BMJ Admits Competing Commercial Interests in Wakefield Attacks Warranted Disclosure
BMJ editor admits that they should have disclosed competing commercial interests in Wakefield attack
By John Stone
British Medical Journal’s editor has been forced into an embarrassing admission that the journal should have disclosed connections with MMR manufacturers Merck and GSK when publishing attacks on the integrity of Andrew Wakefield in January (HERE). Godlee’s admission came eight days after my letter to the journal was submitted, and three days after the publication of my article on Age of Autism (HERE). My letter was occasioned by an article in Age of Autism by Martin J Walker (HERE ) subsequently also published in Vera Sharav’s AHRP newsletter (HERE). I had been responding to an article highlighting the issue of free access journals and advertising: BMJ apparently did not think this applied to them.
Godlee’s admission, “We did not declare these competing interests because it did not occur to us to do so”, underlines the complacence, and even arrogance, of large journals that think they are above having interests. Nor will her defence carry much water amid the hotly disputed claims of Brian Deer’s articles that the issue was fraud so who manufactured the products did not matter. BMJ in a breach of the basic traditions of peer review journals have been unwilling to allow their and Deer’s allegations to be discussed directly in its columns, many letters to the journal have been blocked, Deer has never been required to respond to criticisms, and the defence of their position has been crudely legalistic (HERE ).
Godlee was also reduced to make a technical defence of the journal decision to publish the Deer articles in Age of Autism (HERE) and BMJ Rapid Responses (HERE).
However, Godlee’s admission represents a major blow against scientific journals, however large, not declaring their commercial interests: the excuse “it did not occur to us” will scarcely wash again.
This is the latest episode in a long running series of battles between Age of Autism and the journal. In February 2010 BMJ were forced to admit that Prof Trisha Greenhalgh had not only contributed to Brian Deer’s website, but had also received £1.4m in Department of Health research grants since 2003 (HERE, HERE ). In March 2010 Age of Autism highlighted the removal by BMJ of a series of letters questioning how Brian Deer obtained confidential material about Royal Free patients and MMR litigants, while in May 2010 the journal refused to acknowledge that Brian Deer was the undisclosed complainant to the GMC against Wakefield and colleagues (HERE), which has been covered by tortuous language in the latest publications, though never acknowledged in the Sunday Times. Age of Autism has also focussed on the role of Harvey Marcovitch who doubles as a BMJ associate editor, co-authoring editorials against Wakefield, and chairman of panels at the GMC (HERE ).
http://www.theamericanscholar.org/flacking-for-big-pharma/
Flacking for Big Pharma
"Medical journals are utterly dependent upon pharmaceutical advertising, which can provide between 97 and 99 percent of their advertising revenue. By 2005, some major journals, including Consultant, Geriatrics, and American Family Physician, carried more advertising than editorial pages and glossy, full-color inserts that were longer than the journal’s longest article. This explains why medical journals themselves advertise to drugmakers, flooding the pages of pharmaceutical-industry publications such as Medical Marketing and Media to vie for the attentions of Big Pharma. The Journal of the American Medical Association (JAMA) bills itself in advertising as 'a priceless audience at a price you can afford,' while the Annals boasts: 'With an audience of more than 90,000 internists (93 percent of whom are actively practicing physicians), Annals has always been a smart buy.'
Moreover, drugmakers sometimes agree to buy journal advertising only if it is accompanied by favorable editorial mentions of their products. Or their in-house stables of writers or hired pens generate 'advertorials,' a Frankensteinian mix of medical content and marketing messages that can be indistinguishable from editorial material. 'Pharmaceutical firms also inform journals,' Smith observes, 'that they are receptive to buying huge volumes of reprints that favor their wares: The profits for the journal can easily reach $100,000.'"
Posted by: Carol | June 04, 2011 at 09:02 AM
Carol & Jenny
Th most misleading and treacherous thing is the empty piety of people who are very much on the wrong side of the fence. Godlee was, of course, cornered and embarrassed, but even then she did not act effectively to rectify BMJ's omissions.
1) The notice that she put up acknowledges the support of Merck and GSK in BMJ awards, but still doesn't acknowledge that BMJ are in business partnership with Merck through Univadis, the original basis of the complaint.
