Thursday, January 31, 2008

Peer Review, GSK, Cash, and Limp Noodles

Stephanie Saul has a quite interesting story in the New York Times about a peer-reviewer who really dropped the ball.

A key member of the Senate said Wednesday that a prominent diabetes expert leaked an unpublished and confidential medical journal article to GlaxoSmithKline last year, tipping the company to the imminent publication of safety questions involving the company’s diabetes drug Avandia.

The doctor, Steven M. Haffner of the University of Texas Health Science Center in San Antonio, faxed the article to the drug maker after agreeing to read it as part of the peer-review process for the New England Journal of Medicine, according to a statement Wednesday by Senator Charles E. Grassley...

An article on the matter that was published online Wednesday by the journal Nature quoted Dr. Haffner. “Why I sent it is a mystery,” the quote says. “I don’t really understand it. I wasn’t feeling well. It was bad judgment."

OK, I have to give Haffner credit for admitting his error. However, "I wasn't feeling well" -- not a great excuse. According to a GSK spokesperson, Haffner sent the article to GSK for "advice from experienced statisticians." The spokesperson denied that GSK provided any feedback to Haffner. Um, couldn't Haffner have found a statistician who did not work for GSK? As you might guess, this type of behavior is a no-no; the New England Journal of Medicine (as well as virtually all journals) has a policy where peer reviewers are not to share the content of papers under peer review with others.

Why did Haffner go to GSK? Well, here's one possible reason...

Dr. Haffner has previously disclosed that he has conducted research and served as a paid speaker for Glaxo. [Iowa Senator] Mr. Grassley said that Dr. Haffner had received $75,000 in consulting and speaking fees from GlaxoSmithKline since 1999

Maybe it was his relationship with GSK, maybe not. Haffner is apparently not a fan of medical journals, as can be seen in the quote below:

“The three major medical journals are becoming more like British tabloid newspapers — all they lack is a bare-chested woman on page 3,"
Apparently if they changed their peer review process to include submitting papers critical of industry for "objective" peer review by precisely the companies they are criticizing, that would help to de-tabloid the journals??

At the end of the article, Saul notes a case of limp noodle punishment for a similar violation...

Last year the New England Journal sanctioned another physician, Dr. Martin B. Leon, for commenting on a study before its publication. Dr. Leon, who was a reviewer of a journal article on the effectiveness of heart stents, disclosed at a medical conference that the study’s findings were negative before the article appeared. As a result, the journal barred Dr. Leon from reviewing articles for five years, and said he could not submit commentary for publication in the journal during that period.

Oh, THAT will teach him a lesson! He can't spend his free time reviewing articles for a journal. Ouch, that might leave a mark. And he can't publish an editorial for five years in one journal?? With hundreds of other journals to choose from, how will he survive? See some interesting comments on the Leon case here.

Hat Tip: Furious Seasons

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