(Press-News.org) There may be a link between receiving industry funding for speaking, consulting, or research, and the publication of apparently promotional opinion pieces on menopausal hormone therapy. Furthermore, such publications may encourage physicians to continue prescribing these therapies to women of menopausal age. These are the key findings of a study by Adriane Fugh-Berman from Georgetown University Medical Center, Washington D.C., USA, and colleagues, published in this week's PLoS Medicine.
Over the past three decades, menopausal hormones have been heavily promoted for preventing disease in women. However, the 2004 federally-funded Women's Health Initiative study that enrolled more than 26,000 women in the USA found that the most popular estrogen-progestin and estrogen-only formulations (often prescribed to women around the age of menopause) increased the risk of stroke, deep vein thrombosis, dementia, and incontinence; the combined therapy also increased breast cancer risk. Two years after the results of the Women's Health Initiative were published, a survey of more than 700 practicing gynecologists—the specialists who prescribe the majority of hormone replacement therapies—in the USA found that almost half did not find the findings of the Women Health Initiative Study convincing. This current study investigated whether promotional tone could be identified in narrative review articles regarding menopausal hormone therapy.
The authors conducted a comprehensive literature search that identified 340 relevant articles published between July 2002 and June 2006—the 4 years following the cessation of the estrogen-progestin arm of the Women's health Initiative study. Ten authors had published 4-6 articles, 47 had published 2-3 articles, and 371 had published one article each. The researchers focused on authors who had published four or more articles in the four-year period under study. After author names and affiliations were removed, 50 articles were independently evaluated by three readers for scientific accuracy and for tone.
Although most of the articles were scientifically accurate, common themes in the 50 articles included arguments that clinical trial results should not guide treatment for individuals, and suggestions that the risks associated with hormone therapy have been exaggerated and that the benefits of hormone therapy have been, or will be, proven. Of the ten authors studied, eight were found to have received payment for speaking or consulting on behalf of menopause hormone manufacturers and 30 of 32 articles evaluated as promoting hormone therapy were written by those with such potential financial conflicts of interest. Articles promoting the use of menopausal hormone therapy were more than twice as likely to have been written by authors with potential conflicts of interest as by authors without such conflicts of interest.
The authors say: "There may be a connection between industry funding for research, speaking, or consulting and the publication of promotional pieces on menopausal hormone therapy." They add: ''Health care providers should exercise caution if they choose to read such articles."
INFORMATION:
Funding: This study received no external or internal funding, and none of the authors received any funds or salary support for conducting this study.
Competing Interests: Adriane Fugh-Berman directs PharmedOut (http://www.pharmedout.org/), a Georgetown University Medical Center project that educates physicians about inappropriate pharmaceutical marketing practices. Dr. Fugh-Berman is also a paid expert witness on behalf of women who developed breast cancer while taking menopausal hormone therapy. Alicia M. Bell was the paid project manager of PharmedOut during part of the time this study was conducted. Christina McDonald and Emily Catherine Bethards received graduate school credit for their work on this study while they were master's students in Physiology at Georgetown University Medical Center.
Citation: Fugh-Berman A, McDonald CP, Bell AM, Bethards EC, Scialli AR (2011) Promotional Tone in Reviews of Menopausal Hormone Therapy After the Women's Health Initiative: An Analysis of Published Articles. PLoS Med 8(3): e1000425. doi:10.1371/journal.pmed.1000425
IN YOUR COVERAGE PLEASE USE THIS URL TO PROVIDE ACCESS TO THE FREELY AVAILABLE PAPER: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000425
CONTACT:
Adriane Fugh-Berman
Georgetown University Medical Center
Department of Pharmacology, Med-Dent SE-402
3900 Reservoir Rd. N.W. Washington, DC 20007
United States of America
202-687-7845
ajf29@georgetown.edu
Association found between industry funding and promotional pieces on menopausal hormone therapy
2011-03-16
ELSE PRESS RELEASES FROM THIS DATE:
Standard retreatment regimen for TB is inadequate
2011-03-16
The standard retreatment regimen for tuberculosis has low treatment response rates and is associated with poor long term outcomes in certain subgroups of patients, particularly those infected with both HIV and multi-drug resistant TB. These findings from a study by Edward Jones-López from Boston University Medical School, Boston, USA, and colleagues and published in this week's PLoS Medicine, indicate that the standard retreatment approach to TB as implemented in low and middle-income settings, with a high prevalence of HIV, is inadequate and stress the importance of a ...
New reporting guidelines for genetic risk prediction studies: GRIPS Statement
2011-03-16
This week PLoS Medicine publishes the Genetic RIsk Prediction Studies (GRIPS) Statement, a checklist and guidance to help strengthen the reporting of genetic risk prediction studies.
