According to a story from blogs.bmj.com, the situation has been tense recently in the halls of the Cochrane Collaboration. Cochrane is a non-profit organization that involves the work of over 30,000 medical experts from across the world. The organization performs reviews of medical data and clinical trials, essentially serving as something of a watch dog in order to measure the objectivity of scientific study related to medical treatments, drugs, and technologies. The work of Cochrane has generally been well received by the scientific community, and is frequently commended for its thoroughness and methodological rigor.
However, recent events appear to be calling the organization’s effectiveness into question. One of the most prominent members of its board was recently voted off, and four other members have resigned to protest the move. The decision was effectively the end result of a dispute between Cochrane’s CEO Mark Wilson and Peter Gøtzsche. Peter was the board member that was voted out and was also one of the founders of the Cochrane Collaboration when it began in 1993.
The conflict seemed to start as a rather trite, personal spat between the two men, but it soon escalated. Peter along with some of his colleagues released a report that was highly critical of a recent Cochrane review of HPV vaccines. Peter has been a highly vocal critic of the drug industry and is known for his merciless critiques of industry practice. Cochrane fired back, calling the report dishonest and damaging to the organization’s representation, even going so far as to accuse Peter of aiding anti-vaxxers.
Peter responded by criticizing Mark and the Cochrane leadership for becoming more industry-friendly, sacrificing its principles of objectivity and fact-finding, and treating the group more like a business than an independent non-profit. An internal investigation found that neither of the accusations leveled at Peter or Mark were truly justified.
In the next meeting, Peter was given five minutes to explain his side of things but was constantly interrupted before being asked to leave the room. After a six hour deliberation, the remaining twelve board members voted him off the decision-making body. Five thought he should stay, one abstained, and the rest voted for him to leave.
Much of Cochrane’s work has helped reveal the way in which the drug industry manipulates research in order to produce results that look better and result in drug approvals. But now one of its most valuable board members has been released for attempting to curtail similar corruption within the organization.
The future of Cochrane remains uncertain, but what is certain is that the potential for bias in medical research is immensely high. A recent piece from Dr. Tom Jefferson of the Centre for Evidence-Based Medicine highlights the many conflicts of interest that appear in such research, including clinical trials. Many studies published in scientific journals have the peculiar habit of emphasizing good looking data and downplaying potential problems.
Issues of bias will unfortunately continue to plague medical research and drug development as long as money and human beings are involved.
