BMJ No 7102 Volume 315
Press Releases Saturday 26 July 1997
Embargoed: 00.01 Hrs 25 July 1997 UK time
Medical editors unite against research fraud
Alcohol has major role in socioeconomic variations in mortality
Shake-up needed in pharmaceutical pricing
Risk factors in hip fracture same between sexes
Medical editors unite against research fraud
The editors of the British Medical Journal, the Lancet and leading specialist medical journals have united to combat research misconduct by establishing a Committee on Publication Ethics (COPE).
The initiative came from Michael Farthing, editor of Gut, who encountered four cases of misconduct in his first year as journal editor. The move follows last weekıs decision by the General Medical Council to strike off John Anderton, former registrar and secretary of the Royal College of Physicians in Edinburgh, for faking data in a clinical trial.
Writing in this week's edition of the British Medical Journal, editor Richard Smith says that it is increasingly difficult to argue that British cases of research misconduct are rare, but that shamefully, we are leaving it to pharmaceutical companies, a private agency and the media to uncover cases of fraud. Dr Smith argues that the failure of medical schools and royal colleges to get to grips with the problem undermines the medical profession's case for self-regulation.
Dr Smith hopes that the new Committee will encourage editors to respond more rigorously to possible research misconduct and ethical misbehaviour, rather than taking the easy option of simply rejecting questionable papers.
Note to editors: This week's Lancet carries a linked editorial.
Contact:
Dr Richard Smith
Editor, BMJ
c/o Public Affairs Division, BMA
Tel: 0171 383 6254
Fax: 0171 383 6403
Email: 106002.1311@compuserve.com
Alcohol has major role in socioeconomic variations in mortality
[Contribution of deaths related to alcohol use to socioeconomic variation in mortality: register based follow up study]
Lower socioeconomic classes have higher mortality than higher classes in all countries where data exist. A paper in this week's BMJ shows that alcohol consumption makes an important contribution to this imbalance, especially where violent or accidental deaths are concerned.
The authors studied the Finnish adult population covered by the 1985 and 1990 censuses, and found that alcohol related deaths constituted 11% of all deaths among men aged 20 and over and 2% among women. Alcohol related deaths accounted for 14% of the mortality differentials between manual workers and non manual workers among men, 4% among women, and 24% and 9% respectively of the differentials between socioeconomic classes In life expectancy.
Half of the excess mortality from accidents and violence among male manual workers and 38% among female manual workers was attributable to alcohol. However, say the authors, there may be other factors at work here; financial problems, difficulties at work, and a general lack of opportunity for lower socioeconomic classes may increase their inclination towards heavy drinking. "Excessive alcohol use can be partly seen as a pathway along which mortality and differentials in mortality are affected by material living conditions", they conclude.
Contact:
Ms Pia Makela
University of Helsinki
Finland
Tel: 003589 19123897
Fax: 003589 19123967
Shake-up needed in pharmaceutical pricing
[Regulating the pharmaceutical industry]
The Pharmaceutical Price Regulation Scheme, currently under review, has succeeded in maintaining the health of the pharmaceutical industry, but done little to reduce the price of drugs to the NHS. Drug prices are higher in the UK than in other countries, says an editorial in this week's BMJ, and the Government should require changes to the scheme to minimise its inherent conflicts.
The authors propose four changes:
 | the adoption of a 'fourth hurdle' of comparative cost effectiveness by the NHS before it agrees to pay for new drugs. In Australia, for example, new drugs which show no advantage over existing products are offered at the same price. | |
| a more explicit annual report to Parliament, revealing not only how the scheme works but detailing its achievements in engendering efficient research and development in the industry, and including the real cost to the taxpayer of the scheme. | |
| an increase in access to data generated by pharmaceutical companies' research programmes. Data relating to licensed drugs should be made publicly acceptable, and drug trials registered in advance with the Committee on the Safety of Medicines. | |
| the opportunity for policymakers to determine the prioritisation of research and innovation. If pharmaceutical industry is to continue to be subsidised by taxpayers. Research within priority areas could be taken into account In setting individual companies' profit targets within the scheme. |
These four policy innovations, say the authors, will result in a more efficient scheme for regulating the UK pharmaceutical industry. Without explicitness about the goals of pharmaceutical policy, drug expenditure will continue to inflate with little accountability and insufficient benefits for patients, they conclude.
Contact:
Karen Bloor
Co-author
University of York
Tel: 01904 434 515
Fax: 01904 434 517
email: keb3@york.ac.uk
Risk factors in hip fracture same between sexes
[Bone density and risk of hip fracture In men and women: cross sectional analysis]The risk of hip fracture increases with age, with men reaching the same risk point five years later than women, says a paper in this week's BMJ. Though the age related decline in bone density is larger in women, the risk of hip fracture when age and bone density are considered together is remarkably similar in both sexes.
The authors studied the records of all people admitted to hospital in the Netherlands during 1993 with a fractured hip, and took bone density measurements from a sample of 5814 men and women of 55 and over living in a district of Rotterdam. They found that, of the 15107 hospital admissions for hip fractures in 1993, a quarter occurred in men. This high incidence in men has been has largely neglected, they say, and, as most fractures occur in women, attention until now focused on their bone loss, predominantly around the menopause. But, say the authors, the difference in age specific hip fracture between the two sexes can be explained completely by the different distribution of bone density in men and women.
Contact:
Dr Chris De Laet
Epidemiology & biostatics
Erasmus University
Rotterdam
The Netherlands
Tel: 0031 408 8292
Fax: 0031 10 4365933
Tel (home): 0032 3 3660382
Embargoed: 00.01 Hrs 25 July 1997 UK time
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