2) It still took weeks of pressure to make BMJ put links on-line on the relevant editorials to the limited correction, and they are still not on Deer's articles, so most people reading them will be none the wiser.
3) Unlike the original articles the correction was not the subject of global press release.
John
Posted by: John Stone | May 15, 2011 at 05:42 AM
Carol reported:-
“It has been said that journals are the marking arm of the pharma industry and that is not untrue; to a large extent that is true,” Godlee told the Science and Technology Select Committee. Godlee called for more efforts towards transparency in medical publishing, especially around centralised systems for declaring conflicts of interest and making explicitly clear when industry funding has been involved."
OMG- The NERVE of that woman!! How DARE she request 'more efforts towards transparency in medical publishing', when she herself is up to her pretty neck in publishing Brian Deer's slanderous lies in those 'Secrets of the MMR scare' BMJ articles.
Furthermore, Deer's first article, 'How the case against the MMR vaccine was fixed', 5-01-11, was stated by Godlee to have been properly 'peer reviewed'. The accompanying editorial,'Wakefield's article linking MMR vaccine and autism was fraudulent', (Godlee, Marcovitch and Smith), effectively stated that all of Deer's spurious allegations against Wakefield et al were FACTS!!
Even worse, Godlee FAILED to declare BMJ funding by MMR manufactuers Merck and GSK, at the conclusion of these articles although it IS admitted that Deer was COMMISSIONED to write them by the BMJ!!(After pressure from AoA etc, she was forced to publicly admit this pharma funding).
I think we can take SOME comfort from Godlee being forced to explain herself before a UK Government Committee. This seems to suggest unrest within Government circles about, previously 'respected' medical journals being used as 'mouthpeices' for the pharma industry.
I suggest those of us who live in the UK should write to the Science and Technology Select Committee expressing our disgust with the BMJ and Godlee in particular!!
Posted by: Jenny Allan | May 15, 2011 at 02:41 AM
http://blogs.nature.com/news/2011/05/medical_journals_are_the_marke_1.html
May 11, 2011
A leading medical editor has warned that journals are rightly seen as the marketing arm of the pharmaceutical industry and they must go further to be open about where their money comes from.
Fiona Godlee, editor in chief of the BMJ group, told a select committee of the UK Parliament that “We have to acknowledge that the publishing industry has a number of different revenue streams, one of which is the pharmaceutical industry.”
Speaking before a committee hearing into peer review, Godlee was asked about the practice of many publishers producing sponsored publications – where companies can pay for special publications covering certain diseases or topics.
Such publications could be confusing to readers and it was not always clear what industry involvement was, she noted. And even traditional fully peer-reviewed medical journals should not be viewed as pure.
“It has been said that journals are the marking arm of the pharma industry and that is not untrue; to a large extent that is true,” Godlee told the Science and Technology Select Committee.
Godlee called for more efforts towards transparency in medical publishing, especially around centralised systems for declaring conflicts of interest and making explicitly clear when industry funding has been involved."
Posted by: Carol | May 14, 2011 at 07:53 PM
Re: “We did not declare these competing interests because it did not occur to us to do so" The BMJ did not declare this because that is how it's always done, competing interests and conflict of interest is an everyday part of medical journals.
Hi John, Although you are on the other side of the ocean it seems like you are right here with us. Apparently the British Medical Journal has the same corrupt track record as JAMA and the other medical journals in the USA. Anything published in medical journals has a high risk of medical fraud, especially when the journal is publishing so called "clinical studies" which support the FDA approval and sales of pharmaceutical drugs. Here are a few articles from my files with a few quotes, which really show that both American and British medical journals are engaging in fraud.
The truth about medical journals, and how drug companies exert heavy influence over published scientific articles
http://www.naturalnews.com/012119.html
Can the medical journals be trusted to provide accurate, unbiased information about medicine even as they are almost entirely funded by drug companies? In her book, Vaccination, Peggy O'Mara writes that the current era of medical beliefs (or dogma) began to develop soon after Louis Pasteur's demonstration that some pathogens could be converted into vaccines. The medical community then decided to try the same method for all afflictions. Medical journals were soon afterward reporting the discovery of "miracle" vaccines for every disease under the sun, and drug companies were simultaneously advertising those vaccines on those very same pages.
