THE WALL STREET JOURNAL
Nonprofit Hits JAMA, Seeks Inquiry
By David Armstrong
MARCH 26, 2009
A non-profit group that monitors industry links to medical research called for the suspension of the top two editors of the Journal of the American Medical Association, and an investigation into allegations that they threatened a researcher who criticized a study published in the journal.
The Alliance for Human Research Protection, which is often critical of industry-academic ties, made the requests in a letter it sent Wednesday to the AMA and the journal, also known as JAMA.
(This story and related background material will be available on The Wall Street Journal Web site, WSJ.com.)
"We are deeply concerned about the unbecoming and unethical conduct of the editor-in-chief and executive deputy editor of the Journal of the American Medical Association, who were reported to have used unprofessional and intimidating tactics against a conscientious academic," the alliance wrote in a letter requesting the investigation. Many doctors and academics have criticized JAMA’s reaction to the academic, Dr. Jonathan Leo, on Internet blogs in recent weeks.
The AMA and JAMA said they were reviewing the letters and declined further comment. Jordan J. Cohen, a professor of medicine at George Washington University, who is chairman of JAMA’s oversight committee, hasn’t returned telephone and email messages this week.
The controversy stems from a March 5 letter published by the British journal, BMJ, in which Leo criticized how results were reported in a JAMA study last year that looked at the use of the antidepressant Lexapro’s use in stroke victims.
Leo also pointed out that JAMA didn’t report that the study’s author had a financial relationship with Lexapro’s maker, Forrest Laboratories Inc.
Leo is a professor of neuro-anatomy at Lincoln Memorial University in Harrogate, Tenn.
Forrest acknowledged that it had paid the author for speeches, but said his research on Lexapro was independent.
The publication of the BMJ letter upset JAMA’s editor in chief, Catherine DeAngelis, who acknowledges contacting Leo’s dean in an effort to get Leo to retract the letter. Leo says JAMA’s executive deputy editor, Dr. Phil Fontanarosa, also called him to request a retraction. Leo has said Fontanarosa told him "You are banned from JAMA for life. You will be sorry. Your school will be sorry. Your students will be sorry." Fontanarosa, through a spokeswoman, has said Leo’s version of the conversation is "inaccurate."
JAMA editors have said they were "strong and emphatic" when discussing Leo’s letter with him and his dean because of the importance of protecting JAMA’s reputation. "We regret if anyone involved in these communications interpreted our intentions in any other way," the editors said in a special editorial published last week.
In an interview with The Wall Street Journal earlier this month, JAMA editor-in-chief Catherine DeAngelis called Leo "a nothing and a nobody."
DeAngelis later said he is "certainly is somebody doing something very important."
In the editorial, DeAngelis and Fontanarosa said Leo was guilty of a "serious breach of confidentiality" by writing about the problems with the JAMA study while it was still investigating the matter. JAMA said that from now on, anyone complaining of an author failing to report a conflict of interest will told not to disclose an investigation is under way.
That policy has been criticized by other medical journal editors as well as by some physicians and researchers. In her letter, Vera Sharav, the president of the Alliance for Human Research Protection, said journal editors have a responsibility to provide an open forum for scientific debate. "Not only have Drs. Fontanarosa and DeAngelis failed to meet this responsibility, they resorted to threatening retribution against a researcher who detected failures in their editing and gate-keeping processes" Sharav wrote. Her organization has often criticized the efficacy and safety of antidepressants.
JAMA has a unique management structure that was born from another controversy a decade ago when DeAngelis’ predecessor was fired by the AMA. George Lunderberg, who had edited the journal for 17 years, was fired in 1999 when he published a study that found most college students didn’t consider "oral sex" as "having sex." The article was published during the debate over the impeachment of then-president Clinton.
In wake of that controversy, the AMA ceded direct editorial control of JAMA to its seven-member oversight committee made up of six outsiders and the journal’s publisher.
See also, Medical Journal Decries Public Airing of Conflicts, WSJ March 22, 2009: