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Money's Only Part of the COI Story


 

“Any senior scientist will tell you that the biggest conflict of interest he or she has has nothing to do with the [disclosures] they list on their PowerPoints or in their publications,” Dr. Paul M. Ridker said at his talk on the inflammatory hypothesis of atherosclerosis at the meeting of the International Society on Hypertension in Blacks in Boston. “It has to do with our individual belief in the biology of what we're doing.”

For this reason, his lengthy disclosure slide was less relevant than his fundamental bias, which is his belief that inflammation is “part and parcel, if not the cause, of atherosclerosis.” That type of bias, not industry support, “is what drives my work, and it is what drives most scientists,” stressed Dr. Ridker of Brigham and Women's Hospital in Boston.

That contention is likely a nod to the diatribe that followed the 2008 publication of the JUPITER trial results, in which he and his coinvestigators attributed a 44% reduction in cardiovascular events to the ability of rosuvastatin (Crestor) to both lower LDL cholesterol and reduce C-reactive protein (CRP) levels (N. Engl. J. Med. 2008;359:2195-207).

Following the publication of the findings, cardiology colleagues questioned the interpretation and veracity of the data in the face of what they deemed to be an unacceptable degree of commercial bias. They were referring not only to the fact that the study was funded by AstraZeneca, the drug's manufacturer, and that 9 of the 14 authors disclosed financial ties to the company, but also that Dr. Ridker holds the legal patent on CRP testing technology. Without question, the skeptics argued, Dr. Ridker had much to gain from the acceptance of his research.

For his part, Dr. Ridker vigorously defends the quality of the JUPITER data. He has also introduced a salient argument, that the COIs that have the most potential to bias research are the ones that defy enumeration. He does not argue against financial disclosures, but he does warn that they don't tell the “whole story.”

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