It Ain't Necessarily So
Remember the old Christmas story about a little girl named Virginia who wondered if Santa was real? Her father told her to address her question to their city's newspaper - because "if you read it in the Sun, it's so."
We're far too cynical now to fathom such blind trust in the media. But there still seems to be some remnants of that faith when it comes to medical journals.
We'd like to think that the physicians and scientists who devote themselves to research have only altruistic motives. And beyond that, we'd like to think that the editors and publishers of these journals hold their authors to a higher standard, knowing that they often are dealing with life or death issues.
Unfortunately, events in recent years have shown us we're wrong, on both counts.
The most recent dose of reality comes from an article published in the Journal of General Internal Medicine. The authors evaluated the conflict of interest practices at a wide range of biomedical journals. One of the study's authors summed it up well in an interview with ANI: "We found it striking how many author disclosures were not made public in these prominent journals."
I agree. But I think I would use stronger language than "striking." How about "outrageous"? "Unbelievable"? "Down right stupid and unethical"?
After the recent scandals that have rocked the medical research community (think Baycol, Vioxx, Ketek, etc.), you think every single medical journal in the country would have a conflict of interest policy. But only about 80 of the 91 journals surveyed reported having a rule in place.
What's more, those that did have a policy applied it haphazardly. Few collected conflict of interest information for all authors, and only about half said they published all the information they collected. In most cases, conflicts or interest were not published with narrative reviews, editorials, policy statements or writings that "reflected the opinions of the authors."
Excuse me, but isn't the just the right time to disclose a conflict of interest? An editorial or opinion piece is a lot easier to distort - it doesn't require the heavy duty data and research backup typically included in a published clinical trial or meta-analysis. And simply by the nature of the beast, isn't an editorial more likely to persuade and influence readers? Isn't that what an editorial is supposed to do?
Even fewer journals collect and publish conflict of interest information on their peer reviewers, the physicians and scientists who read all submissions and make recommendations on what to publish. (Gee, that makes sense.)
Now, the contrarians among you may be thinking that I quote published research all the time in my writings. That's true. But nearly all of the studies I quote are showing the benefits of nutrition, exercise, or a natural supplement - in other words, things that don't offer much of a profit motive. Conflict of interest scandals almost always arise when physicians and scientists write (or suppress) research on a pharmaceutical they have a stake in. No one is getting a kickback when a published study reinforces the benefits of exercise or eating more vegetables.
The JGIM article concludes: "We encourage more transparency in conflict of interest reporting." I second that. But we also have to encourage the mainstream media to report any existing conflicts when they write about newly published research. If it's covered at all, the facts on funding and author's conflicts is often buried far down in print coverage. It doesn't even make it into the one-minute mention or bottom-of-the-screen crawl on the TV news.
As a consumer, here's what you can do. Whenever you see a health headline, look for details about the authors and who funded the study. If your paper (or TV station) doesn't provide it, let them know how you feel about that decision. You may also be able to look up the original published study online and find out for yourself (assuming that the journal provides the information). The best way to find published medical research is through the National Library of Medicine's PubMed; check it out at www.ncbi.nlm.nih.gov/entrez/.
What ever you do, don't assume that just because it was published in a leading medical journal, it must be so. Sometimes cynicism is a good thing. Just not when it comes to Santa. Freedom from fries Here's a head scratcher: scientists have announced that microwaving French fries before frying reduces the amount of acrylamide they contain - good news, since acrylamide is a carcinogen.
I'm not sure where to begin with this one. Note that it doesn't say that microwaving eliminates the acrylamide from the finished fries - it just reduces the amount. How much is still there? We don't know. How much is safe? We don't know that either - and anyone who tells you he does is lying.
For purposes of this argument I'll ignore the microwave factor, except to say there are still those who believe that exposing foods to this low-level radiation still constitutes a cancer risk in and of itself. Microwaving also destroys nutrients - up to 90 percent of important vitamins, minerals and antioxidants in most fruits and vegetables, fresh or frozen. But what about the other health risks of French fries? No amount of microwaving will make them nutritious. We know they are packed with saturated fat (even trans fat in some cases), sky-high sodium and empty calories. Is the taste (and ok, I'll agree they taste good) really worth all these risks?
I can see it already - soon fast food restaurants across the country will be touting the fact that they microwave their fries before submerging them in boiling oil. Somehow this will be flaunted as a health breakthrough. But don't fall for it - French fries are not good for you, and no amount of spin - or microwaving - will change that.
