FacebookTwitterGoogle+RedditEmail

Is Your Doctor’s Continuing Ed Funded by Drug Makers?

Raise your hand if you’ve breathed a sigh of relief seeing your doctor had a CME (Continuing Medical Education) certificate next to the medical school diploma on the wall.

Did your doctor pass  Bipolar Disorder: Individualizing Treatment to Improve Patient Outcomes, Part 2 “taught” by Trisha Suppes, MD, PhD and offered by CME Outfitters?

Suppes is a Professor in Stanford’s Department of Psychiatry and Behavioral Science and funded by Abbott, AstraZeneca; GlaxoSmithKline, Janssen, Novartis, Pfizer, Wyeth, Bristol-Myers Squibb, Eli Lilly, Shire and four more drug companies.

Maybe your doctor passed Quadrivalent HPV Vaccine May Be Effective in Women 24 to 45 Years Old — which sounds like a sales pitch for Gardasil because it is — which “studies” a Lancet article written by Nubia Munoz, MD, two Merck employees and other authors.

Sample question: “What was the main conclusion of the current study by Munoz and colleagues of HPV vaccine among women between the ages of 24 and 45 years?” (Italics CME’s) Hint: the answer is in the title.

Upon “completion on this activity” offered by CME giant Medscape, part of the WebMD monolith — still available for credit if you hurry — “participants will be able to: “Specify the currently recommended age range for the administration of the quadrivalent human papillomavirus vaccine” and “Describe the effects of the quadrivalent human papillomavirus vaccine among women between the ages of 24 and 45 years.”

Maybe your doctor passed Medscape’s Innovative Approaches to Vaccination Challenges: Overcoming Barriers for Adult Patients sponsored by — surprise! — vaccine makers Novartis, GSK and Merck and meaning sales barriers.

CMEs, continuing medical education courses, are sponsored by drug makers, “taught” by industry-funded specialists and bracketed by pop-up drugs ads which sometimes occlude the text you’re reading. (“Which of the following manic symptoms are most seriously impacting your bipolar patients’ lives?” asked a disease-baiting ad for Geodon, direct-to-consumer style, when we looked at a CME.) Yet doctors are required to sit through the canned message like a time-share presentation and answer a quiz just to keep their state licenses and sometimes insurance policies.

In fact the only good thing doctors have to say about CMEs is they are hard to fail–“second chance” questions pop up if you miss the first ones; and they are often free. Why?

CMEs are supposed to be monitored by the Accreditation Council for Continuing Medical Education (ACCME) but like Standard and Poor’s and Moody’s stock ratings funding comes from the client side so buyer beware.

Last year Bernard Carroll, MD a former chairman of psychiatry at Duke, challenged the objectivity of a CME Outfitters course called Atypical Antipsychotics in Major Depressive Disorder: When Current Treatments Are Not Enough (what are they trying to say?) funded by Seroquel maker AstraZeneca and taught by disgraced Emory University psychiatrist Charles Nemeroff, MD who lost his department chairmanship from unreported drug industry income.

Two doses of Seroquel were tested but only the results of one were “statistically significant,” writes Carroll on a blog called Health Care Renewal. “One of the junior presenters stated very clearly that there was ‘significant improvement in both response and remission with both doses’ of Seroquel. That is a falsification of the scientific record.”

In October AstraZeneca agreed to pay $520 million to settle Seroquel suits and investigations of “physicians who participated in clinical trials involving Seroquel,” presumably on which safety was established, and a JAMA article red flags Seroquel’s metabolic proclivities in which studied children gained a pound a week and more. Yet AstraZeneca still seeks FDA approval to market Seroquel to kids.

Nor did the April 2009 article about Seroquel, Maintenance Treatment For Patients With Bipolar I Disorder: Results From A North American Study Of Quetiapine In Combination With Lithium Or Divalproex in the American Journal of Psychiatry (AJP) by CME presenter Trisha Suppes fare well.

Why were two-thirds of pre-randomization patients discontinued because of “lack of therapeutic response, developing an adverse event” and being lost to follow-up, ask Debasish Basu, MD, and Kaustav Chakraborty, MD from Chandigarh, India in the October AJP? “Could it be possible that the remaining patients, who did eventually proceed to the randomization phase, represented a group favorably predisposed to the quetiapine combination?”

A second letter in the same AJP echoes the methodology questions. “Only one-third of the patients were selected for maintenance therapy, which raises the possibility of selection bias,” write Bettahalasoor S. Somashekar, MD, DPM, Ashok Kumar Jainer, MD, MRCP and Wajid Shafi, MD from Coventry, UK. “In this regard, Healy [David Healy, MD, Cardiff University professor] stated that company sponsored clinical trials invariably recruit samples of convenience, which by definition do not actually sustain extrapolation to normal clinical practice.”

