Factoring in disclosure

Courtesy Expedient InfoMedia/Creative Commons License

In the mid-1980s, a young woman of my acquaintance who distrusted the results of the studies funded by companies with a financial interest in their results was concerned about the side effects of her birth control pills. She asked her gynecologist about the evidence for the risks and benefits.

Her doctor assured her. The modern contraception dosing was so low that the serious side effects associated with the early pill had become quite rare. Her doctor handed her copies of several recent large studies from major medical journals.

Each paper disclosed its funding source: a major pharmaceutical maker.

The woman could not judge the science, but she had closely followed the string of scandals beginning in the late 1970s and mid 1980s that prompted congressional hearings and began eroding public trust in academic-industry relationships. In almost every case, life science researchers with financial interests in the outcome engaged in flagrant misconduct and badly done studies.

She leaped to the same conclusion that would be issued in a federal report five years later: Financial conflicts of interest are hazardous to health. So she discontinued the pill and attempt a less effective method of contraception, which led to a medical procedure several months later that was probably slightly riskier than the pill.

Today, we know more about the influence of funding on science and medicine. A substantial body of evidence, as discussed by Lisa Bero at University of California, San Francisco, here, shows that funding biases studies, as well as the body of scientific knowledge, in many measurable ways. Disclosure is a favored remedy.

Yet disclosure begs the same difficult question: What do we do with that information, as reporters, as health consumers, as scientists? How do we factor it into our stories, our health decisions, our practice guidelines, our public policies? It’s necessary, but is it sufficient?

— copyright Carol Morton

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