Thursday, September 20, 2012

Chelsea Conaboy's GOTBO

Study: Physicians give less credence to studies funded by pharmaceutical industry

By Chelsea Conaboy, Globe Staff

Doctors are less likely to trust studies funded by the pharmaceutical industry even when they are well-designed, a study lead by researchers at Brigham and Women’s Hospital and Harvard Medical School found.

Recent ethical transgressions in industry-funded studies likely have affected how physicians view industry research, the authors write. But pharmaceutical companies continue to play a big role in drug development.

Doctors should be wary, said Dr. Aaron Kesselheim, lead author on the study published in this week’s New England Journal of Medicine. “On the other hand,” he said, “there is a lot of good industry-funded research out there. If people are being too skeptical and painting everything with the same brush, then that will reduce the inclination for physicians to act on really good research simply because it’s being funded” by pharmaceutical companies.

The researchers evaluated the responses of 263 internists assessing a series of studies for hypothetical new drugs to treat persistent chest pain, diabetes, or high blood cholesterol. The physicians were asked to score the studies on how confident they were in the results and how likely they were to prescribe the drug.

The studies were of variable levels of quality. Some were characterized as large, randomized, long-running studies that included reports on a drug’s safety. Others were significantly smaller, with no safety report and no “blinding,” meaning patients and physicians knew whether they were in the study group or control group, which can bias the results.

The studies also had either no funding disclosure or were described as being funded by a pharmaceutical company or by the federal government’s National Institutes of Health.

Kesselheim said he was “heartened” to see how well the doctors distinguished between strong study designs and weaker ones. The ways in which they interpreted funding disclosures were trickier.

Doctors generally discounted the credibility they assigned to studies funded by industry, as compared with those that were government-funded or had no funding disclosure at all. That was true even when the strength of design was the same across the studies.

The authors note that a doctor’s willingness to prescribe a new drug may be determined in large part by a single significant study, so a physician’s perception ultimately can affect patient care.

Kesselheim said the results should put pressure on the pharmaceutical industry to prevent further ethical lapses. They highlight the need for more NIH funding of drug studies and continued efforts to monitor research to guard against results tampering, he said.

Chelsea Conaboy can be reached at cconaboy@boston.com. Follow her on Twitter @cconaboy.

http://www.boston.com/whitecoatnotes/2012/09/20/study-physicians-give-less-credence-studies-funded-pharmaceutical-industry/xd8MAnN5SqizUiBO6kTTOJ/story.html

GOTBO = glimpse of the bleeding obvious

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