{"id":4561,"date":"2010-12-17T12:30:30","date_gmt":"2010-12-17T17:30:30","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=4561"},"modified":"2010-12-17T18:32:07","modified_gmt":"2010-12-17T23:32:07","slug":"suspicious-minds","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2010\/12\/17\/suspicious-minds\/","title":{"rendered":"suspicious minds&#8230;"},"content":{"rendered":"\n<div align=\"justify\">I was pointed to this article because of it&#8217;s meta-analysis of logic, but even though it doesn&#8217;t have to do with my recent topics, the analytic process of the author deserves wide attention:                    <\/div>\n<blockquote>\n<div align=\"center\"><strong><a target=\"_blank\" href=\"http:\/\/hcrenewal.blogspot.com\/2010\/12\/why-i-shouldnt-read-non-systematic.html\">Why I Shouldn&#8217;t Read Non-Systematic Review Articles:<\/a><\/strong><br \/>                      <a href=\"http:\/\/hcrenewal.blogspot.com\/2010\/12\/why-i-shouldnt-read-non-systematic.html\" target=\"_blank\"><strong>Special Pleadings and Undercover Authors<\/strong><\/a><br \/>                      <strong>Healthcare Renewal<\/strong><br \/>                      by Dr. Roy Poses<br \/>                      12\/16\/2010<\/div>\n<\/blockquote>\n<div align=\"justify\">He begins with a review article in the <strong>American Journal of Cardiology<\/strong> [<a target=\"_blank\" href=\"http:\/\/www.ajconline.org\/article\/S0002-9149%2810%2901631-0\/abstract\"><strong>Beta-Blockers in Hypertension<\/strong><\/a>] that concludes:<\/div>\n<ul>\n<div align=\"justify\">&#8230; it is time for a reexamination of the clinical evidence for the use of &beta;  blockers in hypertension, recognizing that there are patients for whom &beta;  blockers, <strong><font color=\"#200020\">particularly those with vasodilatory actions<\/font><\/strong>, are an  appropriate treatment option.<\/div>\n<\/ul>\n<div align=\"justify\"><strong><font color=\"#990000\">I. SUSPICIOUS LITERATURE: Review Articles, Specific Treatment Recommendations<\/font><\/strong><\/div>\n<p align=\"justify\">Dr. Poses then looked at the logic of the article. First, it references studies that compare &beta;-blockers [often combined with diurectics] against other anti-hypertensives that raised questions of metabolic consequences with the &beta;-blockers. Then, it looks at studies comparing&nbsp; vasodilating &beta;-blockers [not included in the first group of studies] to placebo that do not report metabolic consequences. Ergo vasodilating &beta;-blockers are better[?]. Poses points out the logical fallacy &#8211; <a href=\"http:\/\/www.nizkor.org\/features\/fallacies\/special-pleading.html\" target=\"_blank\"><strong><font color=\"#200020\">Special Pleading<\/font><\/strong><\/a> [see <a href=\"http:\/\/www.nizkor.org\/features\/fallacies\/\" target=\"_blank\"><strong>Nizkor: Logical Fallacies<\/strong><\/a>].<\/p>\n<p align=\"justify\"><strong><font color=\"#990000\">II. SUSPICIOUS LOGIC: In this case, apples are compared to oranges &#8211; and the conclusion that oranges are better does not follow from the specific comparison<\/font><\/strong><\/p>\n<div>He then finds evidence of secret authorship &#8211; a ghost in the machine:<\/div>\n<ul>\n<div align=\"justify\">I would like to thank Tamalette Loh, <a href=\"http:\/\/www.proedcom.com\/WhoWeAre.aspx\" target=\"_blank\"><strong>ProEd Communications<\/strong><\/a>, Inc. [Beachwood, Ohio], for her editorial assistance and literature  validation in the preparation of this report.<\/div>\n<\/ul>\n<div><strong><font color=\"#990000\">III. SUSPICIOUS AUTHORSHIP: A ghost in the machine<\/font><\/strong><\/div>\n<p>             <\/p>\n<div>Poses then has to do some sleuthing. He find other articles touting the wonders of said vasodilating &beta;-blockers assisted by Tamalette Loh one of which connects her to <a href=\"http:\/\/amec.glp.net\/c\/document_library\/get_file?p_l_id=843157&#038;folderId=754745&#038;name=DLFE-19217.pdf\" target=\"_blank\"><strong>PHARMA<\/strong><\/a>:<\/div>\n<ul>\n<div align=\"justify\">Editorial assistance, specifically revisions to the final draft, was  provided by Tamalette Loh, PhD, at ProEd Communications, Inc.&reg;, whose  services were also funded by GlaxoSmithKline. Dr Loh&rsquo;s revisions were  reviewed and approved by Dr McGill.<\/div>\n<\/ul>\n<div>and <strong><a href=\"http:\/\/ajpblive.com\/media\/pdf\/Ergas_2-2.pdf\" target=\"_blank\">another article<\/a><\/strong> by Dr. Ram [author of the proband article, <a target=\"_blank\" href=\"http:\/\/www.ajconline.org\/article\/S0002-9149%2810%2901631-0\/abstract\"><strong>Beta-Blockers in Hypertension<\/strong><\/a>] that makes the same PHARMA connection:<\/div>\n<ul>\n<div align=\"justify\">Dr Ram is in the speakers&rsquo; bureau pool of Cogenix, ProCom, and Genesis,  which manage medical education programs for Bristol-Myers Squibb,  GlaxoSmithKline, and Novartis.