crazy&hellip;<\/a>]. The incidence of COI was appalling, and the responses from the APA were too. The worst was this one [from<a target=\"_blank\" href=\"http:\/\/www.pharmalot.com\/2012\/03\/should-apa-purge-dsm-panels-with-pharma-ties\/\"><strong><font color=\"#004400\"> Pharmalot<\/font><\/strong>]<\/a>:<\/div>\n<blockquote>\n<div align=\"justify\">In a statement, APA Medical  Director and CEO James Scully says the DSM-5  development process &ldquo;is  the most open and transparent of any previous  edition of the DSM. &ldquo;We  wanted to include a wide variety of scientists  and researchers with a  range of expertise and viewpoints in the DSM-5  process. <strong><font color=\"#200020\">Excluding  everyone with direct or indirect funding from the  industry would  unreasonably limit the participation of leading mental  health experts  in the DSM-5 development process.<\/font><\/strong>&rdquo;<\/div>\n<\/blockquote>\n<div align=\"justify\">But this story about Dr. Kupfer beats those allegations by a mile. This story is about starting a commercial company to profiteer on the DSM-5 itself, the DSM-5 he was directing, on an aspect of the DSM-5 he was specifically promoting [see Dr. Costello&#8217;s resignation letter in <a target=\"_blank\" href=\"http:\/\/1boringoldman.com\/index.php\/2014\/01\/03\/dsm-5-retrospective-ii\/\">DSM-5 retrospective II&hellip;<\/a>], a COI <em>maximus<\/em> that was undeclared.<\/div>\n<div align=\"justify\">&nbsp;<\/div>\n<div align=\"justify\">I know why Dr. Kupfer hasn&#8217;t said anything about it &#8211; the same with the APA. I expect they&#8217;re hoping it passes by unnoticed. They&#8217;re likely counting on the <em><strong><font color=\"#200020\">anechoic effect<\/font><\/strong><\/em> Dr. Poses talks about on Healthcare Renewal [<a href=\"http:\/\/1boringoldman.com\/index.php\/2012\/02\/27\/more-on-echo-echo-echo-echo-echo-echo-echo\/\"><em>more on<\/em> <font color=\"#2f1401\">echo<\/font> echo <font color=\"#6d543d\">echo<\/font> <font color=\"#8c7461\">echo<\/font> <font color=\"#a99485\">echo<\/font> <font color=\"#c6b4a9\">echo<\/font> <font color=\"#d3d4cd\">echo&hellip;<\/font>      <\/a>      ] &#8211; a story with a short news cycle that then dies out with no echo. But I don&#8217;t know why no one else outside the APA has even mentioned it. Perhaps nobody sees it as particularly newsworthy, assuming that the DSM-5 Task Force was a flawed body and its members were all compromised anyway. No big surprise that the leader was too &#8211; something analogous to scandal fatigue. Just another piece of corruption in psychiatry. Ho hum, what else is new? That would be a sad testimonial, indeed.  <\/div>\n<p align=\"justify\">Personally, I think this story has a more ominous portend than that. First, the lead author on the papers is bio<font>&middot;<\/font>statistician Robert Gibbons who has spent a lot of time writing papers that recommend ignoring the black box warnings about possible suicidality on Neurontin, antidepressants in children, and most recently Chantix. The articles are based on special access to data provided by the drug companies but unavailable to anyone else. And in each case, Pfizer drugs have been involved. And each publication has been accompanied by a lot of publicity. A shaky track record. Second, Dr. Kupfer&#8217;s involvement in this commercial enterprise is a huge unacknowledged conflict of interest. Had it been acknowledged, I doubt very much that the articles would&#8217;ve been published at all. And had it been acknowledged on the DSM-5 site, it would&#8217;ve turned heads. Third, and perhaps most ominous is the product itself. These tests are designed to be &quot;quickies.&quot; The tests are designed to get to some index for anxiety and depression with as few questions as possible. This looks like something designed for primary care physicians&#8217; waiting rooms and could only lead to even more over<font>&middot;<\/font>medication than we have already. And finally, Dr. Carroll&#8217;s original criticisms about their validity of the test were not addressed [<a href=\"https:\/\/archpsyc.jamanetwork.com\/article.aspx?articleid=1707797&#038;resultClick=1\" target=\"_blank\">Not Ready for Prime Time<\/a>].<\/p>\n<div align=\"justify\">This story badly needs some legs&#8230;<\/div>\n","protected":false},"excerpt":{"rendered":"<p>How the Official Psychiatric Guidebook Deals With the Internet Doctors don&#8217;t fully understand biology of depression Mind Mysteries: Docs seek to understand depression When I Google David Kupfer under News, I find these three articles near the top, all from December. But I don&#8217;t find anything about this: Failure to Report Financial Disclosure Information by [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-43023","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/43023","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=43023"}],"version-history":[{"count":9,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/43023\/revisions"}],"predecessor-version":[{"id":43069,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/43023\/revisions\/43069"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=43023"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=43023"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=43023"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}