Conflicts of Interest - and silence

I'm a fan of Scott Adams and Dilbert. I like this 1996 strip. First, it features Procter and Gamble. Second it has something to say about conflicts of interest.

Phil the Prince of Insufficient Light is the ruler of Lower Heck (and the brother of the pointy-haired boss). It pokes fun at P&G's logo controversy. In brief, P&G received undesired media publicity in the 1980s when an urban legend declared that their corporate logo was a Satanic symbol. This forced P&G to adopt a new logo. In 2007 a court ruled that P&G is not in league with his Satanic Majesty. P&G won a $19m lawsuit against rival Amway over the rumours. I'll have more to say of this controversy later.



"This is about protecting our reputation," said Jim Johnson, P&G's chief legal officer.

The strip also has something interesting to say about conflicts of interest (and declaring of such conflicts). Some imagine that declaring conflicts is the be-all-and-end-all solution to the problems of pharmaceutical science. One counter-argument is that conflicts influence not only that which is done, but also that which is not done. Sitting in silence while a colleague is bullied for example.

I propose that more consideration should be given to the concept of corporate sponsorship "to stay away". Click Here to fund the Scientific Misconduct Blog.

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Memory Hole (13 October): A process known as lying

Scientific Misconduct Blog Memory Hole: Events of October the 13th

Quote of the day

Men occasionally stumble over the truth, but most of them pick themselves up and hurry off as if nothing had happened.
Winston Churchill

19 years ago today: North Pole explorer - raw data discovered

On 13 October 1988 the discovery of a famous set of scientific raw data (a notebook) was announced. These gave Peary's sightings on the day he was supposed to have reached the Pole on 6 April 1909. These notes were said to indicate that Peary missed the Pole by 120 miles, and suggest that Peary knew that he had missed.

The truth remains unclear. The National Geographic Society has stood by Peary's claim through thick and thin. It is said it suited the businessmen who were backing the Geographic society. Their judgment was confirmed by no less than a committee of the U.S. House of Representatives in 1911. Peary has also been criticised for his treatment of the Inuit.

Source: "Peary's Notes Said to Imply He Fell Short of the Pole," New York Times, 13 October 1988

7 years ago today: William Simmons admits faking results

On 13 October 2000 it was announced that scientist William Simmons had admitted to falsifying research.

This is the traditional type of scientific misconduct that fits nicely within the restricted definitions proposed by those who want nice neat crimes. William Simmons, formerly of the University of Texas left his job in 1998 only to be called back to repeat an experiment that could not be repeated. The research involved HLA-B27. While doing these repeats it was noticed that he had added fluid containing radioactive chromium 51 into vials in order to shift radioactive counts in the direction he wanted. He then admitted to falsification of research results over at least a 5-year period

His penalty was a 5-year ban on receiving federal research grants.

All nice and tidy.

Source: "Texas Scientist Admits Falsifying Results," Science 290 (13 October 2000), 245-246.

5 years ago today: Dr Benbow comments about Seroxat/Paxil

On 13 October 2002 Dr. Alastair Benbow, Head of European Psychiatry for GlaxoSmithKline stated that Paxil/Seroxat drug was well tolerated and had been used all over the world for a decade. He further stated.

"As with all prescriptions medicines, Seroxat does have side effects, but these are clearly stated in the information that's made available to doctors and to patients."

The mission statement of GSK is "to improve the quality of human life by enabling people to do more, feel better and live longer".

Source: BBC

5 years ago today: More troubles for Seroxat/Paxil

On 13 October 2002 Seroxat (Paxil in the USA) was subject of a major BBC-TV documentary on the discordance between the disclosures by GlaxoSmithKline and the addictive properties of the drug (Panorama).

That same week, GSK was ruled in breach of the pharmaceutical industry own (ABPI) code of "self regulation" for misleading promotion in the UK . The issue addressed was the company's denial that the drug is addictive and was causing great difficulty in withdrawal.