Scientific medical journals like JAMA fail basic credibility standards; medical journals become increasingly irrelevant
http://www.naturalnews.com/001890.html
Here's how the con works: the study author receives cash from these pharmaceutical companies, gets his study published in a prestigious scientific journal, and then the drug companies can state that they are basing the marketing of their product on published, peer-reviewed scientific facts. The hidden fact in all of this, of course, is that the author of the study is on the payroll of these companies and didn't even bother to disclose that relationship to the journal. It's good old fashioned corruption... but with the stamp of approval from so-called "modern science."
Big Pharma researcher admits to faking dozens of research studies for Pfizer, Merck
http://www.naturalnews.com/028194_Scott_Reuben_research_fraud.html
Business as usual in Big Pharma
What's notable about this story is not the fact that a medical researcher faked clinical trials for the pharmaceutical industry. It's not the fact that so-called "scientific" medical journals published his fabricated studies. It's not even the fact that the drug companies paid this quack close to half a million dollars while he kept on pumping out fabricated research. The real story here is that this is business as usual in the pharmaceutical industry.
Dr. Reuben's actions really aren't that extraordinary. Drug companies bribe researchers and doctors as a routine matter. Medical journals routinely publish false, fraudulent studies. FDA panel members regularly rely on falsified research in making their drug approval decisions, and the mainstream media regularly quotes falsified research in reporting the news.
Fraudulent research, in other words, is widespread in modern medicine. The pharmaceutical industry couldn't operate without it, actually. It is falsified research that gives the industry its best marketing claims and strongest FDA approvals. Quacks like Dr Scott Reuben are an important part of the pharmaceutical profit machine because without falsified research, bribery and corruption, the industry would have very little research at all.
Posted by: AutismGrandma | March 13, 2011 at 05:37 PM
From Trisha Greenhalgh's critical appraisal of the Wakefield et al Lancet Article 1998:-
(url in cybertiger's post above)
"The alleged link with MMR vaccine was made on the basis of retrospective parental recall – in other words, parents (who had just signed a consent form to take part in a study of whether there is a link between MMR and autism) were asked to consider how closely in time the vaccine was with the onset of autism-like behaviour pattern in their child."
The following is from The Royal Free Hospital's standard consent form, issued to ALL parents of children (including the Lancet 12) who were about to undero DIAGNOSTIC colonoscopies:-
" Your child has been referred for diagnostic colonoscopy and/or endoscopy. Several small pieces of tissue (biopsies) are taken during the procedure for diagnostic purposes. Clinic inflammatory bowel diseases are still little understood and their cause is unknown. It is therefore of great value for laboratory research to have such biopsies available to study how inflammation in the bowel develops and is influenced by treatment. Your permission is asked to agree for two extra biopsies to be taken for these purposes.
Whether or not you agree to this will in no way influence your assessment or treatment."
(My daughter agreed to this and signed the form; the date was 14-03-99, AFTER the Lancet article. )
The form is headed with the names:- Professor Walker-Smith (Head of Dept), Dr Simon Murch and Dr Alan Phillips (Sen Lecturers) and Dr Mike Thomson (consultant)
Dr Wakefield's name DOES NOT APPEAR on this form.
BOTH Brian Deer and Dr Greenhalgh are making out that these parents were consenting to their children undergoing colonoscopies for purely research purposes. In fact these tests were for DIAGNOSTIC purposes only. The two additional biopsies consented to WERE sent to the research scientists, but this form makes it very clear that parents could refuse permission for the EXTRA biopsies without in any way prejudicing the treatment received for their child.
Note the date of consent, almost a year after the Lancet article 1998. This consent form DOES NOT MENTION MMR OR EVEN THE NATURE OF THE RESEARCH. Indeed it states that the causes of bowel disease in these children are still unknown!!
