Would the Chief Scientist of a Research Consulting Firm Pen an Editorial that Would Harm the Financial Interests of Many of His Company's Clients?

The answer is no. It would be quite unusual for such a scientist to voluntarily write a commentary in which he argues, for example, that a major class of drugs manufactured by many of his clients is ineffective. Doing so would almost certainly risk losing his job. And the company's clients.

Therefore, it is not difficult to see that if such a scientist were to write a commentary about the effectiveness of the drugs in question, the fact that he is high up in a company with pharmaceutical clients - clients who manufacture the drugs in question - would constitute a financial conflict of interest that would have to be disclosed in any articles that he were to write about the effectiveness of these drugs.

The Rest of the Story

As I revealed yesterday, this is not a hypothetical scenario. It played out just last week.

In a response a recent article which argued that nicotine replacement medications (NRT) are largely ineffective, Dr. Douglas Kamerow - chief scientist at RTI International and associate editor at BMJ - published a commentary in BMJ last week in which he dismisses the findings of the Alpert et al. study based primarily on what he states are a very low sample size and a high likelihood of recall bias. He also suggests that the results of "hundreds" of randomized clinical trials are being nullified by a "single" cohort study.

Indeed, many of the pharmaceutical companies that manufacture NRT products are clients of RTI International. Thus, there is a profound conflict of interest. RTI International receives or has received funding from a host of pharmaceutical companies, many of which produce and market the very products about which Dr. Kamerow is opining in the commentary. Among the pharmaceutical companies listed as clients of RTI are: Abbott Laboratories; AstraZeneca; Bristol-Myers Squibb; Eli Lilly and Company; The Johnson & Johnson Family of Companies; Merck & Co., Inc.; Novartis; Novo Nordisk; Pfizer; Roche; Sanofi-Aventis; Takeda Pharmaceuticals UK; and Tioga Pharmaceuticals.

However, this scenario differs from the hypothetical one above in one important way. In this case, the conflict of interest was not disclosed in the commentary.

This apparent failed disclosure appears to be in conflict with BMJ's stated policy: "We believe that, to make the best decision on how to deal with a paper, we should know about any competing interests that authors may have, and that if we publish the article readers should know about them too."

Well in this case, readers do not know about them too. Unless they also happen to read The Rest of the Story.