The ruling came as a result of complaints by the group Social Audit. GSK was judged in breach of three clauses of the marketing code of the Prescriptions Medicines Code of Practice Authority (PMCOPA). Complaints upheld related to the following provisions of the Code:

• "Information, claims and comparisons must be accurate, balanced, fair, objective and unambiguous and must be based on an up-to-date evaluation of all evidence and reflect that evidence clearly. They must not mislead either directly or by implication." (ABPI Code, clause 7.2)
• "Information and claims about side-effects must reflect available clinical evidence or be capable of substantiation by clinical experience. It must not be stated that a product has no side effects, toxic hazards or risks of addiction. The word "safe" must not be used without qualification." (ABPI Code, clause 7.9)
• Information about medicines made available to the public ... must be "presented in a balanced way and must not be misleading with respect to the safety of the product" (ABPI Code, clause 20.2)

Sources: BBC, AHRP, Social Audit

4 years ago today: PLoS commences publication

On 13 October 2003 the Public Library of Science (PLoS) commenced publication of its first open access scientific journal, PLoS Biology. All content in PLoS Biology is published under the Creative Commons "by-attribution" license. PLoS Medicine, in contrast to most other "big" medical journals has been careful to avoid commercial interference with publication.

Source: PLoS Biology; The PLoS Medicine Editors: PLoS Medicine and the Pharmaceutical Industry. PLoS Med 2006:3:e329

3 years ago today: PPA decongestants first court case (how do they sleep at night?)

On 13 October 2004 Bayer lost the first of 1500 PPA claims pending. PPA is a nasal decongestant (phenylpropanolamine):

In the words of Mike Lascales, I sometimes wonder how the medical directors for some pharmaceutical companies sleep at night.

"How was your day at work dear?"
"Good - I think I managed to discredit those dumb scientists who tried to show our drug causes strokes."

Many consumers "suffered strokes after a landmark study (sponsored by the drug industry) concluded in October 1999 that the use of PPA was associated with an increased risk of stroke. Recently obtained internal company documents show that rather than alerting the public, drug makers launched a yearlong campaign to keep the results quiet and stall government regulation. By the time the FDA acted, 13 months and hundreds of strokes later, the companies had reformulated their brand names with little interruption in sales."

The LA Times (read here or here) used the Freedom of Information Act to get an inside look at commercial behavior when questions were asked about phenylpropanolamine (PPA):

"The Los Angeles Times reviewed thousands of pages of documents produced through discovery in PPA lawsuits and from the FDA. The documents demonstrate that the pharmaceutical industry consistently challenged any notion that PPA could be dangerous and dismissed evidence to the contrary. They also show that the manufacturers assured the public that PPA was safe even as some FDA scientists and industry officials were raising concerns."

As early as 1982, an FDA report warned that PPA had "the ability to cause cardiovascular effects, cerebral hemorrhage and cardiac arrhythmias."

Two years later, a memo from the medical-services department at Sandoz Pharmaceuticals, which made the PPA products Triaminic and Tavist-D, referred to PPA as "an agent known to cause hypertension and stroke."

Yet the drug companies accelerated their marketing of PPA, winning FDA approval to sell prescription PPA products on an over-the-counter basis and introducing flavorful formulas for children.

Upon learning that the 1999 study had found a stroke link, the drug makers opened a relentless assault on its methodology and on the integrity of the Yale University researchers who conducted it. They did so despite having paid for the five-year, $5 million study, approving its protocol and handpicking investigators who had previously expressed skepticism about a link between PPA and stroke.

The FDA eventually recommended the withdrawal of more than 100 PPA products. FDA officials said they did not move faster because the industry's efforts to discredit the Yale results effectively delayed the final report.

Once the FDA stepped in, the manufacturers issued news releases, but neither the companies nor the FDA mounted major advertising or direct-mail campaigns to warn Americans they might have dangerous products at home.
A survey estimated that 3.5 million U.S. households still possessed PPA formulations 15 months after the withdrawal in November 2000. (Read more).

