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The Boston Globe

Business

White Coat Notes

Doctors wary of industry research

Excerpts from the Globe’s health care blog.

Doctors are less likely to trust studies funded by the pharmaceutical industry even when they are designed well, a study led by researchers at Brigham and Women’s Hospital and Harvard Medical School found.

Ethical transgressions in industry-funded studies probably have affected how doctors view industry research, the authors write.

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Doctors should be wary, said Dr. Aaron Kesselheim, lead author of the study, published last week in the New England Journal of Medicine. “On the other hand,” he said, “there is a lot of good industry-funded research out there. If people are being too skeptical and painting everything with the same brush, then that will reduce the inclination for physicians to act on really good research simply because it’s being funded” by pharmaceutical companies.

The researchers evaluated the responses of 263 internists assessing a series of studies for hypothetical new drugs to treat persistent chest pain, diabetes, or high blood cholesterol. The physicians were asked to score the studies on how confident they were in the results and how likely they were to prescribe the drug.

The studies were of variable levels of quality. Some were characterized as large, randomized, long-running studies that included data on a drug’s safety. Others were smaller, with no safety data and no “blinding,” meaning patients and doctors knew whether they were in the study group, which can bias the results.

The studies had either no funding disclosure or were described as being funded by a pharmaceutical company or by the government’s National Institutes of Health.

Kesselheim said he was heartened to see how well the doctors distinguished between strong study designs and weaker ones. The ways in which they interpreted funding disclosures were trickier. Generally, doctors discounted the credibility they assigned to studies funded by industry, compared with those that were government-funded or had no funding disclosure. That was true even when the strength of design was the same across the studies.

Top performers

The Joint Commission released its list of top-performing hospitals, and it has none of Boston’s top teaching hospitals. The list tracks reported performance in treatment of heart attack, heart failure, pneumonia, and other conditions.

The Joint Commission is the nation’s largest hospital accreditation organization. To make the 2011 list, hospitals had to perform the recommended practices at least 95 percent of the time on all measures they reported to the commission.

Eighteen percent of hospitals in the country met the standard, and 17 percent were close behind, said Dr. Mark Chassin, the commission’s president.

That the biggest hospital brands and academic medical centers in the state are missing from the list makes it distinct from many other national hospital surveys, some of which account for hospital reputation.

Chelsea Conaboy
can be reached at
cconaboy@boston.com.

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