May 5, 2009

Merck Publishes A Fake Journal

Oh, The Last Psychiatrist wrote another conspiracy article.  That must mean it's wrong.  So I don't have to deal with it.  Phew.  Pass me the Blue Pill, I'm feeling anxious again, for no reason at all.

From The Scientist:

Merck paid an undisclosed sum to Elsevier to produce several volumes of a publication that had the look of a peer-reviewed medical journal, but contained only reprinted or summarized articles--most of which presented data favorable to Merck products--that appeared to act solely as marketing tools with no disclosure of company sponsorship.
The journal is called the Australasian Journal of Bone and Joint Medicine.  No, I'm not kidding.

Cue populist rage: "Pharma is tricking people!  There needs to be a separation between Pharma and medicine!   Don't let them in our medical schools to corrupt our impressionable 30 year old students!"  

Go to bed satisfied; no sex necessary.


I have a question: is anyone accusing Merck of faking the data?  Are the studies all lies?  No.  This journal contained research previously published (and I assume therefore peer reviewed) elsewhere, and review articles.  I'll grant that the review articles are hardly cutting edge, but no one can say they are false or incorrect.   Isn't it possible that Merck might have something useful to say on the subject of bone loss? 

"But they're misleading, in that you don't know Merck is sponsoring them."  I see.  So what you object to, actually, is not the content, but the impression.  What matters to you are appearances.


Any doctor who couldn't sense something is amiss with a journal called "Australasian" anything is an idiot.  And a danger to the public.  He is much better off doing exactly what Merck tells him to, and not thinking for himself.  I'm absolutely serious.  Do you really think such a doctor is in any position to critique the methodology of a clinical trial?  Make reasonable distinctions between treatments?  Of course not. You know what he'll do instead, as a shortcut?  Look for the financial disclosure. 


"I've seen no shortage of creativity emanating from the marketing departments of drug companies," Peter Lurie, deputy director of the public health research group at the consumer advocacy nonprofit Public Citizen, said, after reviewing two issues of the publication obtained by The Scientist. "But even for someone as jaded as me, this is a new wrinkle."
New?  Hey Ponce De Leon, what did you think the past fifteen years of throwaway journals were?


All together now: What does the author of this story want to be true?

The point of this story is to direct your outrage onto Merck publishing a biased journal, so that you are not conscious of the fact that all of the journals are even more biased.

I can, and have, published an entire journal by going to Kinko's at 3am, and I did it drunk.  And it was in physics.  So why would Merck need to partner with Elsevier to get a limited run of a fake journal?  Obviously it is because having the Elsevier imprint makes the journal appear more legitimate.  Fine.

So why would Elsevier partner with Merck?  You think it needs the money?  Elsevier can get the money for the journal this way, or it can get it from selling ad space, or it can get it via the study authors who are funded by Merck ("publication costs.")  It's the same money.  What's the difference to them?  Why do it this way?

Here's why: by publishing a fake journal, it can then apologize for making a fake journal, thereby reinforcing that its other journals are not fake: "sorry, this does not meet our otherwise high standards of integrity."  


Oh, the other journals aren't fake? Then, knowing nothing about osteoporosis and without looking,  I shouldn't be able to tell you that all the articles about Fosamax published in the past year will say it's good; except for any published in NEJM, which will say it's bad.  Wow, what do you know, I was right. (NEJM: 1 2 3 4)

Of course I don't want Merck publishing journals.  But they have been publishing the content of all the other journals for decades.  They control you practice, and you don't even know it, because you think, "I've never received anything from Pharma!"  Yes you have, you received their message.  Or did you prescribe Vioxx (and Depakote and blah blah) because you analyzed the data and you thought it was better/safer than the alternatives?

You think there's any difference at all to the patient between getting paid to prescribe Fosamax, and prescribing it in good faith based on hearing about the studies conducted by  academics who were paid by Merck, reviewed by three other idiots/academics also paid by Merck, and published in a journal with ads paid by Merck; and while medical students are taught in school that Fosamax is useful for X and Y, based on those journal articles?

Do you think the elderly are on 8 meds at a time because they're all necessary?

And at least I have a good idea of the bias Merck has on Fosamax, I know how to interpret their results.  Do you think I have any clue what to do with anything published in NEJM?  Do you think a layman has any chance when the regular media reports, "scientists have found that..." 

You're worried about Australasia?

The question isn't whether Merck should be able to publish a journal; the question is why no one is rioting.