Selected Sources: Bayer loses first of 1,500 PPA claims pending, Seattle Times

2 years ago today: Texas TMAP and a process known as lying

On 13 October 2005 the Rutherford Institute interviewed Allen Jones about a Texas drug research scam linked to then Governor George W. Bush.

Jones was appointed lead investigator for the Pennsylvania Office of the Inspector General in July 2002 in a case concerning off-the-books payments from pharmaceutical companies in Texas. He uncovered documents showing "state officials accepting large honorariums. His discoveries cost him his career. His findings showed that the drug company Janssen had paid honorariums to key state officials with influence over prescriptions for state institutions. Although accounts were marked for "educational grants," funds were channeled to employees who developed guidelines recommending new psychiatric drugs rather than older and potentially safer drugs.

After revealing his discoveries to OIG managers, Jones was taken off the case. When he went public with his findings, he was fired. The formulary investigated by Jones is based on the Texas Medication Algorithm Project (TMAP). "It has also been revealed that TMAP personnel may have tampered with research results through a process known as Retrospective Analysis. Patients who had previously been treated with the new medications were researched, and files showing positive results were selected and reported on."

See complete interview here

2 years ago today: Merck - bad language and failure to release data

On 13 October 2005 Merck's former research chief testified that his insulting description of federal regulators in a 2001 e-mail was meant as a joke.

Edward Scolnick was asked by an attorney about his description of FDA regulators as "grade D high school students" after Merck faced officials at a government advisory committee meeting. "In another memo a few months later, Scolnick described regulators as "bastards" after they demanded Merck cite on its Vioxx label the fact that five times as many patients on Vioxx than on a placebo had suffered heart attacks during a clinical trial."

"My language was clearly, clearly inappropriate and was not respectful to the FDA," Scolnick said.

"Earlier yesterday, a current Merck executive, Alise Reicin (see her other adventures in integrity), insisted repeatedly that she never thought Vioxx was dangerous and therefore did not initially release all the data on deaths of Vioxx users in another study"

"Asked whether Merck's revenue would have suffered if it had publicized the results of a study showing more deaths - from all causes - in patients using Vioxx than a placebo", Reicin responded: "Yes, you would expect sales would go down. But that would not influence the way I made decisions."

Approximately 100 000 people are thought to have died as a result of taking Vioxx. Today, two years later, it is reported that the FDA are very reluctant to hand over documents that show Merck’s relationships with the FDA (See Pharmalot).

Source Philadelphia Inquirer

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Memory Hole (9 October): When white is black and black is white

Scientific Misconduct Blog Memory Hole: Events of October the 9th

Quote of the day

"There was a society of men among us,
bred from their youth in the art of proving,
by word multiplied for the purpose,
that white is black and black is white
according to how they are paid"
Jonathan Swift

20 years ago today: Cornell whitewash is undone

On 9 October 1987 final resolution of a dispute involving Cornell Medical center was announced in the journal Science.

The story began in 1981 when a prominent cardiologist, Dr. Jeffrey Borer was accused of making several misstatements in a scientific paper. the whistleblower was Dr Jerome Jacobstein. Jacobstein said that Borer had falsely declared that there were two observers in the experiment (there had only been one), and that subjects had not been chosen randomly as the paper had stated.

The committee criticised Cornell for not treating Jacobstein's initial charges properly.

Jacobson states that it is hardly surprising that cases of proven scientific misconduct are so rare, that the costs of raising it are too high and that Cornell whitewashed his concerns. "Everybody concerned dragged their feet".

Borer had served on the Cardiorenal Advisory Committee of the FDA.

