Applause to Editor of Amer J of Hypertension Who Said NO to financially compromised Society

Fri, 29 Jul 2005

The Wall Street Journal reports: “In a dispute reflecting heightened concerns about the control and credibility of medical information, the American Society of Hypertension said it is severing its 16-year relationship with the American Journal of HypertensionŠ..The rift highlights the issue of bias in science and whether researchers are unduly influenced by drug companies. It also reflects the importance of medical journals to doctor organizations, which often offer subscriptions to their members as a means of giving them up-to-date information on treatments in their fields. In many cases, the journals also provide medical groups with a source of revenue and prestige. Disagreements between doctors and medical journals over industry influence are increasingly common, but an outright split is rare.”

Dr. John Laragh, the editor of the Journal and co-founder of the Society is to be commended for taking a courageous stance by refusing to give editorial oversight to the ASH whose leaders, he accused, of being “improperly influenced by financial ties to the pharmaceutical industry and becoming, in essence, marketers for drug companies, which pay them consulting and speaking fees.”

Such financial relationships by doctors have created a major credibility gap: America’s medical establishment has yielded to financial temptation allowing money from industry to influence medical practice. The cost is loss of public trust.

See: The Truth About Drug Companies by Marcia Angell, MD and On the Take by Jerome Kassirer, MD, both former editor of The New England Journal of Medicine; Overdosed America: The Broken Promise of American Medicine by John Abramson, MD, of Harvard Unviersity.

Given the credibility gap, and the failure of journal editors to cleanse the literature by retracting articles that made false claims about treatments, patients need to assume a self-defense strategy when dealing with the medical profession. The first question a patient needs to ask his/her doctor is: How much money have you accepted for any reason from the manufacturer whose drug you’re prescribing for me?

Contact: Vera Hassner Sharav
212-595-8974

THE WALL STREET JOURNAL
High Blood Pressure: Doctors Sever Ties With Medical Journal
By RON WINSLOW and RACHEL ZIMMERMAN
July 29, 2005; Page B1

In a dispute reflecting heightened concerns about the control and credibility of medical information, the American Society of Hypertension said it is severing its 16-year relationship with the American Journal of Hypertension.

But the journal’s editor, John H. Laragh, said he had beaten the society to the punch by announcing in an editorial being published in the July edition that it was ending its relationship with the society.

The split caps months of tension between the leaders of the society, a group of 3,000 researchers and clinicians who specialize in the treatment of high blood pressure, and Dr. Laragh, a co-founder of the society and the long-time editor of its journal.

The society says it has been seeking, at the recommendation of its auditor and legal counsel, to establish a formal agreement with the journal giving the society editorial oversight and more influence over the journal’s direction and philosophy.

Dr. Laragh, a researcher at Cornell University’s Weill Medical College, has accused the society’s leaders of being improperly influenced by financial ties to the pharmaceutical industry and becoming, in essence, marketers for drug companies, which pay them consulting and speaking fees.

He singled out the continuing-medical-education symposia that societies often hold in conjunction with their medical meetings. In an email to society members in May, before the hypertension group’s annual meeting, Dr. Laragh said the organization’s continuing-medical-education agenda had become “unacceptably dominated” by members who are “heavily involved in pharma marketing for personal gain.” He alleged the change occurred since Thomas D. Giles, a hypertension researcher, became president of the society in 2004.

Dr. Laragh said the industry was “merely doing its job by hiring favorable lecturers.” But in the process, he said, it is “inadvertently creating a new category of ‘academic’ businessmen who gain not only money but name recognition and prestige.”

In an interview last night, Dr. Laragh said the journal is ending ties with the society because “we decided we couldn’t live under the environment they created.”

Dr. Giles denied the charge that the society’s members are improperly influenced by drug companies. “We have the same sort of fire wall that most organizations build,” he said, adding that on at least one occasion, a physician was sanctioned for giving a “commercially biased presentation.” In that case, he said, the doctor was reprimanded in a letter.

The rift highlights the issue of bias in science and whether researchers are unduly influenced by drug companies. It also reflects the importance of medical journals to doctor organizations, which often offer subscriptions to their members as a means of giving them up-to-date information on treatments in their fields. In many cases, the journals also provide medical groups with a source of revenue and prestige. Disagreements between doctors and medical journals over industry influence are increasingly common, but an outright split is rare.

Citing “irreconcilable differences,” the hypertension society said its members no longer will pay for subscriptions to the journal after Oct. 1. The payments amount to about $210,000 a year and come out of member dues. In a letter to the journal’s Dr. Laragh, Dr. Giles said the journal “may no longer identify itself as an official journal of the American Society of Hypertension or in any other way indicate that is affiliated with the society.” That identification is in part what prompted the society to seek greater editorial influence.

Torry Sansone, executive director of the society, said relations between the two groups had been festering for some time. He said the journal’s leadership hasn’t welcomed the society’s efforts to establish a formal agreement giving it some oversight of the journal’s editorial content as well as its philosophy and direction. In addition, he said, the society wanted some control over the editor’s compensation and length of stay. Currently, “the society has no say whatsoever” on those issues, Mr. Sansone said.

In a letter to members announcing the severing of the relationship, Dr. Giles, a cardiologist at Louisiana State University, New Orleans, also questioned whether the journal editor’s compensation — $229,000 in 2003 — was appropriate, given that the journal is owned by a nonprofit group, the American Journal of Hypertension Ltd. Much of the journal’s income, Dr. Giles said, comes from the drug industry in the form of advertising, reprints and supplements.

The journal’s editorial board has defended Dr. Laragh’s salary as reflecting his two posts, editor in chief of the journal and chief executive of the nonprofit parent corporation. The editorial board also cited his “stature as a leading scholar” and said members of the society, in a survey, had rated the journal as the No. 1 benefit of membership.

Dr. Giles said the society would seek new “official publications” to communicate scientific developments to its members. They will have “complete editorial independence,” he said, but the society will provide “appropriate editorial oversight” to make sure they serve the society’s mission.

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