The illusion of evidence based medicine

Jureidini, Jon; McHenry, Leemon B.

doi:10.1136/bmj.o702

Cited by 44 publications

(43 citation statements)

References 8 publications

(7 reference statements)

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“…Yet despite evidence that industry-sponsored trials are inherently biased, ∼60% of clinical trials in the USA are industry funded [13]. Many of these trials are conducted by industry but published in the names of senior academics in order to lend respectability to the study [22]. Industry-sponsored clinical trials make up between two-thirds and three-quarters of studies published in major journals such as JAMA, Lancet and New England Journal of Medicine [23].…”

Section: Industry and Academic Researchmentioning

confidence: 99%

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Industry influence in healthcare harms patients: myth or maxim?

Trayer

Rowbotham

Boyle

et al. 2022

Breathe

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Healthcare is a major global industry accounting for a significant proportion of government spending. Drug and medical device manufacturers are publicly traded companies with a responsibility to their shareholders to maximise profits by increasing sales. In order to achieve this, industry exerts influence over every part of healthcare including academic research, medical education, clinical guideline development, physician prescribing and through direct interactions with patients. In contrast, healthcare services seek to provide effective, safe and evidence-based treatments. This article examines interactions with industry across these domains and seeks to identify mutually beneficial relationships and potential conflict leading to patient harms. Case studies are used to illustrate these interactions.There is no single solution for improving healthcare's relationship with industry, although increased transparency has raised awareness of this issue. We briefly discuss some successful interventions that have been tried at national and regulatory level. While industry influence is widespread in healthcare and this has benefits for shareholders, healthcare practitioners have an ethical obligation to prioritise their patients’ best interests. Industry interactions with healthcare professionals have a valid role in product development and distribution, but industry sponsorship of healthcare education and practice, guideline development or regulatory decision-making can have harmful consequences for patients. Healthcare practitioners need to carefully consider these issues when deciding whether to collaborate with industry.Educational aimsTo explore the many areas where industry influences healthcare and the subsequent effects on patient care. Case studies are used to illustrate examples of beneficial and harmful effects of this influence.To raise awareness of the effects of industry influence and for readers to consider their own potential conflicts of interest.To suggest potential ways to improve the current system with a focus on solutions which have successfully been trialled already.

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Section: Industry and Academic Researchmentioning

confidence: 99%

“…This leads to a conflict of interest where the journal's financial survival depends on continued engagement with industry. Industry's influence on academia may undermine the academic process leading to an "illusion of evidence-based medicine" [22].…”

Section: Industry and Academic Researchmentioning

confidence: 99%

Industry influence in healthcare harms patients: myth or maxim?

Trayer

Rowbotham

Boyle

et al. 2022

Breathe

View full text Add to dashboard Cite

show abstract

“…They continually deserve a comprehensive update of their pharmacological and clinical features. Dubovsky and Marshall [3] provided an excellent updated review that increased our self-confidence in prescribing BZ and criticizing the literature that is full of data involving conflicts of interest [4]. The savage marketing of serotonin selective reuptake inhibitor (SSRI) and serotonin and norepinephrine reuptake inhibitor (SNRI) is among the worst episodes in the recent history of psychopharmacology [1].…”

mentioning

confidence: 99%

“…They are efficacious for the short- and long-term treatment of anxiety disorders [6]. Clinicians and investigators have recognized their benefits for many anxious patients, but some medical “propagandists” have popularized a critical view of these medications, and this view has become entrenched in the media and general medical opinion [2, 4]. For example, due to the possibility of withdrawal symptoms with BZ, most recent treatment guidelines recommend SSRI as the first-line choice for the treatment of anxiety [7].…”

mentioning

confidence: 99%