Source: "NIH Finally Resolves 7-Year Dispute," Science 238 (9 October 1987)

15 years ago today: Public learns of Bristol Heart Scandal through a satirical magazine

On 9 October 1992 the British satirical magazine "Private Eye" revealed that mortality rates for infants undergoing certain cardiac procedures in Bristol was unacceptably high and that operations were still being carried out despite concerns raised by staff.

The article read:

"The sorry state of paediatric cardiac surgery at the United Bristol Healthcare Trust has been confirmed by an internal audit over the last two years' operations. The results of procedures to correct two congenital heart abnormalities (Tetralogy of Fallot and transposition of the arteries) were especially poor.

James Wisheart, chairman of the hospital management committee and medical advisor to the trust board, is required to maintain standards of medical practice at UBHT. Curiously he has not felt it necessary to inform the trust board or the trust's purchasers of these findings. Could it be because he is also associate director of cardiac surgery?"

Thus began the public exposure of what became known as the "Bristol heart scandal" as well as the institutional cover up and the ignoring and bullying of the whistleblower anaesthetist Stephen Bolsin. Between 30 and 50 babies died unnecessarily at the Bristol Royal Infirmary between 1984 and 1995. In 1992 it needed a satirical magazine to take notice. The report into the scandal made more that 200 recommendations but the real problems were not addressed. Raising concerns about patient safety and scientific misconduct is more difficult than it has ever been. The cover up culture has persisted and has been reinforced through legislation such as the Public Interest Disclosure Act. There is an illusion of change.

15 years ago today: Death of Dr Joseph Mengele confirmed

On 9 October 1994 a report confirmed that bones in a grave at Embu near Sao Paolo in 1985 were authenticated by forensic experts as belonging to Mengele. On 1943, he became medical officer of Auschwitz-Birkenau's "Gypsy camp." Mengele supervised many sadistic experiments on Gypsies and Jews.

Source: "U.S. Report on Mengele Reaffirms His Death," New York Times, 9 Oct 1992

10 years ago today: Delayed release of report into the effect of above-ground nuclear tests

On 9 October 1997 it was reported that the US National Cancer Institute (NCI) admitted they should not have avoided releasing a study of exposure to radioactive iodine from above-ground nuclear tests in the 1950s.

The study reported that up to 75,000 additional cases of thyroid cancers in America were probable given the amount of radioactive iodine to which Americans on average were exposed.

Joseph Lyon, a professor of family medicine at the University of Utah suggested that funding for follow up studies had been blocked by Bruce Wachholz, chief of NCI's Radiation Effects Branch.

(I note in Pubmed a cohort study authored by the above Lyon some 10 years later. Life near a nuclear blast site doesn't sound too bad)

Source: "NCI Apologizes for Fallout Study Delay," Nature (9 October 1997) p534.

10 years ago today: African HIV experiments criticised

On 9 October 1997 the New York Times reported on the ethics of HIV experiments in Africa. It turns out that individuals studied were given placebo and didn't grasp "what exactly a placebo is" or why they "might have been given one instead of a real medicine". It would have been virtually impossible to get approval for placebo controlled studies of HIV in the United States. There is much more to this story.

Source: " AIDS Research in Africa: Juggling Risks and Hopes" New York Times, 9 Oct 1997

5 years ago today: Declassified documents reveal further unethical toxicology experiments on military recruits

On 9 October 2002, The New York Times reports that 16 newly declassified reports from the Pentagon describe experiments conducted on soldiers without consent between 1962 and 1971.

Ships and sailors had been sprayed with sarin gas and other chemical and biological agents. An estimated 5,500 persons were involved.

Tests conducted together with the Canadian government used VX, and tests with Britain used sarin and VX, the documents show.

It took 40 years to disclose these experiments.

Source: "U.S. Troops Were Subjected to a Wider Toxic Testing" New York Times Oct 9 2002

2 years ago today: Secret funding to ADHD patient "support" groups

On 9 October 2005, a newspaper article in the UK Telegraph revealed that UK patient "support" groups for parents of children with ADHD were being secretly funded by pharmaceutical companies with an interest in selling drugs for ADHD.

