Articles Posted in Conflicts of Interest

nihclincenterFederal officials have decided to sweep out the executive ranks at the flagship hospital of the National Institutes of Health in Bethesda, this after a blue-chip investigating committee rebuked the institution and declared that research concerns there had wrongly taken precedence over patient safety.

Initial reports about the NIH Clinical Center, as I wrote recently, had suggested that systemic changes were required at the venerated and sprawling facility, particularly after disturbing reports surfaced about neglect and unsanitary conditions in its pharmacy operations. Officials first spoke just of creating a new, external oversight body, and an office to monitor quality and safety concerns.

But, as the Washington Post since has reported, the NIH’s chief has decided to “replace the hospital’s longtime leadership with a new management team with experience in oversight and patient safety, similar to the top structure of most hospitals. He is recruiting for three new positions: a chief executive, a chief operating officer and a chief medical officer. … [He] wants all three to be physicians, and he wants them in place by the end of the year.”

oxycontinOxyContin in two decades not only has become a highly profitable, exceedingly popular prescription, it also has become one of the nation’s most abused painkillers─for a crucial reason, the Los Angeles Times says. The paper investigated and found that the drug’s maker wrongly has promoted the medication as having a 12-hour effectiveness─twice that of generic medications.

That isn’t so. It wears off for many much sooner, leaving them with intense cravings and excruciating withdrawal symptoms. This leads to addictive abuse of the drug, the paper says.  The Times reports:

More than half of long-term OxyContin users are on doses that public health officials consider dangerously high. … Over the last 20 years, more than 7 million Americans have abused OxyContin, [which] is widely blamed for setting off the nation’s prescription opioid epidemic, which has claimed more than 190,000 lives from overdoses involving OxyContin and other painkillers since 1999.

eisenCaulfieldpaltrowHype and health misinformation is a metastasizing aspect of our age, in which technology both increases the public’s access to varying points of view─and, to put it kindly, the great gullibility of all too many. Which is why it’s also heartening to see skeptics also are out there to question the widespread humbug.

Look, for example, at what may be one of the most-read health information websites around, WebMD. Yes, it provides some good information. It also seems to be one of the high temples for cyber practitioners of clickbait-ing, offering headlines in recent days such as: Could you be allergic to kissing? 6 ways to fix eggs. Does getting older have to a drag? And Is it OK to drink your pee?

There’s a good reason for the site, of course, to provide provocative teases, upping its online traffic and boosting its appeal to advertisers. Like who? Try Big Pharma for millions of dollars in ads. As the website Vox reports, WebMD also has raised eyebrows by the way it places Big Pharma pitches with content that (hypochondriacal) readers see when they seek information about certain health conditions. Caveat emptor, use caution and common sense when consuming health related information, as I have written before.

ny-med-premiereHospital patients who are dying or in extreme duress should not have their privacy exploited by reality television camera shows, federal health care regulators now have made clear. They have just settled with a noted New York hospital on $2.2 million in penalties and fines for its role in cooperating with a celebrity doctor whose crews recorded for broadcast the last throes of a an elderly Manhattan resident fatally injured when hit by a garbage truck.

The dead patient’s family complained that neither he nor they gave the hospital permission to film during his unsuccessful emergency treatment. Further, they said repeated broadcasts of the reality TV show “New York Med,” headlined by Mehmet Oz (the heart surgeon-cum-TV show celebrity known as “Dr. Oz”), caused them great pain and distress, as well as invading their and their loved one’s privacy.

Federal authorities, who oversee patient privacy matters under the Health Insurance Portability and Accountability Act (HIPAA), finally agreed with the family years after they filed complaints, posting online this stance about patients’ protected health information (PHI):

zapSome recent health headlines have made stories sound so enticing they’re hard to resist:  Are there genetic superheroes walking among us who can provide invaluable clues to preventing deadly diseases? What’s the secret of a big, long lost research study and could it have changed contemporary views on the risks of dietary fat? Should many older Americans who take statins, one of the most commonly prescribed medications, give them up in favor of a more costly therapy? And is there really a dazzling new way to test the blood for health markers?

