The Peer Review "Fig Leaf": Vera Hassner Sharav
By SUZAN MAZUR
Vera Hassner Sharav
While the chief of the US National Institute of Mental Health this week stopped short of saying scientists are corrupt because of their ties to industry, as AP reported -- Vera Hassner Sharav does not give scientists a similar pass, partly because the testimonies she organized on unethical research on the mentally ill before the National Bioethics Advisory Committee in 1997 led to the shut down of 29 clinical trials at NIMH. Hassner Sharav is founder and president of the Alliance for Human Research Protection, a public interest watch dog group based in New York that aims to "unlock the walls of secrecy in biomedical research and to bring accountability to that endeavor". As a human rights champion, she has opposed experiments on children such as the EPA's CHEERS pesticide tests and pushed for a federal investigation into foster care children being used in AIDS drug experiments. She has appeared before various national advisory panels addressing her concerns about experiments on prisoners, about the use of antidepressants and the risk of suicide, among other issues. Hassner Sharav is also a former law librarian and has developed a database that tracks unethical research practices and the failure to disclose information on drug hazards.
I spoke with Vera Hassner Sharav earlier this week by phone about peer-reviewed science journals.
Suzan Mazur: Science peer review is regarded as censorship. That's the issue David Noble and I explored in my recent interview with him . . .
Vera Hassner Sharav: That's clearly not how peer review was originally supposed to work. Once reviewers are selected based on what's good for industry, they are not independent peers. But the process is so much more corrupt than even censorship. For example, Elsevier published propaganda favoring Vioxx as "peer-reviewed" inarticles in a phony journal paid for by Merck.
When reviewers are under contract and financially tied to industry, articles that get approved for publication, say in medical journals, are those that promote newly patented drugs or medical devices.
Suzan Mazur: What is the concern with peer review at the Alliance for Human Research Protection.
Vera Hassner Sharav: The concern is that this corruption of the peer review process leads to the promotion of defective drugs that cause harm and even kill people, whether it's Vioxx, Avandia, Zyprexa or the like -- toxic, dangerous drugs that were promoted within peer review. Independent scientists do not have access to the complete data on these newly patented drugs being promoted in scientific journals and elsewhere in the media. We should be able to ask authors for the actual data about which they are reporting.
Industry controls the process and the data, it controls the clinical trials, the selection and design of the trials. It controls what is disclosed and what is concealed. What gets published and what gets put in the so-called "drawer". Peer review has become a fig leaf covering up make-believe peer review. It's not rigorous, not independent and not honest. It's rubberstamp, paid for and controlled by the pharmaceutical industry.
The integrity of the scientific literature has been compromised. The clinical practice of medical doctors is jeopardized because physicians think these articles in influential journals have been vetted (i.e., peer reviewed). They then unwittingly prescribe to patients dangerous drugs that are being marketed widely. And people are harmed.
Suzan Mazur: With the passage of the Obama health care bill, do you see the beginning of a clean up of the peer review process?
Vera Hassner Sharav: No it doesn't touch corrupt practices at all. Obama health care is totally silent on this. The assumption is that science professions are policing themselves. But if science is under the influence of industry, receiving huge money from industry, then there is a disincentive to police.
Suzan Mazur: Can you tell me about the controversy surrounding the public being kept out of sessions at the upcoming American Psychiatric Association conference in New Orleans?
Vera Hassner Sharav: The American Psychiatric Association is having its annual meeting in New Orleans in May. Science journal publishers -- Wiley, Elsevier, etc. -- and pharmaceutical companies will be attending as well as psychiatrists.
Dr. Charles Schulz, chairman of psychiatry at the University of Minnesota Medical School, who has received hundreds of thousands of dollars as a paid consultant to AstraZeneca and Eli Lilly, whose favorable report about the antipsychotic Seroquel -- presented at an APA conference in 2000 -- was contradicted by an analysis of the drug's manufacturer AstraZeneca, is holding a session at the APA 2010 conference: "How to help parents of a first psychotic episode patient". A parent whose son committed suicide in a clinical trial conducted by Schulz wants to attend but was told the meeting is closed to all but APA members.
