Comments on: Surgeons make millions on Medtronic payroll

By: Carolyn Thomas

Carolyn Thomas — Sun, 28 Oct 2012 14:33:17 +0000

Agreed, Dr. Joe. But some doctors seem to willingly believe that simple disclosure of all cash payments from industry somehow gets them off the hook, rather than stepping back and asking if these pervasive financial relationships are ethical in the first place? As Harriet Washington wrote in an American Scholar essay last year: “Despite the ubiquitous mantra of ‘evidence-based medicine’, a curious lack of skepticism pervades journals about experts who accept money from the makers of the products they evaluate.”

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By: Carolyn Thomas

Carolyn Thomas — Sun, 28 Oct 2012 14:25:57 +0000

Thanks for the link to your article, which clearly explains how the initial studies were flawed. And as you say, the lawyers are now getting involved – which is when we’ll see the extent of the consequences caused by use of the product.

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By: Dr. Joe Kosterich

Dr. Joe Kosterich — Sun, 28 Oct 2012 14:14:38 +0000

In simplest terms this is fraud.

How can someone edit a journal, and submit articles to it and be paid to produce those same articles? Sure if you invent something you deserve royalties. But you are not independent. Doctors need to learn that you cannot play a game and be a neutral umpire. It is either or!

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By: Doctor Skeptic

Doctor Skeptic — Sun, 28 Oct 2012 12:03:09 +0000

Well done, and thank you for this blog post. This is only one example of the problems with undisclosed financial ties, withholding of negative data, bias reporting, and biased publication that is rife in the surgical community, particularly surgery relating to implants.

Unfortunately, even without the biases from financial interests, there remains a bias amongst surgeons that new, expensive implants, devices and drugs are good and should be preferred over cheaper alternatives. The surgeons who received the money used INFUSE, but so did thousands of others who bought the story without being skeptical.

This drug was tested in open tibia fractures (as you state) based on one trial that was favourable. That trial had unequal distribution of treatments and was suspected as being biased. The lead author repeated the study (more stringently) and showed that the drug was not helpful in bone healing, and was associated with an increased risk of infection.

We have not used these drugs in our institution for over 10 years. And we don’t miss them. Story of BMPs (of which INFUSE is one) is covered in one of my blog posts.

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