In particular, the "Attention Deficit Disorder Information and Support Service" (ADDISS), a Department of Health-funded "charity" had been providing details of drugs to parents. Andrea Bilbow, chief executive of ADDISS, admitted that ADDISS had solicited and received funding from Janssen-Cilag, which makes Concerta, UCB Pharma, and Eli Lilly, which makes Strattera (an ADHD drug linked to an increased risk of suicide in children). Bilbow maintains that "not enough children are given the drugs" and that at least 700,000 children in the UK should be taking Ritalin.

Whether that is a reasonable belief or not, the drug firms' financing was not acknowledged on ADDISS website and nor did their names show up on the accounts lodged with the Charity Commission.

Bilbow stated: "If we put the names on the site that would be promoting the companies and I've told them I won't do that" and "That would be advertising and I'm not getting enough money from them for that."

Although such secret funding might not cause surprise outside of the UK, it was a shock. The funding also assumed importance because a psychologist Lisa Blakemore Brown had maintained that ADDISS had been receiving such funding. Furthermore, she maintained ADDISS had coached a patient to place a spurious complaint about her to the British Psychological Society. In leaked transcripts of the case, it appeared that the BPS had then accused Blakemore Brown of being paranoid (and hence not fit to practice). As part evidence for this supposed paranoia, Dr Friedman (a psychiatrist who had not examined her) felt such as idea would be "amazing" and "extremely unlikely". Friedman also works as psychiatric assessor for Doctors facing fitness to practice tribunals with the GMC.

Source: ADHD advice secretly paid for by drugs companies", Telegraph, 9 Oct 2000

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P&G Pharmaceuticals: how to deal with a public relations disaster

Patients get damaged by misrepresented pharmaceutical research. “Ghost-writing” has been repeatedly criticized - but this diverts attention from the more important problem – “ghost science”, of which “ghost-writing” is only a small part. Ghosts work behind the scenes at every level of the pharmaceutical scientific process. Sometimes these ghosts make mistakes and get startled by the headlamps - as Procter and Gamble discovered this week.

The steps P&G have taken to suppress concerns about their research procedures involving the drug Actonel seem to have derived from a Monty Python script. For the backstory read press reports, collated postings on this blog, report in AAAS, or Slate.

Last year, Procter and Gamble released previously hidden raw data underlying one published paper, several meeting abstracts, and two draft publications (with myself as first author). Work by independent statisticians has confirmed that the data does not provide credible support for P&G's reporting of a convenient "plateau" for Actonel in any of the three ghosted publications.

A declaration of Mea Culpa would have served Procter and Gamble far better than the endless attempts to collude with other script writers (like the editors of the Journal of Bone and Mineral Research). Instead P&G have now stepped further into the mud:

1. They refused to allow me to place the data they eventually provided (underlying three publications) into the public domain. This did not serve to enhance their credibility.
2. They refused to allow me as author to submit raw data directly to a journal editor requesting such data.
3. They declined to provide a copy of the consent form patients would have signed upon agreeing to participate in this research. Did patients consent to have the measurements I performed? Did participants realize that data derived from their risk would not be open to scrutiny by authors of the publications, or that it could be misrepresented?
4. But wait .... whatever next .... the Python team would be impressed by P&G's new attempt to act behind the scenes to have a perfectly valid conflict of interest declaration removed from the first of several scientifically correct meeting abstracts submitted about this research.

Read what happened and laugh (or cry):

Step 1: The abstract below (authored by myself and an independent statistician) was submitted on 22 January for presentation at The International Bone and Mineral Society Meeting (to be held in Montreal). The statistical aspects have been redacted pending publication. The electronic submission was accompanied by a declaration of funding leading to the footer as shown - "Study funded by Procter & Gamble Pharmaceuticals".

