NEJM survey on hypothetical candidate reviewers

[MeSci]

One for experts, methinks, but an interesting exercise.

http://www.nejm.org/doi/story/10.1056/feature.2015.05.27.41?query=TOC

Reader Poll

In light of the recent Medicine and Society series of articles by Lisa Rosenbaum, M.D., and the accompanying editorial by Jeffrey M. Drazen, M.D., we invite you to put yourself in the role of editor and help us decide about the suitability of three hypothetical potential authors of review articles for the Journal. A summary of the community responses to this informal poll will appear during the summer. We thank you for participating in the discussion.

Participate in the poll and share your comments through June 17, 2015.

Reader Poll on Conflicts of Interest

Comments and Poll open through June 17, 2015

Case 1.

Jane Doe, M.D., Ph.D., is a world-renowned researcher in the area of disease X, a condition affecting hundreds of thousands people worldwide. There is a good diagnostic test for disease X, but there are no effective treatments. Doe’s lab developed the diagnostic test, and her institution held a patent on key technology related to the test. Doe’s institution, her laboratory, and Doe herself received annual royalty payments of $15,000 to $20,000 until 2 years ago, when the patent expired. Doe has consulted for four different pharmaceutical companies; over the past 3 years, each company has paid her over $10,000 per year to develop new therapeutic agents for the disease. Although there are promising leads, no drug has progressed beyond phase 1 safety testing in humans. The Journal is considering soliciting a review article on disease X. Since there are no available treatments, the review will focus largely on disease biology, with indications of where treatments could be used.

Is it appropriate to consider Dr. Doe as an author of this review article? Go to the poll at the top of this page to vote.

Case 2.

John Smith, M.D., is a world-renowned clinical trialist in the area of disease Y, a common condition that affects about 1 of every 3000 people worldwide. Smith was instrumental in the clinical trials of three drugs that can be used to treat disease Y; all three are still patented, and there are no generic drug equivalents. The three treatments are all relatively safe, with good efficacy, low adverse event rates, and acceptable side-effect profiles. All three are also moderately expensive, with monthly retail costs of about $300, but most pharmacy benefit plans cover at least one of the three drugs, with a monthly copayment on the order of $50.

Smith continues to conduct research to define who would be most likely to benefit from treatment with these agents. His university receives about $500,000 a year from each of the companies to support his research, but according to university rules, none of that money can be used to support Smith’s salary or otherwise benefit him personally. The Journal is considering soliciting a review article on disease Y. It would be a clinical review, with the author asked to indicate how he or she would treat people with the condition.

Is it appropriate to consider Dr. Smith as an author of this review article? Go to the poll at the top of this page to vote.

Case 3.

Sam Green, M.D., is a well-established physician in his community and beyond, by virtue of his activities with a number of patient-advocacy groups. Although Green is a general internist, he is viewed as the local expert in disease Z, which has a point prevalence of about 2%. Through a commercial database, Alpha, Inc., learned that Green is the largest prescriber of the company’s drug Q in the region. Drug Q is a new treatment for disease Z that is currently available only as a branded drug. A new research study, in which Green enrolled three patients from his practice, shows that drug Q is more effective than the current generic treatment for the disease, with a similar side-effect profile. The margin of enhanced efficacy is such that one would need to treat 15 patients with drug Q to show an advantage over treatment with the generic drug. The cost of drug Q is $100 per month, as compared with $10 per month for the generic.

As Journal editor, you receive an inquiry from Green about your interest in a review article on disease Z. He offers to cover its epidemiology, pathobiology, clinical recognition, monitoring, and treatment in 2000 words, with two tables and two figures. In reviewing the form that lists his financial associations, you note that he has received over $10,000 per year for the past 3 years from Alpha, Inc., for talks about drug Q given at various venues.

Is it appropriate to consider Dr. Green as an author of this review article? Go to the poll at the top of this page to vote.