THE RESEARCH RECESSION: 12 years of Anesthesiology progress in question

Over the past 12 years, anesthesiologist Scott Reuben revolutionized the way physicians provide pain relief to patients undergoing orthopedic surgery for everything from torn ligaments to worn-out hips. (Brendan Borrell, Scientific American)

Rueben’s drug studies were responsible for convincing orthopedic surgeons to move away from the first generation of non-steroid anti-inflammatory drugs to a new method, known as COX2 inhibitors. He claimed that these new drugs, made popular under the names Vioxx, Celebrex, and Bextra, in combination with anticonvulsants could be effective in decreasing postoperative pain and reduce the use of addictive pain killers, such as morphine, after surgery. What seemed to be a break through, Reuben’s findings were hailed as a great step forward in redesigning anesthesiology.

12 years later however, the profession is in a state of crisis after an investigation by the Baystate Medical Center revealed that at least 21 of Reuben’s papers were entirely made up, faking the beneficial results and in some cases, masking possible dangers. The investigation found that the data in these 21 studies had been partially doctored, and in some cases, entirely fabricated by Dr. Rueben.

Although this most recent investigation has brought the wall tumbling down for Dr. Rueben, signs of cracks had leaks had begun to rear their ugly head over the past five years. In the early part of the decade, orthopedic surgeons began to distrust Rueben’s COX2 inhibitors, when animal testing found that the drugs might actually hinder bone healing. Soon there after, in 2004, Vioxx and Bextra, and Celebrex were pulled from the market because of their link to an increased risk of heart attacks and strokes. All the mean time, Dr. Rueben continued to present positive “findings” for the use of these COX2 inhibitors in his research.

So, even with the public at risk, what motivated Dr. Rueben continue his campaign for these drugs? Simple. Money. It was discovered during the course of the Baystate investigation that Dr. Rueben’s research was entirely funded by Pfizer; the maker of both Celebrex, and the anticonvulsants lauded by Dr. Rueben’s study to be used in conjunction with the COX2 inhibitors. Baystate however could not find any records of the payments, suggesting that the payments were made not to Dr. Rueben’s research group, but instead directly to Dr. Rueben.

Although we may think of doctor’s as always having the best intentions, one must always remember the power of money. Pharmaceutical corporations are some of the richest and most powerful companies in the world, and they need doctors on their side. It is much easier today for these drug companies to pay off a doctor to get the results they need rather than go back to the drawing table and leave behind an unsuccessful product. Because of this, remember to always remain informed when consulting with your doctor about possible medication options. An informed patient is always the safest patient.

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Cigarette Companies and Their Red Handed Researchers

In 2006, a study by Dr. Claudia I. Henshke of the Weill Medical College at Cornell University shocked the medical professional world by reporting that the widespread use of CT scans could help prevent 80% of lung cancer deaths. The study was published in the renowned New England Journal of Medicine, and sent shock waves of hope through the medical profession. Unfortunately, the good news would be tainted by the discovery of a crippling conflict of interest: The study was funded almost entirely by the cigarette industry.

After Ms. Henshke reported her study to the Accreditation Council for Continuing Medical Education, an investigation revealed a long string of deceivingly named non-profit funding, leading all the way back to big tobacco. After its startling discovery, the council wrote to the Journal, explaining its concern over the validity of Ms. Henshke’s findings.

The study failed to disclose that Dr. Henshke’s work had been underwritten in part by a $3.6 million grant from the parent company of the Liggett Group, a cigarette maker, something the journal editors said they had been unaware of.

The council’s criticism was received quickly by the Journal, who quickly moved into damage control mode. A letter in response from the Journal stated, “When we published Dr. Henschke’s article in 2006 it was not routine NEJM editorial policy to publish details about… funding. Since that time our thinking on this issue has evolved.” The journal now asks authors to disclose all royalties related to their research, and it publishes the information with the studies. The letter was signed by Dr. Jeffrey M. Drazen, the journal’s editor in chief, as well as Corinne Broderick, executive vice president of the medical society.

The New England Journal of Medicine has taken the proper steps to remedy this immoral conflict of interest. Unfortunately, not every journal has taken the hint. When reading a medical study that might effect your decision making process, remember to read the fine print. Don’t let your well being be effected by corporate influence on greedy doctors.

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The Secret Relationship of Medical Researchers and Pharmaceutical Companies

Finally, congress is investigating the giant pharmaceutical company’s corrupt research practices.  In the drug business, promoting health and safety should be priority number one.  Unfortunately, it is merely a distant second.  In the pharmaceutical industry, making money supersedes science. Some even go as far as claiming that drug makers have become a billion dollar empire not because of research and science, but rather from slick marketing and deceit.  This claim has some validity since the drug companies spend almost twice as much on the marketing of their drugs then on the development of their drugs.

 Some also argue that many drugs are over-prescribed, and that drug companies’ huge profits are often spent developing and advertising expensive designer drugs (such as Viagra) instead of life-saving medications. But now, even the effectiveness of the drugs is being called in to question by the on going congressional inquiry.  Presently, Congress is learning that the drug makers have paid millions of dollars in cash and other benefits to the very doctors who are supposed to be independently testing these drugs.  Rarely will such a doctor bite the hand that feeds them.  Even more insidious, the drug companies employ thousands of foreign-born chemists who are in the US on a work visa.  Their career allows them and their family the right to live and work in the U.S.  This demands allegiance to their employer and many suspect that end result of their research reflects this allegiance.

Perhaps the most alarming discovery of the investigation however points towards the work of Dr. Joseph Beiderman.  Dr Beiderman, one of the world’s most renowned child psychologists at the Harvard Medical School, apparently failed to report to Harvard University that he had received at least $1.4 million in personal income from drug companies.  It was also found that Dr. Biederman had asked a Johnson & Johnson subsidiary to provide him with almost $1 million to start a research center to, “move forward the commercial goals of J.& J.” As a front-runner in the field of psychology, Biederman was responsible for introducing a new era of using powerful, risky, and expensive antipsychotic medicines in young people. 

Hopefully, the present congressional investigation will lead to reforms for the pharmaceutical industry.  One reform would be to break the financial relationship and dependence of the medical profession to drug makers.  Others would be to hold drug makers accountable in a court of law for false advertising and marketing of drugs that harm patients.  The recent vioxx civil trials, which resulted in huge verdicts against the drug makers, is just one example of how effective this system works.  After a few juries heard the truth about this drug maker, and awarded appropriate damages, the vioxx maker quickly settled all the claims against it.  That result sent a strong message to the drug makers that they will be held accountable for deceit in the pursuit of profits.  Hopefully, congress will enact stricter and further reforms as well.  This will allow all of us to have confidence that the medicine we pay for and use has been fairly and legitimately tested by independent doctors and are benefiting our long term health.