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July 24, 2006
Are the National Academies Fair and Balanced?
Today Center for Science in the Public (CSPI) Interest hosted a public forum to discuss conflicts of interest on National Academy of Sciences (NAS) issue panels. CSPI's most notable finding was that out of 320 NAS issue panel committee members evaluated, 18% had "direct conflicts of interest " defined as "a direct and recent connection to a company or industry with a financial stake in the study outcome." CSPI has made clear that they do not dispute the high quality of reports produced by NAS, but feel that full disclosure of industry ties should be mandated and strictly enforced to allow panels to be balanced with scientists who have contrasting views.
Six presenters were on hand at the conference to give their impressions of the report and on the issues related to the intersection of industry and science--not just limited to the NAS, but also including EPA and FDA advisory panels. In brief, here are some of their positions on the matter:
Dr. David Michaels, chairman of George Washington University School of Public Health, believes that scientist with conflicts of interest should be barred from government agency panels that "reach conclusions." He also discussed the results-driven leanings of science firms for hire that manipulate science to help companies clear regulatory hurdles and arrive at their desired outcome.
James Conrad, attorney for American Chemistry Council, argued that the best qualified scientists on any given substance, have at one time or another worked with or for a company that deals with that substance. To exclude scientists with ties to industry would, in his view, not be taking advantage of the "best available science" and “expertise.” He also reminded attendees that those with “intellectual interests can be as biased as those with financial interests.”
Steve Nissen, president of the American College of Cardiology, was most blunt in his estimation of the effect of commerce on scientific integrity. He described the FDA as currently "facing a crisis in public confidence," and blamed budget limitations for the FDA's dependency on the very companies it regulates. Dr. Nissen didn't sugar-coat his disapproval of the former and acting commissioners of the FDA, whom he said have significant conflicts of interest themselves, nor did he withhold his frustration at the appointment of Scott Gottlieb, senior advisor to Andrew von Eschenbach, and also a presenter at the forum. He said Gottlieb had come “straight from Wall Street” and had no regulatory experience.
Dr. Gottlieb said that to screen out scientists with industry ties would be very difficult since the "standing" advisory committees are convened, sometimes years, before a drug or substance is brought before them to be evaluated. When the moderator, NPR reporter Snigdha Prakash, asked Gottlieb if there were any circumstances under which he felt it would be necessary to exclude a scientist based on ties to industry, he did say yes, but wasn't able to give a clear example of what those circumstances might be. Gottlieb did say that he was not at the meeting to defend the current status quo FDA advisory panel policies, and acknowledged that there was a need for greater transparency and consistency in the regulatory process. He added—during a Q & A at the end of the forum—that it is becoming increasingly harder to assemble advisory panels due to the poor compensation offered and candidates’ fear of having their reputations besmirched.
The next speaker was CSPI director and former Chicago Tribune reporter, Merrill Goozner. Goozner insisted that there are an ample number of qualified experts available who do not have conflicts of interest. He identified previous employment at think tanks such as CATO or The American Enterprise Institute as being indicative of a pro-industry slant. In Goozner's opinion the NAS currently does "an abysmal job of disclosure."
The final speaker, frequent NAS panelist Frederick Andersen, accused the CSPI report of making “broad, sweeping, and unsubstantiated claims.” Andersen dismissed the CSPI report as being a "witch-hunt" against scientists with ties to industry, and suggested that CSPI's definition of "conflict of interest" led to their shocking findings.
Current NAS policy does not does not consider a scientist as having conflicts of interest if his or her financial relationship ended before the start-up of the panel. In their report, CSPI used a five-year time frame for considering financial ties, which is comparable to the financial conflict-of-interest disclosure policy at the Journal of the American Medical Association.
Other Useful Links:
Union of Concerned Scientists report which found some FDA scientists are pressured to alter their findings, and fear retaliation for voicing safety concerns
Project on Scientific Knowledge and Public Policy (SKAPP), of which Dr. David Michaels is a chair.
Merrill Goozner's blog, GOOZNEWS.com