Ортопед рассказывает в BMJ, как его вовлекли в «академическое» совещание, чтобы потом от имени «рабочей группы» опубликовать статью и провести «съезд» — для того, чтобы продвинуть новый препарат
- Per Aspenberg, professor of orthopaedics, Linköping University, Sweden
In February 2015, I was invited to join an academic working group to analyse procedures for increasing bone mass, structure, and strength through “intraosseous interventions.” The group, which included some of the world’s most prominent osteoporosis researchers, was meeting at a luxury hotel in Switzerland as part of the preparations for the world congress on osteoporosis. I was asked to give a presentation on “currently available orthopaedic procedures for bone enhancement.”
The subject puzzled me, because there are no such procedures. But I was flattered by the invitation so rather than decline I spent several days preparing a presentation in which I concluded that prophylactic surgery in osteoporosis was not a good idea.
One week before the meeting I received an email from a professional medical writer, attaching a synopsis for the meeting in which I was said to be positive about prophylactic surgery in uninjured bone and especially to the idea of injecting bone cement into the proximal femur to make it stronger. I was unaware of this cementing concept, looked into it, and found that it has been evaluated only in cadaveric studies. I revised my analysis to include consideration of cement injections, completely ruling them out as too risky in relation to the small possible benefit.
Nine people were listed as participants at the meeting. Six of us would give a presentation, and I was the only one with an orthopaedic background. When I arrived in June at the meeting, three more people were present and introduced themselves as representing a US healthcare company. It was soon clear that this company was developing a product for injecting cement into the proximal femur, with the purpose of preventing fracture. I immediately protested: I had been invited to an academic working group and found myself on an advisory board for an American company. The chair of the meeting said I “didn’t need to be nervous”; the meeting was purely academic. So I gave my presentation. One of the world experts at the meeting presented the company’s cement product using unpublished company data, its representatives filling in the details. There followed a general discussion about the product and its marketing possibilities. The entire meeting lasted less than four hours. Before breaking up, we were informed that all nine of us would be coauthors of a “position paper” that would be drawn up and submitted to an osteoporosis journal, the editor of which had cochaired the meeting.
The manuscript
On 20 July the draft “position paper” arrived. The draft misquoted the literature to inflate the need for the American company’s product. It was the only product mentioned and described as “promising.” The points I had made regarding risk versus benefit were not included. I concluded that this “position paper” was commissioned to create a market for the sponsor’s product and I asked to be removed from the author list. My request was accepted, and I was told that I would also be removed from the list of speakers at the world congress.
Lessons learnt
I was flattered by the invitation to Geneva. It’s fun to meet famous people and fly business class, and it could have been tempting to get an “easy paper.” However, I was invited under false premises, which made me angry. If their methods had been more subtle, it could have been difficult to avoid developing loyalties and ties to the group. Such ties are hard to break, and once you’re in, you’re a part of it. One group member expressed concern about the ethics of the whole thing, privately, on the way to the airport. He hadn’t said a word during the entire meeting. I think some others were unhappy too, but as far as I am aware no one else has withdrawn.
Cooperation between academia and industry is often fruitful and fun, and it would be disastrous to cut the ties between them. The solution to the problems I have described may not necessarily be stricter rules. The only way to expose this is for more people to speak out when they experience these things, however embarrassing it is to admit you were nearly drawn in.
Notes
Cite this as: BMJ 2015;351:h6605