Posted by: Jenny Allan | March 13, 2011 at 11:06 AM
John Fryer
With regard to the Professor Greenhalgh idiocies, Andrew Wakefield deals with these on pages 12&13 of his book 'Callous Disregard', in Chapter One, entitled 'That Paper'. The link to the fatally conflicted Greenhalgh folly is No. 5 in the chapter endnotes: 'Greenhalgh T: a critical appraisal of the Wakefield et al paper',
http://briandeer.com/mmr/lancet-greenhalgh.htm
I hope that helps.
PS. Who do you imagine plays the role of 'Biggus Dickus' the Roman Centurion, in the real 'Life of Brian'?
Posted by: Cybertiger | March 13, 2011 at 09:49 AM
John
Thanks for all the interesting comments. I should clarify that Greenhalgh contributed an article about the 'Lancet paper' to Deer's website. I know that at least latterly he has accepted financial donations but obviously have no details. Apologies for the confusion.
John
Posted by: John Stone | March 13, 2011 at 06:07 AM
Thanks John for your meticulous work.
I am interested in the Greenhalgh link.
Is there any way of finding how much money she contributed to Brian?
Also on the matter of MMR can we work on the rubella aspect of this mix of live viruses.
Only starting to look at the issue of BMJ - Andrew Wakefield and The Life of Brian since January but the possibility of rubella live vaccine transfer from baby to another soon to be pregnant mother etc etc does not bear thinking about.
Is there any work on the link of rubella from vaccine inappropriate use at 12 months and autism thereafter?
I predict that saturation has already been reached so the rise in autism must surely halt now?
Posted by: John Fryer Chemist | March 13, 2011 at 05:50 AM
“We did not declare these competing interests because it did not occur to us to do so”. Godlee must walk the plank for this.
Posted by: Cybertiger | March 13, 2011 at 05:17 AM
"It did not occur to us to do so."
HAHAHAHAHAHAHAhahahahahahahahah.....riiiiiight.
Pst. Mirrors are 99p.
Thanks John. History has a funny way of defining itself. Keep up the great work.
STOP AUTISM NOW
Posted by: STOP AUTISM NOW | March 12, 2011 at 10:37 PM
"It did not occur to us to do so." What a lordly attitude.
Thanks once more, John, for holding the corrupt accountable.
Posted by: nhokkanen | March 12, 2011 at 09:43 PM
Thanks so much, John. Perhaps the BMJ isn't "too big to fail" after all.
Posted by: Zed | March 12, 2011 at 09:40 PM
Excellent stuff John.......but we must ALL keep up the pressure on the BMJ. If Godlee ignores all your letters and e-mails, then make a formal complaint via the BMJ's own complaints procedure below:-
http://resources.bmj.com/bmj/about-bmj/bmj-complaints-procedure
"Complaints procedure
This procedure applies to complaints about the policies, procedures, or actions of the BMJ’s editorial staff. We welcome complaints as they provide an opportunity and a spur for improvement, and we aim to respond quickly, courteously, and constructively. The procedure outlined below aims to be fair to those making complaints and those complained about.
Definition
Our definition of a complaint is as follows:
*The complainant defines his or her expression of unhappiness as a complaint
*We infer that the complainant is not simply disagreeing with a decision we have made or something we have published (which happens every day) but thinks that there has been a failure of process—for example, a long delay or a rude response—or a severe misjudgment
*The complaint must be about something that is within the responsibility of BMJ editorial department – content or process
How to make a complaint
Complaints may be made by phone, email, or letter, ideally to the person the complainant is already in contact with over the matter being complained about. If that is not appropriate please email: [email protected]
Whenever possible complaints will be dealt with by the person to whom they are made. If that person cannot deal with the complaint he or she will refer it to a section editor or the deputy editor responsible for complaints.
Complaints that are not under the control of BMJ editorial staff will be sent to the relevant heads of department.
Complaints about editorial matters that are sent to the chairman of the BMJ Publishing Group Board, to the chief executive of the BMJ Publishing Group, or to BMA officers and officials will usually be referred in the first instance to the Editor (and invariably if they relate to editorial content, for which the editor is wholly responsible).
All complaints will be acknowledged (immediately on the phone, within three working days if by email or post).
If possible a definitive response will be made within two weeks. If this is not possible an interim response will be given within two weeks. Interim responses will be provided until the complaint is finally resolved.
