BMJ 2002;324:723-729 ( 23 March )

Education and debate

    Alteplase for stroke: money and optimistic claims buttress the "brain attack" campaign
    Commentary: Who pays the guideline writers?
    Commentary: Thrombolysis in stroke: it works!

Alteplase for stroke: money and optimistic claims buttress the "brain attack" campaign

Jeanne Lenzer, medical investigative journalist. 

Oak Ridge Journalism, Ellenville, NY 12428, USA

Jlenzer1@csi.com

The first 150 words of the full text of this article appear below.

Both doctors and the public are becoming more alert to potential conflicts of interest, and an increasing number of journals now require competing interest statements from their authors and reviewers. In this article Jeanne Lenzer uses the example of guidelines produced by the American Heart Association to discuss some of the questions that can arise when interests conflict

As doctors and the public become more aware of conflicts of interest involving study bias,¹ publication bias,² and industry gift giving³ they turn to credible non-profit organisations for sound medical recommendations. Unfortunately, many groups (and their individual panellists) that serve as arbiters of inconclusive data may also suffer from conflicts of interest. ^{4 5}

One such conflict is self referencing bias. An example of this is in specialty guidelines for colon cancer screening, where radiologists recommend barium enemas while gastroenterologists recommend colonoscopy. A more important conflict arises when corporations with a financial stake in . . . [Full text of this article]

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Rapid Responses:

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The efficacy analysis of the NINDS trial is flawed

Jeffrey Mann
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Robert Solomon
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Howard Mann
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Patients need to know true risks and benefits

Dennis P Briley
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Concerns

Jerome R Hoffman, et al.
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Self-interest and statistical bias may obscure real patient harm.

James Li, et al.
bmj.com, 26 Mar 2002 [Full text]

Setting the record straight

David Faxon
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Re: Setting the record straight

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bmj.com, 24 Apr 2002 [Full text]

Alteplase and Acute Stroke

Philip B Gorelick, et al.
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Re: Re: Setting the record straight

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In Reply

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Ongoing scientific debate allows the scientific truth to be more clearly established

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The NINDS Stroke Study Group Response

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Conflict of interest important at all levels

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