[NOTE Schulz office 3/29/2010 email to me: "He [Dr. Schulz] has been thinking about her [the parent Hassner Sharav refers to above is Mary Weiss, whose child died in a Schulz clinical trial] and is glad she wants to obtain more information. If you wanted to provide her name and address, Dr. Schulz would like to send her his book on the Early Stages of Schizophrenia, which is published by the APA and has chapters about psychotherapy and family therapy.]
So the question arises -- if this meeting is geared toward helping parents, what is it Schulz is going to say that he doesn't want parents to know? This is serious. This is peer review at its maximum corruption. These meetings are a commercial circus.
Suzan Mazur: Is the public completely barred?
Vera Hassner Sharav: Some meetings are open, but it costs a lot of money that individuals can't afford. [NOTE: APA advises admission is $860 - $950 for non-APA members.] But the Schulz session is closed.
Robert Whittaker, author of the forthcoming book Anatomy of an Epidemic, wanted to attend last year's APA meeting. The APA didn't want to let him in. His publisher, Crown, intervened to get him in. Whittaker attended and recorded quite a few of the sessions. They were humdingers. What's discussed at these APA meetings is information that does not reach the public.
[NOTE: -- APA has emailed me stating the following:
"Charles Schulz's Case Conference is only open to residents. Case conferences are closed to nonmembers because of the clinical nature of the discussions and the patient confidentiality restrictions inherent in presenting cases. Members are bound by ethics confidentiality and nonmembers are not, which is why nonmembers are restricted.
A few sessions are only open to residents to allow residents to have a more hands-on experience with less people, but all other sessions are open to members and nonmembers."]
Suzan Mazur: Regarding Wiley, one of the major science journal publishers attending the APA meeting -- it's been around for over 200 years but apparently just became profitable in the 1990s. Do you have any insight into that?
Vera Hassner Sharav: What this shows is that when industry began to influence the content of journals by paying Wiley hefty fees, Wiley became profitable.
Suzan Mazur: Advertising?
Vera Hassner Sharav: There are many ways to influence publishers, but two things especially. Advertising is one but at least with advertising you know an ad when you see one. And doctors are perhaps less influenced by ads than the public. Maybe.
What is even more insidious is the articles that are published as peer-reviewed scientific articles facing those ads. The reports are promotional pieces, not independently and rigorously reviewed. They are masquerading as scientific articles. That's deception of the worst kind.
Suzan Mazur: You have a Masters degree in Library Science.
Vera Hassner Sharav: Yes.
Suzan Mazur: Is there a movement on the part of libraries to challenge this corruption?
Vera Hassner Sharav: No they have no power, no say.
Suzan Mazur: Do they have any interest in dealing with it?
Vera Hassner Sharav: I don't know if they've even been asked about it. The librarians have been pretty much bypassed in the information explosion age. It was their own fault.
Suzan Mazur: They have to know about the bogus information.
Vera Hassner Sharav: They simply transmit it. You ask for an article, they'll fetch it for you. And now with the Internet, librarians are used less and less.
Suzan Mazur: One recent open-access journal called Philosophy and Theory in Biology, "a product of the Scholarly Publishing Office of the University of Michigan Library and DLXS" has come under criticism as a reflection of the gaming of the system. Here's a complaint from an independent investigator whose article was rejected by the journal after 36 hours. The journal editors include a half dozen Altenberg 16 cronies (esteemed cell biologist Stuart Newman is not among them):
"But the most insulting rejection came from Philosophy and Theory in Biology, a relatively new publication (started in August) whose senior editor is none other than Massimo Pigliucci. It took his team of editors only 36 hours to reject the paper on the grounds that it was not appropriate. The science and math in the paper, unless examined by specialists in the field, could not possibly have been understood by the editors in that amount of time. . . . I don't think Massimo ever saw the paper, trusting instead to his editorial scriveners to do their duty. In an embarrassing rant, presented in two emails, I raged that not only was his journal the most appropriate one, given its stated objectives, but also his editorial linemen were stultifying in their ignorance not just of current trends in the biosciences, but of the philosophy of science and the physical sciences. . . . [D]espite his posturing as a man of science and a skeptic, [he] is an obstacle to scientific progress although chief editor of a journal alleged to advance that very thing." -- Gregory O'Kelly
Any idea how that library affiliation works?