If the complainant is not happy with the initial response he or she can ask for the complaint to be escalated to the individual’s manager or to the deputy editor (complaints).
If the complainant remains unhappy, complaints should be escalated to the editor, whose decision is final."
You will note that this system ACTUALLY ends up back with the editor-whose decision is 'final'. In other words, they are policing themselves!! If Godlee continues to 'stonewall' then, after the two week period for 'responding' has been exceeded, I suggest taking the complaint to the press commission and the The Committee on Publication Ethics, COPE,(details below). I would also SEND a hard copy to the Chairman of the BMJ Group Board, since I strongly suspect Godlee et all are not properly informing them about all these complaints and e-mails. There would be no harm in copying complaints to friendly press and media outlets (NOT Murdoch owned!)
YES!! As both John Stone and Martin Walker pointed out previously, these two supposed press and publications 'watchdogs' are actually part of the 'nice cosy relationship' which the press has with political and commercial interests!! The following is extracted from a reply I received following a previous complaint to the Press Complaints Commission about a Sunday Times article:-
"Please Find enclosed a copy of our How to Complain booklet, which sets out how the Press Complaints Commission deals with complaints we hope you find it helpful. I also enclose, for ease of reference, a copy of the newspaper and magazine publishing industry’s Code of Practice, which you may already have seen.
I should emphasise that the PCC will normally only consider complaints from people who are directly affected by the matters about which they are concerned. Indeed, only in exceptional circumstances will the Commission consider a complaint from someone not directly involved. For the PCC to take this matter forward we would generally require a complaint from Dr Wakefield."
Dr Godlee's collective responses made to Age of Autism and the BMJ Rapid responses,show just how worried she is about her part in publishing the three recent highly questionable and slanderous Deer articles. She will be hoping, fervently, that this will all die down over time and will be forgotten, but it was the BMJ, via Deer who MUST take responsibility for re-igniting the MMR/Wakefield issue, via the three recent COMMISSIONED BMJ Deer articles, one of which is now only available to paid subscribers.
Appendix 1: External bodies
If the complainant has exhausted the internal processes and is still unhappy he or she can complain to one of the following bodies.
The Press Complaints Commission
“The Press Complaints Commission is an independent body which deals with complaints from members of the public about the editorial content of newspapers and magazines.” http://www.pcc.org.uk/
The Committee on Publication Ethics
COPE publishes a code of practice for editors of scientific, technical, and medical journals http://www.publicationethics.org.uk/
It will consider complaints against editors but only once a journal’s own complaints procedures have been exhausted.
Posted by: Jenny Allan | March 12, 2011 at 07:36 PM
Very well done John.
Posted by: Theresa Cedillo | March 12, 2011 at 07:30 PM
More sickening evidence that science is for sale. Anyone interested in a free bumper sticker supporting Dr. Wakefield please email [email protected].
Posted by: Mfischer | March 12, 2011 at 06:37 PM
Well done John ,must be just the tea ladies at the BMJ who haven`t got a conflict ..
Angus Files
Posted by: Angus Files | March 12, 2011 at 04:56 PM
This 2009 research paper is interesting to read, also by V. K. Singh whom I quoted in an earlier post:
".... we performed serologic studies of antibodies to vaccines. We selected 4 vaccines: measles-mumps-rubella (MMR), diphtheria-tetanus-pertussis (DPT), diphtheria-tetanus (DT), and hepatitis B (Hep B).
The laboratory testing revealed that the autistic children had a hyperimmune reaction to MMR vaccine but not to the other 3 vaccines that we investigated (TABLE 3). Extensive characterization by immunoblotting technique showed that the MMR antibodies were specifically directed toward the measles subunit of the MMR vaccine but not against the rubella or mumps subunits.22-24 Furthermore, the immunochemical characterization showed that the immune response (MMR antibodies) was directed toward a 78,000 molecular weight protein of the measles subunit.22 This protein closely resembled the hemagglutinin (HA) antigen, which suggests that the inappropriate immune response in autistic children is most likely directed toward the HA protein of measles virus rather than the nucleoprotein (N) or matrix (M) protein....Collectively, these findings suggested an etiologic link between the MMR vaccine and autoimmunity in autism. As far as we know, this is the first study of its kind to examine associations between a viral factor (virus serology) and an autoimmune factor (brain autoantibodies) in a medical condition (autism/ASD) in which autoimmunity appears to be the core of the problem. Evidently, our study might also represent a novel mechanism by which the so-called autistic regression post-MMR vaccination might be explained in at least some children with ASD."