<\/div>\n<\/ul>\n<div align=\"justify\"><strong><font color=\"#990000\">IV. SUSPICIOUS SPONSORSHIP: Money flows to the Author and the &quot;editorial assistant&quot; from some source with a vested interest<\/font><\/strong><\/div>\n<p>      <\/p>\n<div align=\"justify\"><strong><font color=\"#990000\">&quot;vested interest&quot;<\/font><\/strong> you ask? By this time, you&#8217;ve probably already figured out that <strong>GlaxoSmithKline<\/strong> makes <strong>Coreg<\/strong>, a vasodilating &beta;-blocker. Dr. Poses comments:<\/div>\n<blockquote>\n<div align=\"justify\">The series of articles above demonstrated a phenomenon I have not seen  explored before. All articles were written with some sort of assistance  from an employee of a MECC, perhaps partly funded&nbsp;by a company which  marketed a drug which was the subject of all the articles. The  assistance was openly acknowledged.&nbsp; The three articles had some  remarkable similarities not explained by an overlap among their listed  authors.&nbsp; This&nbsp;suggested that the ostensible editorial assistant they  had in common was substantively involved in the content of the papers,  that is, was truly an author. Her presence was not ghost-like. However,  the substance of her contribution may have been downplayed.&nbsp; So let&#8217;s  call her an &quot;undercover author&quot;&nbsp; [If someone has a better term, please  leave a comment to that effect]&#8230;<\/p>\n<p>       So the reasons I rarely read narrative review articles except to make teaching points about health care dysfunction are:<br \/>      &bull;They often are based on idiosyncratic, if not biased selections of data<br \/>      &bull;They may employ logical fallacies to make their points<br \/>      &bull;They may be written by people with conflicts of interest, that is,  with financial arrangements with companies seeking to market products,  particularly drugs and devices.<\/div>\n<\/blockquote>\n<p>     <sup><em><strong>Shortcut<\/strong>: Dr. Ram is listed as being paid $55,300.00 by GSK this year in <u><a href=\"http:\/\/projects.propublica.org\/docdollars\/\" target=\"_blank\"><strong>Propublica<\/strong><\/a><\/u>&#8216;s database. Dr. Poses comes up clean. No surprises there&#8230;<\/em><\/sup> <em> <\/em>   <\/p>\n<p align=\"justify\">Poses suggests that we just don&#8217;t read narrative reviews because they&#8217;re likely to be industry driven. Unfortunately, the &quot;we&quot; that his writings might reach isn&#8217;t the &quot;we&quot; that matters &#8211; those busy doctors conscientious enough to want to keep up but too busy to take the time to parse articles with this kind of thoroughness and\/or read the primary studies. Seems to me that a better approach would be to hound the Journals to stop publishing tainted literature like this. Tamalette Loh of <strong><a href=\"http:\/\/www.proedcom.com\/WhoWeAre.aspx\" target=\"_blank\"><strong>ProEd Communications<\/strong><\/a><\/strong> obviously specializes in anti-hypertensive drugs. Maybe her argument is even right, who knows? But she could publish under her own name in the GSK handouts &#8211; then we could evaluate her argument fairly.    <\/p>\n<div align=\"justify\">If it is true that review articles are generally this biased, ghost-written, then the legitimate Journals could simply reject them unless they&#8217;ve been vetted by a pro like Dr. Poses. That solution would get my vote&#8230;<\/div>\n<div align=\"justify\">\n<blockquote>\n<div align=\"justify\">My conclusions for health care professionals are: be very skeptical of  non-systematic review articles, look for evidence that they are parts of  stealth marketing campaigns, and do not assume all conflicts of  interest are disclosed and all authorship roles revealed.<\/p>\n<p> My conclusions for journal editors are: strictly demand more complete  disclosure of conflicts of interest, or&nbsp;risk losing the trust of your  readers. <\/p>\n<p> My conclusions in general:&nbsp;until we start to sweep away the pervasive  web of conflicts of interest that is draped over medicine and health  care, expect further discombobulation.&nbsp; <\/div>\n<\/blockquote>\n<\/div>\n<hr size=\"1\" \/>\n<div>I&#8217;ve been thinking about:<\/div>\n<ul>\n<div>So let&rsquo;s  call her an &quot;undercover author&quot;&nbsp; [If someone has a better term, please  leave a comment to that effect]&hellip;&nbsp; <\/div>\n<\/ul>\n<div>How about <strong><font color=\"#200020\">surrogate author<\/font><\/strong> who, like the surrogate mother carries the product of the pharmaceutical company&#8217;s egg and the listed author&#8217;s sperm, does all the work, and delivers the baby [for a fee]&#8230; <\/div>\n","protected":false},"excerpt":{"rendered":"<p>I was pointed to this article because of it&#8217;s meta-analysis of logic, but even though it doesn&#8217;t have to do with my recent topics, the analytic process of the author deserves wide attention: Why I Shouldn&#8217;t Read Non-Systematic Review Articles: Special Pleadings and Undercover Authors Healthcare Renewal by Dr. Roy Poses 12\/16\/2010 He begins with [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","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_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-4561","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/4561","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=4561"}],"version-history":[{"count":0,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/4561\/revisions"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=4561"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=4561"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=4561"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}