Intended for healthcare professionals

Rapid response to:


Pharmaceutical industry sponsorship and research outcome and quality: systematic review

BMJ 2003; 326 doi: (Published 29 May 2003) Cite this as: BMJ 2003;326:1167

Rapid Response:

Bias ?

Dear Sir,

The article by Lexchin et al is interesting but does not address two
major issues. Firstly as a metanalysis it is vulnerable, as are all such
publications to publication bias itself. The authors do not report whether
any of the studies they examined were themselves drug - company sponsored.
I assume none of them were so funded. Adopting a cynical view - which is
de rigure in any discussion of bias - there seems a fairly strong
potential bias for publication of studies that discover bias, if there is
no contrary pressure.
Secondly, the discussion does not cover what is in my view a major source
of such 'bias' in original studies. Take the case of a drug that is
about to complete approval. Assuming crudely, that it is either successful
or not, then I would argue that if it is not successful - ie does not
gain approval then there are a number of strong forces stopping
publication that could not be seen by a reasonable person as bias.
1) The drug company will now have no interest in the drug, and would be
extremely reluctant to fund conference travel for example.
2) The researchers would realise that such a publication is likely to be
less valuable to them than a postitive one, and would be reluctant to
"waste time" on a publication that will not lead to follow ups.
3) Any journal would be less likely to publish the results of a study on a
drug that is not going to be available.

However, taking the example where a non- drug company funded study
occurs for a new technique or treatment, the researcher does at least gain
credit for the intellectual effort made in deciding to invent the
treatment, and such a publication will assist the researcher in terms of
prestige etc. This does not occur when the invention was made by someone
else - for example a drug company, and even the protocol was devised by

Undue influence by drug companies may be a problem, but I am
unconvinced that crude analysis of numbers of positive studies is
helpful. Indeed, as the paper points out, the drug company funded studies
were of equal or better methodological quality than the non-funded. I am
particularly concerned that as the phrase "Publish or perish" becomes
ever more popular that people are blinded to the intrinsic bias that
arises in such an environment

Competing interests:  
I was involved in drug company funded research more than 10 years ago. Currently I must publish or perish.

Competing interests: No competing interests

30 May 2003
David T Parry
AUT Auckland New Zealand, 1002