Did Catherine DeAngelis think she was off the record when she described a critic of the disclosure practice of the Journal of the American Medical Association – of which she is editor-in-chief – as, “a nobody and a nothing.”?

DeAngelis was talking to Wall Street Journal Health Blog reporter David Armstrong, and the target of her vitriol was Jonathan Leo, a professor of anatomy who is also an osteopath and a long-time critic of pharma marketing. Leo had had the temerity to deal out on JAMA in a letter published at rival bmj.com over its publication of a study purporting to show the antidepressant escitalopram was superior to psychological therapy for people suffering depression after having a stroke. One of its authors, Leo said, had been a paid consultant for the drug’s manufacturer – which had not been disclosed in the JAMA paper.

“[Leo] is trying to make a name for himself. Please call me about something important,” DeAngelis imperiously told Armstrong, in a clue that she possibly did not expect to be quoted. Swift to the personal attack, she was less forthcoming about the substance of Armstrong’s question and would not address the potential conflict of interest.

But Armstrong did not obediently back off and has unleashed – to judge from the comments his entry has attracted – a storehouse of pent-up resentment against the journal and the American Medical Association itself. At least 80 per cent of the 30 comments listed as of yesterday where highly critical of the AMA and JAMA in general, or of the apparent arrogance of DeAngelis in particular.

junlee wrote: “This sad episode gives additional pause to translating anything i read in jama into practice.” AlgG asked: “Are the doctors who read JAMA ‘nobodies’ also?” Several commentators said they would cancel their AMA or JAMA subscriptions.

And the conflict of interest that sparked the spat? JAMA belatedly published this week a letter from an author of the original paper, Robert Robinson, in which he acknowledges but downplays the infraction, explaining that he had indeed received honoraria and expenses from the company, Forest Laboratories, in 2004 – blaming, “errors of memory” for not having mentioned it earlier, and insisting the relationship had not influenced the study design or results.

Oh, come on … scientists who expect to take the industry dollar and still have their work taken seriously have got to be able to do better than that. Surely Robinson could just have looked back over his tax returns to have given JAMA an accurate picture of his financial.

Full marks to Armstrong for blowing the lid off this one, and for using the blog to do so. The JAMA juggernaut may have been thinking print when they tried to call him off – and in print terms it’s true this story this story is a small and marginal one. Procedural issues at medical journals have only minority appeal to readers and there’s no allegation of big-scale corruption.

But it’s all the more revealing for that, offering an unusually candid insight into how one big journal interprets its role in the vast enterprise of medicine.

-JR

 

 

 

 

 

 

 

This entry was posted on Saturday, March 14th, 2009 at 5:52 pm and is filed under Health & Medicine Stories. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.