Here’s an interesting article about pharma outsourcing clinical trials to India. One quick snip:

The drug regimen, known as Aggrenox, was being tested for its ability to forestall a second stroke. S. P. Kalantri, the doctor tapped to lead the trial in Sevagram, quickly grasped the offer’s appeal. Patients in Sevagram are poor enough that the benefits of taking part in the study would amount to a health care windfall; among other things, Boehringer Ingelheim guaranteed participants two physicals during each of the three years that the trial would run. For each person enrolled, moreover, the hospital would receive 30,000 rupees (about $665) - no small amount, given the puny budget of the center’s stroke ward, a single room of eight pallet beds. Kalantri talked the matter over with the chair of the hospital’s ethics committee, and the two concluded that the trial drug itself, with its possible side effects and limited efficacy, would provide little benefit to their patients. Then they went ahead and signed up.

Did you know the U.S. Army will pay for continuing education for physician assistants? I didn’t until I saw this press release, which says they’ll pay for the full 100 hours per year required for certification. I wonder what the CME benefits are for physicians?

We recently received a fairly blistering e-mail blasting us for the relatively low response rate to this year’s Annual Physician’s Survey. Actually, we thought 16.6 percent was pretty good—of course, more would be better.

I know we’re not alone in our struggle to get higher response rates to surveys; I heard all kinds of grumbling about it at the Alliance meeting in January, but not a lot of solutions. One that I heard during a session on practical strategies for outcomes measurement was to include something lumpy in the envelope. The session leaders said that they had success with putting a piece of candy in the envelope along with the survey; they‘ll open it just to see what the lump is. Once they open it, they‘re somewhat engaged with it, and you have a better shot at them filling it out.

Any other ideas? We include a buck, but I doubt that’s much of an incentive to fill the thing out (yes, we keep it short and sweet). Seriously, I think this is something we all struggle with.

The American

Society of Hematology has donated $200,000 to the New Orleans Metropolitan Convention & Visitors Bureau’s New Orleans Tourism Relief Funds. The money will go toward helping to rebuild the city’s tourism infrastructure.

Recommended reading from Anne Taylor-Vaisey: Academic Medicine is offering some articles in the February issue for free for one month. If you don’t have a subscription, download them while you can!

 

Editorial: Ambulatory-Based Clinical Education: Flexner Revisited, Michael E. Whitcomb

Research Report: Policies of Academic Medical Centers for Disclosing Financial Conflicts of Interest to Potential Research Participants, Kevin P. Weinfurt, Michaela A. Dinan, Jennifer S. Allsbrook, Joëlle Y. Friedman, Mark A. Hall, Kevin A. Schulman, and Jeremy Sugarman

Article: Guidelines for Interactions between Clinical Faculty and the Pharmaceutical Industry: One Medical School’s Approach, David L. Coleman, Alan E. Kazdin, Lee Ann Miller, Jon S. Morrow, and Robert Udelsman

Article: Creating an Infrastructure for Training in the Responsible Conduct of Research: The University of Pittsburgh’s Experience, Barbara E. Barnes, Charles P. Friedman, Jerome L. Rosenberg, Joanne Russell, Ari Beedle, and Arthur S. Levine

From the Cincinnati Business Journal: Procter denies scientist’s challenge on drug claims. A snip:

A researcher hired by Procter & Gamble Co. to analyze its Actonel osteoporisis drug is meeting with U.S. officials this week to argue that the consumer products maker misrepresented his data, the Wall Street Journal reported today.



The scientist, Aubrey Blumsohn, a bone-metabolism expert at the University of Sheffield in the United Kingdom, claims Procter distorted his data about the drug’s effectiveness in its educational and marketing materials. He is meeting with congressional staffers and the National Institutes for Health.

Recommended reading from Anne Taylor-Vaisey: Here’s another one in the unending saga…

Paediatr Respir Rev. 2006 Mar;7(1):54-9: The relationship between paediatricians and commerce:

The interaction between doctors and commerce, particularly the pharmaceutical industry, has recently been subject to increasing scrutiny. Doctors are now exposed to mounting influence from industry as it spends large amounts of money on marketing, is heavily involved with continuing medical education and sponsors a major proportion of research. Conflicts of interest may exist on both sides of the relationship: doctors can be manipulated and companies need to be profitable. Paediatricians are just as open to this influence as are other members of the medical profession. There is evidence that clinical practice is altered by interaction with industry, although doctors appear to deny the likelihood of being influenced. There are significant concerns over the increasing involvement of the pharmaceutical industry with research, although the regulation of the industry continues to be strengthened and the process of research is becoming more transparent. Disclosure of conflicts of interest involving authorship is now common practice and should extend to all facets of the relationship. However, collaboration continues to be necessary in order to develop new therapies, maximise research and particularly in paediatrics, to test medications in children. Paediatricians need to be aware of the sources of influence and understand current guidelines so that interactions with industry continue to be appropriate.

GlaxoSmithKline is planning to use its entire 8,000-person U.S. sales force as a public relations team (free subscription req’d). What could possibly go wrong?

Maybe they should send their sales reps to the American Medical Association’s 26th annual Medical Communications Conference, which by the way looks like a good one for anyone who’s interested in improving how healthcare messages are communicated to the public and the media.

I recently came across a study that finds that surveys that have a Post-it note attached get better response rates than those that are sent out unadorned. Interesting! I wonder if anyone has used this idea for post-activity surveys, and if so, if it really does improve response for longer, more involved surveys (it says there isn’t much difference for short and easy ones).

(Thanks to the MeCo Google Group for the pointer.)

From an AP story: Industry-funded research disputes grow:

Dr. Aubrey Blumsohn was stunned: Research results were submitted to a scientific meeting under his name, yet the British bone specialist insists he not only hadn’t written or reviewed the report, he wasn’t sure it was accurate.



The incident turned into a public feud when Blumsohn charged that the U.S. drug company paying for the study rebuffed his attempts to analyze the data.




It’s the latest in a string of controversies about pharmaceutical industry control of medical research, from hidden antidepressant risks to the undercounting of heart attacks in a critical study of the painkiller Vioxx.




Whoever pays for medical research - not necessarily the scientists who do the work - controls what doctors, and the public, learn about its outcome. Scientific journals, including one that published some of the reports Blumsohn now questions, are grappling anew with how to ensure that they print complete results.

I just felt sick to my stomach at some of the things I learned while researching this article for Medical Meetings and how all this could impact CME. I’m sure it doesn’t happen often, but these are the folks making headlines, and all the good work done by honest researchers, backed by companies that really want to improve the public health as well as make a buck goes for naught.