http://www.jfponline.com/Pages.asp?AID=7937
Posted by: Carol | March 12, 2011 at 03:55 PM
Lets also remember that Merck and GSK were the defendants in the MMR litigation. It is in their own interests to see that Wakefield is derided and that the children do not get a fair hearing as was said when the litigation was wound down "the merits of the case were not tested in court". We are talking about children who have suffered serious health problems that are not getting any better because no-one wants to get into trouble doing any research. We all know what happens to doctors who have tried to care.
Posted by: Martin Hewitt | March 12, 2011 at 03:25 PM
Well done John for your persistent follow through of this issue. It is an excellent achievement to get such a comment in public from Fiona Godlee.
And I did so appreciate your 'Competing interests: None declared' at the end of your last response in the BMJ. What's sauce for the goose...!!
Posted by: Seonaid | March 12, 2011 at 03:19 PM
Eric,
Thanks. Should be £1.4 million - now corrected.
JohnS
Posted by: John Stone | March 12, 2011 at 03:11 PM
Please do correct the amount Prof Trisha Greenhalgh received in Department of Health research grants--right now it reads "£1.4" but I am sure we would all like to see the actual amount.
Posted by: Eric | March 12, 2011 at 03:00 PM
And it appears that the parents' observations and Dr. Wakefield's suspicions were correct after all--or perhaps Dr. Singh and his colleagues are also frauds.
"In recent years, the immunization-autoimmunity topic has gained quite a bit of public attention. This is quite possibly because autoimmune diseases are the commonest manifestations of immunizations. The MMR has been insinuated as a culprit of gastrointestinal problems in some children with autistic characteristics. Approximately one half of the parents with autistic children reported autistic regression after the MMR immunization. Moreover, a serological association of MV [measles virus] with autoimmunity was found in autistic children who did not have a wild type measles infection but they did have the MMR immunization. And, as described herein, autistic children showed a serological correlation between MMR and brain autoimmunity, i.e., over 90% of MMR antibody-positive autistic sera also had autoantibodies to brain MBP [myelin basic protein]. This is quite an intriguing observation in favor of a connection between atypical measles infection and autism; an atypical infection usually refers to infection that occurs in the absence of a rash. An atypical measles infection in the absence of a rash and unusual neurological symptoms was recently described to suggest the existence of a variant MV in children and adults. In light of these new findings, we suggest that a considerable proportion of autistic cases may result from an atypical measles infection that does not produce a rash but causes neurological symptoms in some children. The source of this virus could be a variant MV or it could be the MMR vaccine."
From "Abnormal Measles-Mumps-Rubella Antibodies and CNS Autoimmunity in Children with Autism," Singh et al, 2002
http://vran.org/legacy/docs/singh-orig-ppr.pdf
Posted by: Carol | March 12, 2011 at 01:59 PM
Way to force the issue guys! Pressure! "It did not occur to us to do so." What an idiot.
Posted by: Jen | March 12, 2011 at 01:49 PM
Why do the BMJ feel that it is nothing not to declare competing interests , exactly the same as members of the panel at the GMC , why do they get away with it because they can , they should be ashamed but they are not , and i bet none of them have a child with Autism , so why would they care , well its about time they started
Posted by: Debra | March 12, 2011 at 01:48 PM
So is JB contacting his CNN contacts,,, who is giving this info to Where in the World is Matt Lauer's Brain, Incurious George Steff... (who is a friend to Oprah), and HELLO>>>>Here's your 360 moment Anderson Cooper? Somebody's got to have connections to these not too credible journalists and also make them admit these truths.
Posted by: joyous | March 12, 2011 at 01:37 PM
Now BMJ is not a scientific publication, it is only a propaganda forum for pharma cartels, hence everything what is published there is a lie. We must remember this.
Posted by: Zofie | March 12, 2011 at 01:31 PM