Control/Tracking: 07-A-464-IBMS Current Date/Time: 1/22/2007 3:53:26PM
Relationship of fracture risk to change in bone resorption with risedronate in the HIP study - is there a plateau response?
Authors: A. Blumsohn(1), J. L. Hutton(2)
1 Sheffield Teaching Hospitals, Sheffield, UNITED KINGDOM,
2 Department of Statistics, University of Warwick, Coventry, UNITED KINGDOM.
Understanding the determinants of bisphosphonate induced change in fracture risk is a prerequisite to rational prescribing and therapeutic monitoring. A previous abstract (Blumsohn, Barton, Chines, Eastell. JBMR 2003;18 S2:S89), and draft publications failed to shed light on the true relationship between change in bone resorption (uNTX/Cr) and fracture risk in the HIP study. The study included 938 women (FN T score <-3, age 74 SD 3) who received Ca and either 5mg risedronate/day, 2.5mg or placebo for 3 years. Randomization and event codes were supplied to authors in 2006. Data did not provide evidence to support previous conclusions.
Previous reports on these data suggested risk of incident vertebral fracture (V#) was non-decreasing when NTX decreases beyond -30% (%?NTX < -30%), and the relationship was "non linear" with "little further improvement in fracture benefit below a decrease of 30 to 35%". It further suggested that another marker (%?PINP) was significantly predictive of V#.
We used several statistical models as well as visual inspection to evaluate a potential "plateau" effect at a putative threshold -30% or -40%.
--- --- -------- ---------- ------ ---- ----, ---- ---------- -- ---- --- ----, --- --- --------------- -- ---: ----- --- ---------- --- -------- --- ------- -- ---- --------- ------ ----- --- ----- --- ---------, --- ---- ------ --- --------- ---------- ----------- ---- ----------- --- ---- --- --- ------, ---- -- ------- --------- -- ---- -- --- ---------- ------- -----
------ ---------- ------ -- -------- -- - ------- ---- --- -------- ---------- ---- --- ----------- ---- ------ -------- -- -------- ---- ------ -- --- ------ --- -------- ---- --------- ------- ----- ---- -- --- ------ -- -------- ---- ----- - ---- --------- -- ----- --- ---- --- ----------- ----- ----- -- ---- ----- --------- -- ------- -- --- --------- ------- --- -- -------- -- --- --- ----- - -----
---------- ------ ------ -- -------- --- - ------- -- ------ ---------, --- ----------- -------- -- -- ------- ---- - - ------ --- ---- --- --- --- ----- --- ---- -- -- --------- ------------- ---- ------- --- ---------- ---------- ------ ------ ----------- ---------- --- -------- -- ----- -- --- ------- ------- ------ --- - --- --------- ---- -------, ------ ------- -- - ---- --------- --------, ------ -------- -- ----------- ------------ ------- ------ --- -- --- ----- -- ---------- -- ------- -- ---------- ------ ---- - -------
In conclusion, this study provides no evidence to support a plateau relationship between NTX change and fracture risk with threshold near -30% in patients taking risedronate.
Author Disclosure Block: Study funded by Procter & Gamble Pharmaceuticals.

Step 2: On the 6th of March a fascinating E-mail was sent from the meeting organizers to mysterious Dr C Purple at Procter and Gamble. Unfortunately for Dr Purple the E-mail was also copied to my own E-mail address which had accompanied the abstract submission, together with Dr Purple's earlier secret E-mail to the meeting organizers. Dr Purple had asked for my declaration of interests and funding to be removed from the abstract. The meeting organizers had complied with this request.

Subject: RE: Abstract Change
Date: Mon, 5 Mar 2007 17:33:59 -0500
From: "Paterson, Anne"
To: purple.cr@pg.com
CC: Aubrey Blumsohn

Dear Dr. Purple,

I have adjusted the disclosure so it does not include the below disclosure for P&G. There is currently no disclosure. If there is to be, please let me know and I’ll make the appropriate change.