Because progress in gene discovery for complex diseases is fuelling interest in the application of genetic risk models for clinical and public health practice, the number of studies assessing predictive ability is steadily increasing, but the quality and completeness of reporting varies. The GRIPS Statement (and accompanying explanation document) provides guidance to enhance the transparency ...
Types of Construction Zone Vehicle Accidents
2011-03-16
Not all auto accidents are caused by negligent driving. Sometimes dangerous roadways are to blame. Poorly marked construction zones, poorly maintained roads, and other hazardous road conditions cause many accidents each year in Texas.
At any given time, the Texas Department of Transportation may list over one hundred major work zones involving lane closures and detours throughout the state. Add hundreds of county and city road construction projects, and you could encounter construction zone hazards wherever you drive. It happens more often than most people realize.
Construction ...
Equity, not just economic growth, needed for child health in India
2011-03-16
In this week's PLoS Medicine, K. Srinath Reddy from the Public Health Foundation of India discusses new research published last week by Malavika Subramanyam, S V Subramanian, and colleagues that found no link between economic growth and child undernutrition rates in India, concluding that direct investments in appropriate health interventions may be necessary to improve child health in India.
Dr. Reddy (not involved in the research study) emphasizes that poor health is not only the result of poverty but also of inequality, which manifests in many ways. He says that "developing ...
Why Henry Higgins could tell his barrow girl from his fair lady
2011-03-16
When Professor Henry Higgins instructed Eliza Doolittle that it was "Ay not I, O not Ow, Don't say 'Rine,' say 'Rain'", he was drawing on years of experience as a professor of phonetics. But research funded by the Wellcome Trust and the European Commission suggests that Higgins's ability to differentiate expertly between similar sounds may have stemmed from birth.
Neuroscientists at UCL (University College London) have shown that the brain structure of expert phoneticians differ from those of the general public. However, whilst some of these changes can be explained by ...
Current projections greatly underestimate impact of Haitian cholera epidemic
2011-03-16
Current projections regarding the eventual size and extent of the cholera epidemic in Haiti may greatly underestimate the potential number of cases, according to a report that will appear in The Lancet and has been released online. A mathematical model based on current knowledge about the transmission and course of the diarrheal disease arrives at estimates of new cases through November 2011 that almost double those currently projected by the United Nations. The model also reflects the probable impact of public health measures designed to combat the epidemic.
"Our ...
Prevalence of heavy smokers in US decreases
2011-03-16
CHICAGO – From 1965 to 2007, the population prevalence of persons who smoked 20 or more cigarettes per day declined significantly, and there was also a decrease in the prevalence of smoking 10 or more cigarettes a day, with these declines greater in California than in the rest of the U.S., according to a study in the March 16 issue of JAMA.
Throughout much of the early history of cigarette smoking in the United States, consumption was typically 1 pack (about 20 cigarettes) each day. Since the first surgeon general's report on smoking and health (1964), there has been ...
Study examines outcomes of high-dose antiplatelet drug after stent placement
2011-03-16
CHICAGO – Modifying a patient's dosage of the antiplatelet drug clopidogrel for 6 months depending on the patient's level of platelet reactivity did not result in combined lower rates of nonfatal heart attack, stent thrombosis (clot) and cardiovascular death in patients who had a procedure such as balloon angioplasty and received a drug-releasing coronary stent, according to a study in the March 16 issue of JAMA.
Current guidelines recommend treating patients undergoing percutaneous coronary intervention (PCI; procedure such as balloon angioplasty used to open narrowed ...
Regions with higher rate of diagnoses have lower fatality rate for chronic conditions
2011-03-16
CHICAGO – An examination of data for more than 5 million Medicare beneficiaries finds that hospital regions that have a greater frequency of diagnoses have a lower case-fatality rate for chronic conditions such as coronary artery disease and kidney failure, according to a study in the March 16 issue of JAMA.
According to background information in the article, disease diagnoses are considered a critical factor in risk-adjustment policies designed to reward efficient and high-quality care. "Ideally, a diagnosis would be solely an attribute of the patient, unaffected by ...
Denver Dentist Joins Eco-Alliance
2011-03-16
Scott Greenhalgh, DDS is proud to announce that it has joined the B2B Green Alliance, an industry group that seeks to promote eco-conscious business practices among dentists and other medical and legal professionals.
The B2B Green Alliance is an environmental outreach initiative from web marketing firm Page 1 Solutions, as part of its Page 1 Green Solutions program. Page 1 Solutions strives to further reduce its environmental impact by encouraging its clients to pursue their own eco-friendly business practices and hopes to facilitate the exchange of ideas for eco-conscious ...