Vera Hassner Sharav: I'm not familiar with that particular arrangement. But many of the journals have university affiliation. Little journals. . . . What would make a huge difference would be if academia started to penalize faculty members who sell their name and append it to ghost-written articles. Simply fire them because it's unprofessional conduct.
Suzan Mazur: Here are five questions I submitted to Wiley that they refused to answer. I emailed the questions to Eric Swanson, who is the Wiley point person there in Hoboken in charge of science journals I was told by Susan Spilka in their press office that Swanson was "pondering" responding. I assume he found the questions too challenging. He emailed the Wiley template on ethics via his press office.
"1. As one of the top publishers of science journals and a public corporation, is Wiley aware that the public knows the science peer-reviewed journal system is a major factor corrupting science?2. Is Wiley concerned that science peer review is increasingly viewed by the public as censorship -- a way of keeping out the public, who actually fund science?3. Why does Wiley approve of anonymous peer review of journal articles? There are complaints that too often when a paper is submitted that exposes the errors of science journal editors, the paper is simply rejected and there is no avenue of appeal regarding such unethical publication practices. A psychologist complained this happened in submitting to a Blackwell, now- Wiley psychology journal. In the case of your anatomy journals, there are complaints about a possible conflict of interest regarding what is acceptable content because many of the journal editors [and the journals themselves] are based on the University of Utah campus where the LDS church has a significant presence and a gene-centered approach to science is favored.4. Is Wiley at all concerned by lack of operational financial transparency on the part of its science journals? For example, Wiley Evolution and Development journal editor-in-chief Rudy Raff told me each of his editors gets an allowance FOR an editorial assistant (he wouldn't say how much) but that the editors do not get paid nor do the anonymous referees. Raff says it's "traditional community service" -- but the public increasingly sees the practice as a gaming of the system. What is your response?5. Does Wiley see a serious disconnect between its corporate board of directors who endorse the Wiley journal product and pass it on to the public -- but may not understand the science -- and the scientists who actually write the anonymously-reviewed journal articles for publication?"
Vera Hassner Sharav: The arrogance of Wiley is overwhelming. No Swanson wouldn't respond because to answer would put him and Wiley in jeopardy. Yet they have a public responsibility.
Suzan Mazur: Wiley's got on its board of directors the current CEO of Moody's and the former CFO of Dow Jones.
Vera Hassner Sharav: Elsevier is intertwined with pharmaceutical companies such as Merck and GlaxoSmithKline -- whose board includes James Murdoch and Elsevier's former CEO Sir Crispin Davis. The challenge is, the way the corruption can be halted is if under Obama health care reform, if the publicly-financed reimbursement uses its muscle to not reimburse for drugs where it has been shown in court that they were illegally marketed, that the hazards were concealed and the benefits were made up. Medicare -- Medicaid should not reimburse for them. If that would happen, things would change very fast. The whole system would be shaken. Cutting off the money is the only way to get out of it.
Suzan Mazur: What about the drugs being produced now that may be detrimental to our health? How do you stop that process? Are you in favor of revoking the Bayh-Dole Act.
Vera Hassner Sharav: Bayh-Dole is what started it by encouraging corporate-academic collaboration. By removing the firewall between academia and industry, academic ethics and the integrity of science gave way to corporate ethics -- which above all, seeks to maximize profit. Since academia is far too dependent on industry money, they won't police corrupt practices. Stopping reimbursement in health care for harmful drugs illegally marketed is the way to go. As government gets more involved, they'll have more leverage. When government Medicare - Medicaid stops paying for these drugs and it involves tens of millions of prescriptions, you will see change. Once you cut the profit margin, industry will have no interest. The cycle can't continue without government subsidy.
