Conflicts of interest DOES MONEY CORRUPT SCIENCE? Outrageous fortune May 17th 2001 From The Economist print edition (May 19th 2001) Some people feel that corporate sponsorship of scientific research amounts to the purchase of it. Editors of scientific journals reckon that vigilance is the answer ------------------------------------------------ NEVER look a gift horse in the mouth, goes the adage, and the University of Nottingham, in England, certainly did not. Last winter, when British American Tobacco (BAT) offered the university £3.8m ($5.4m) to finance a centre for research on business ethics, with no strings attached, the university gratefully accepted. One of its academics, however, did not acquiesce so readily. Because Richard Smith, a professor of medical journalism at Nottingham, also happens to be editor-in-chief of the British Medical Journal (BMJ), he was able to air his protests before a large and concerned audience of biomedical researchers. Two weeks ago, the BMJ polled its readers on the matter. It asked whether Nottingham ought to return the money to BAT. And it asked whether Dr Smith should resign his chair if the university kept the cash. When the Internet poll ended on May 10th, having garnered just over 1,000 responses, the voters had decreed by a small margin55% to 45%that Dr Smith should resign. And resign he will. By a far larger margin, however84% to 16%the voters opined that Nottingham ought to give the money back. The university, though, had not promised to make its policy by plebiscite, and so it will not oblige. Should it? To Nottinghams critics, allowing a firm from one of the worlds least socially responsible industries to sponsor a centre for the study of corporate responsibility smacks of the ludicrous. But such curiosities are not new. Alfred Nobel made his fortune from dynamite, yet the Nobel Peace prize is a coveted tribute. The Wellcome Trust, Britains largest medical charity, received its original endowment from a drug firm. Rupert Murdoch, a press and broadcasting baron, recently endowed a chair in media studies at Oxford University. And Harvard has just appointed the first incumbent of a chair modestly entitled the Quincy Jones Professorship of African-American Music, Supported by the Time Warner Endowment. Dr Smith fears that BATs donation amounts to the purchase of respectability by the tobacco firm at the expense of Nottinghams reputation. A more worrying threat would be if the donation amounted to the purchase by an interested company of scientific research at the expense of the integrity of the researchers and their findings. There is evidence that this has occurred in the past, sometimes in subtle and uncontrollable ways. And now, a word from our sponsors If hiring and firing decisions appear to turn on the interests of sponsors, for example, the independence of research may suffer. Such an incident occurred in April at the University of Toronto, which rescinded its offer of a job to David Healy. Dr Healy is well known for arguing that Prozac, an anti-depressant drug, raises the risk of suicide among depressives. The universitys Centre for Addiction and Mental Health, where Dr Healy would have worked, receives funds from Eli Lilly, the makers of Prozac. The incident has caused much hand-wringing among Canadian academics, although the university and Eli Lilly both deny that the companys money influenced the centres decision to withdraw its offer. Financial interests can also exert an insidious bias on the results of research. In 1998, a review of literature published in the New England Journal of Medicine showed that authors who supported the use of a certain kind of drug for treating heart ailments were significantly more likely to have a financial relationship with the drugs makers than those who did not. In the same year, a review published in the Journal of the American Medical Association (JAMA) examined articles about the health risks posed by passive smoking. The reviews authors found that they could reliably predict what an article would conclude about the effects of passive smoking by looking at one simple factor: whether the articles authors had any financial affiliations with the tobacco industry. (No prizes for guessing which way results veered when they did.) On the face of it, these discoveries look damning, both of science and of scientists. But Dr Smith thinks that mendacity is not always the explanation. Unintentionaleven unconsciousbias can have powerful effects. Researchers do try to eliminate this. The standard experimental procedure for a test of a drugs effects, for example, demands a double-blind trial; that is, one where neither the researcher nor the subject knows whether a given pill contains a placebo or a drug. Double-blind design is not meant to imply mendacious intent on the part of researchers or of subjects; it merely takes into consideration the subconscious human bias that subtly creeps into scientific observation. Nevertheless, To try to abolish bias is impossible, according to Dr Smith. Since he is the editor of one of medicines chief journals, and because such journals are the gatekeepers of the scientific community, this attitude may depress those committed to maintaining the purity of scientific research. But Dr Smith, as well as the editors of many other journals, believes that making the links between researchers and their sponsors plain will do the trick as well as it can be done. To this end, the editorial boards of many journals are instituting more stringent and wide-reaching policies designed to get researchers to disclose their financial interests. The move has most relevance to medical journals that report drug trials. The BMJ already asks authors to declare competing interests and may soon shift to asking for relevant interests, because its editors have found that such changes in terminology affect the proportion of people who own up quite significantly. The Lancet requires that a declaration of all conflicts of interest, past and present, must accompany each article submitted. JAMA insists that, if there is commercial sponsorship of a study, the authors must sign a form guaranteeing that they, rather than the sponsors, controlled the design, analysis and presentation of data. Other scientific journals, such as Nature and Science, have less cause for concern, since the research they report tends to be basic, rather than commercial. Nevertheless, Phil Campbell, the editor of Nature, says that within a few months the journal will create a policy on the disclosure of financial interests. Donald Kennedy, who edits Science, says that the journals editorial board is thinking about creating such a policy, too. These editors are quick to point out that such requests, and the disclosures they elicit, are not a watertight way of ensuring the integrity of science. A scientist who is determined to conceal a conflict of interest will have little trouble doing so. But there is a natural check on such trickeryif an observant reader points out the ruse, the journal will publish a correction. Drummond Rennie, the deputy editor of JAMA, says, We are JAMA, not the FBI or the IRS. Authors have lied to us, signing forms they knew to be wrong. That makes us look like naive idiots. Then we publish the facts and they look like corrupt idiots.