Similar methodology questions are raised about the “science” behind Medscape’s Quadrivalent HPV Vaccine May Be Effective in Women 24 to 45 Years Old CME in the October 10 Lancet. Not only should your sons and daughters get the Human Papillomavirus vaccine,says Merck, so should your parents.

Why did Munoz et al exclude women “with pre-existing infections and women who do not complete the full course of the vaccine,” ask six researchers with US National Cancer Institute. Is this also a sample of convenience?

Why was “infection of 6 month duration or longer” used as an endpoint for showing a cancer benefit asks a different set of researchers, Stefanie Schenk and Jutta Halbekath from Berlin, in the same Lancet issue. Why is there no “differentiation” between infection and cancer–a big scientific leap?

Clearly the letter writers need to do their CMEs.

MARTHA ROSENBERG can be reached at: martharosenberg@sbcglobal.net

 

More articles by:

Martha Rosenberg is an investigative health reporter. She is the author of  Born With A Junk Food Deficiency: How Flaks, Quacks and Hacks Pimp The Public Health (Prometheus).

December 13, 2018
John Davis
What World Do We Seek?
Subhankar Banerjee
Biological Annihilation: a Planet in Loss Mode
Lawrence Davidson
What the Attack on Marc Lamont Hill Tells Us
James McEnteer
Breathless
Ramzy Baroud
The Real Face of Justin Trudeau: Are Palestinians Canada’s new Jews?
Dean Baker
Pelosi Would Sabotage the Progressive Agenda With a Pay-Go Rule
Elliot Sperber
Understanding the Yellow Vests Movement Through Basic Color Theory 
Rivera Sun
The End of the NRA? Business Magazines Tell Activists: The Strategy is Working
Kevin Zeese - Margaret Flowers
Historic Opportunity to Transform Trade
December 12, 2018
Arshad Khan
War, Anniversaries and Lessons Never Learned
Paul Street
Blacking Out the Yellow Vests on Cable News: Corporate Media Doing its Job
Kenneth Surin
The Brexit Shambles Rambles On
David Schultz
Stacking the Deck Against Democracy in Wisconsin
Steve Early
The Housing Affordability Crisis and What Millennials Can do About It
George Ochenski
Collaboration Failure: Trump Trashes Sage Grouse Protections
Rob Seimetz
Bringing a Life Into a Dying World: A Letter From a Father to His Unborn Son
Michael Howard
PETA and the ‘S’-Word
John Kendall Hawkins
Good Panopt, Bad Panopt: Does It Make A Difference?
Kim C. Domenico
Redeeming Utopia: a Meditation On An Essay by Ursula LeGuin
Binoy Kampmark
Exhuming Franco: Spain’s Immemorial Divisions
ADRIAN KUZMINSKI
Democratizing Money
Laura Finley
Congress Must Reauthorize VAWA
December 11, 2018
Eric Draitser
AFRICOM: A Neocolonial Occupation Force?
Sheldon Richman
War Over Ukraine?
Louis Proyect
Why World War II, Not the New Deal, Ended the Great Depression
Howard Lisnoff
Police Violence and Mass Policing in the U.S.
Mark Ashwill
A “Patriotic” Education Study Abroad Program in Viet Nam: God Bless America, Right or Wrong!
Laura Flanders
HUD Official to Move into Public Housing?
Nino Pagliccia
Resistance is Not Terrorism
Matthew Johnson
See No Evil, See No Good: The Truth Is Not Black and White
Maria Paez Victor
How Reuters Slandered Venezuela’s Social Benefits Card
December 10, 2018
Jacques R. Pauwels
Foreign Interventions in Revolutionary Russia
Richard Klin
The Disasters of War
Katie Fite
Rebranding Bundy
Gary Olson
A Few Thoughts on Politics and Personal Identity
Patrick Cockburn
Brexit Britain’s Crisis of Self-Confidence Will Only End in Tears and Rising Nationalism
Andrew Moss
Undocumented Citizen
Dean Baker
Trump and China: Going With Patent Holders Against Workers
Lawrence Wittner
Reviving the Nuclear Disarmament Movement: a Practical Proposal
Dan Siegel
Thoughts on the 2018 Elections and Beyond
Thomas Knapp
Election 2020: I Can Smell the Dumpster Fires Already
Weekend Edition
December 07, 2018
Friday - Sunday
Steve Hendricks
What If We Just Buy Off Big Fossil Fuel? A Novel Plan to Mitigate the Climate Calamity
Jeffrey St. Clair
Cancer as Weapon: Poppy Bush’s Radioactive War on Iraq
Paul Street
The McCain and Bush Death Tours: Establishment Rituals in How to be a Proper Ruler
Jason Hirthler
Laws of the Jungle: The Free Market and the Continuity of Change
FacebookTwitterGoogle+RedditEmail