Money is Only Part of the COI Story

“Any senior scientist will tell you that the biggest conflict of interest he or she has doesn’t have anything to do with the [corporate or other] interests that they list on their PowerPoints or at the end of their publications,” Dr. Paul M. Ridker said recently during his presentation on the inflammatory hypothesis of atherosclerosis at the annual meeting of the International Society on Hypertension in Blacks. “It has to do with our individual belief in the biology of what we’re doing.”

For this reason, the lengthy disclosure slide that served as the backdrop to his talk was less relevant, he said, than his fundamental bias, which is his belief that inflammation is “part and parcel, if not the cause of, atherosclerosis.” That type of bias, not industry support, “is what drives my work, and it is what drives most scientists,” stressed Dr. Ridker of Brigham and Women’s Hospital in Boston.

Image courtesy of Flickr user Neubie by Creative Commons license.

Dr. Ridker’s contention is likely a nod to the diatribe that followed the publication of results from the 2008 JUPITER trial on the effects of rosuvastatin (Crestor) in which he and his co-investigators attributed a 44% reduction in cardiovascular events to the agent’s ability to both lower LDL cholesterol and reduce C-Reactive Protein (CRP) levels (N. Engl. J. Med. 2008 Nov. [359]: 2195-207).

Following the publication of the findings, cardiology colleagues questioned the interpretation and veracity of the data in the face of what they deemed to be an unacceptable degree of commercial bias. They were referring not only to the fact that the study was funded by AstraZeneca, the drug’s manufacturer, and that nine of the 14 authors disclosed financial ties to the company, but also that Dr. Ridker holds the legal patent on CRP testing technology. Without question, the skeptics argued, Dr. Ridker had much to gain from the acceptance of his research (Arch Intern Med. 2010 [170]:1032-36).

For his part, Dr. Ridker vigorously defended and continues to defend the quality of the JUPITER data. He has also introduced a salient argument: the conflicts of interest that have the most potential to bias research are not the tangible ones listed at the end of a paper. They are the intellectual and emotional ones that defy enumeration. He doesn’t argue against financial disclosures, but he does warn that they don’t tell the “whole story.”

—Diana Mahoney

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1 Comment

Filed under Cardiovascular Medicine, Drug And Device Safety, Health Policy, Hospital and Critical Care Medicine, IMNG, Internal Medicine, Internal Medicine News, Primary care

One response to “Money is Only Part of the COI Story

  1. Pingback: The problem with transparency… - Alert&Oriented

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