Thank you for your patience and please do not hesitate to let me know if you have additional questions or concerns.

Kindly,
Anne

Anne Paterson
International Bone and Mineral Society (IBMS)
Washington, DC 20036

From: purple.cr@pg.com [mailto:purple.cr@pg.com]
Sent: Tuesday, February 27, 2007 10:47 AM
To: IBMS - Paterson, Anne
Subject: Abstract Change

Dear Anne:

Last Thursday we spoke about changing an abstract, here are the details;

Please check the abstract submitted by Blumsohn and Hutton (Title: Relationship of fracture risk to change in bone resorption with risedronate in the HIP study - is there a plateau response) for a statement in the disclosure block indicating that the study was funded by Procter & Gamble Pharmaceuticals. Would you please let me know if is this disclosure is still attached to the abstract. If it remains associated with the abstract, please tell me what is the process for having it removed from the abstract?

Thank you for your help with this.

Christopher Purple, Ph.D.
Medical & Technical Affairs
Procter & Gamble Pharmaceuticals
513.622.0516
purple.cr@pg.com

Step 3: Professor Hutton and I responded with some consternation. We were informed that the meeting organizers had been duped (misled) by Procter and Gamble.

From: Aubrey Blumsohn
Sent: Monday, March 05, 2007 5:59 PM
To: Paterson, Anne
Subject: RE: Abstract Change


Dear Ms Paterson

Kindly let me know the basis upon which you altered the abstract submitted by myself (removing the conflicts of interest/disclosure section). Please also state precisely who gave you permission to do so.

This is extremely strange. Dr Purple's rather unusual E-mail below your own appears to have derived from a commercial company.

I would appreciate your urgent response. I would also appreciate it if you would send be a copy of the IBMS conflicts of interest and disclosure policy as it applies to this meeting and to IBMS
activities in general.

The abstract as submitted is attached.

Yours Sincerely

Dr Aubrey Blumsohn
MBBCh, PhD, MSc, BSc(hons), MRCPath

Subject: RE: Abstract Change
Date: Mon, 5 Mar 2007 18:11:17 -0500
From: "IBMS - Paterson, Anne"
To: "Aubrey Blumsohn"

Dear Dr. Blumsohn,

I apologize for this misunderstanding as I was under the impression you knew about the conflict. I have reentered the disclosure in the abstract as indicated in your attached pdf.

Please let me know if you have any further questions. I will contact you if anything else comes up regarding this conflict.

Regards,
Anne

Anne Paterson
International Bone and Mineral Society (IBMS)
2025 M Street NW, Suite 800
Washington, DC 20036

Subject: RE: Abstract Change
Date: Tue, 6 Mar 2007 09:19:10 -0500
From: "IBMS - Paterson, Anne"
To: "Professor Jane Hutton"

Dear Dr. Hutton,

Thank you for your concern. It is not our policy and I take responsibility for the misunderstanding. I was misled and can assure you that as soon as I realized that the authors were not notified, I alerted the submitter and immediately returned it to its original form.

I am not sure how Dr. Purple viewed the abstract.

Please do let me know if you have any additional concerns.

Kind regards,
Anne

Anne Paterson
International Bone and Mineral Society (IBMS)

Well thank you Anne Paterson and the IBMS for behaving properly so far. Award of an oral presentation to to 07-A-464-IBMS may help restore a little of the lost credibility in skeletal pharmaceutical research.

And to Dr Purple of P&G: Please watch the Monty Python Parrot sketch below. Perhaps the PR staff at P&G should assist with research into soap and sanitary products like the Rely Tampon until you get some training from a proper pharmaceutical company - like Eli Lilly or Merck. Please invite me to give a seminar to your staff about the obligations of a doctor and how to deal with ethical problems in a more plausible way. I would be happy to do so any time.



You might also want to read some excellent blogs about pseudoevidence based medicine, a more effective public relations gambit, Conflicts of interest and other troubles with research. You are not alone.

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