Skeptics to the front, please. Somehow some very good, very savvy folks, again, are pushing health-related information that needs careful scrutiny or outright howls of complaint. I’ve written about the problems with health care information, and it gives me no pleasure to detail this quartet:

Superhero hype

bwhospitalBecause money makes such a difference in health care in the United States, what happens when it’s no object? The results aren’t pretty, a prestigious Boston hospital has found. It rolled out the red carpet and penthouse suites for a Saudi prince who stayed for seven months of therapy for a drug-resistant infection.

His lavish ways, however, ended up tainting the institution’s best practices, resulting in internal and Massachusetts state investigations. The Boston Globe said the episode, in which the unidentified prince and his entourage made unusual care demands and lavished gifts on staff in violation of hospital policies, shows the risks of so-called VIP care.

The paper said the post-mortem of the royal treatment found that: medical staff failed to adhere to best practices in wearing protective gowns when treating the princely patient who found the attire “off-putting” and dirty; nurses and others were accused of mishandling narcotics, giving them to members of the royal entourage and not administering them to the patient himself.

University_of_Maryland_Seal.svgThe University of Maryland has taken a hit to its credibility as a major research institution─and for one of the silliest reasons possible: The Terps, officials have conceded, showed almost no internal rigor nor basic research processes in promoting a product endorsement. Let’s give kudos to, a nonprofit health information watchdog, and local media for crying bull on the U’s news releases asserting that high school and collegiate athletes who drank a named brand of chocolate milk fared better on measures related to concussion recovery.

It took the folks in College Park months to fess up to their error, pointed out to them repeatedly and pointedly by outsiders concerned that the university was giving out bad health information.

It gets worse, as the school has conceded in releasing its own investigation: A bevy of highly credentialed experts failed to recognize not only the fatuousness of the so-called research the university promoted. They also went blind to blatant conflicts of interest with this study─notably that an industry group gave the work’s principal investigator a $200,000 gift to support his lab and staff just before the questionable news releases went flying. The U also seemed to play fast and loose with tough rules and principles about human experimentation.

valeantAlthough they may have been high-flyers just a few months ago, some big players in Big Pharma have gotten a brutal kind of karmic comeuppance for their craven business strategy of jacking up drug prices to maximize profits, the sick be damned.

Financial journalists have had a field day chronicling the recent, spectacular fall of Valeant Pharmaceuticals and its CEO Michael Pearson. He once  entranced Wall Street with his plan to use Valeant, which was acquired cheaply, as a way to take older, existing drugs and to push their prices into the stratosphere. Hedge funds and big investors loved Pearson and his plan. The company’s stock boomed.

But many who looked at the venal company and its consumer-attacking strategy dissented, calling Valeant as scandalous, suspect, and ready to collapse as the infamous energy company Enron.

prescriptionNew reports show how physicians can improve patient safety and help themselves with two simple steps: Stopping the practice of conducting surgeries at the same time on different patients, and writing prescriptions electronically instead of by hand.

Jamming up on complex surgeries

Investigative journalists at the Boston Globe deserve credit for reporting on a dispute over elite surgeons’ conducting several complicated operations at the same time. Surgeons defend this long-standing practice, saying it lets them help more patients and teach residents, and hasn’t been shown to be detrimental.

NFL-vector-logosThe National Football League may have taken a page from Big Tobacco’s playbook, and played fast and loose with data used in “scientific studies” to downplay players’ risks from concussions, a New York Times investigation finds.

The Times scrutinized the underlying information the league and its top officials provided to researchers on five years of its athletes’ concussion-related injuries. This data became the basis for 13 peer-reviewed studies, including research published in the prestigious journal  Neurosurgery, that the league relied on as a public relations shield against mounting evidence that head trauma posed significant short- and long-term harm to players.

But, the newspaper said, the league – which then did not require teams to report such incidents–left out roughly 10 percent of the head injuries that occurred in the study period (1996-2001). The omissions were blatant because they were hugely public and affected NFL superstars like quarterbacks Troy Aikman, Steve Young, and Kurt Warner.

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