Harvard Med.Students Rebel Against Big Pharma Ties

[sophia_h]

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:D :D :D


Harvard Medical Students Rebel Against Big Pharma Ties


Two hundred Harvard Medical School students are confronting the school’s administration, demanding an end to pharmaceutical industry influence in the classroom.

The students worry that pharmaceutical industry scandals in recent years, including criminal convictions, billions of dollars in fines, proof of bias in research and publishing and false marketing claims, have cast a bad light on the medical profession. The students have criticized Harvard as being less vigilant than other leading medical schools in monitoring potential financial conflicts by faculty members.

Harvard received the lowest possible grade, an “F,” from the American Medical Student Association, a national group that rates how well medical schools monitor and control drug industry money.

The students were joined by Dr. Marcia Angell, a faculty member and former editor in chief of the New England Journal of Medicine, who has vigorously advocated for an end to liaisons between academia and Big Pharma.


Sources:

http://www.ahrp.org/cms/content/view/523/9/


200 Harvard Medical School STUDENTS are confronting the administration demanding an end to pharmaceutical industry influence in the classroom.
A front page report in the Business section of the New York Times should bestir some of Harvard Medical School alumni. 200 Harvard Medical School STUDENTS are confronting the administration demanding an end to pharmaceutical industry influence in the classroom.

"The students say they worry that pharmaceutical industry scandals in recent years - including some criminal convictions, billions of dollars in fines, proof of bias in research and publishing and false marketing claims - have cast a bad light on the medical profession. And they criticize Harvard as being less vigilant than other leading medical schools in monitoring potential financial conflicts by faculty members."


Harvard received the lowest grade--an F--from the American Medical Student Association, a national group that rates how well medical schools monitor and control drug industry money. Harvard Medical School's peers received much higher grades, ranging from the A for the University of Pennsylvania, to B's received by Stanford, Columbia and New York University, to the C for Yale.

The revolt began when a first year medical student "grew wary" when a professor promoted cholesterol drugs and "seemed to belittle a student who asked about side effects." He later discovered that the professor, a full-time Harvard Medical faculty member, was a paid consultant to 10 drug companies, including manufacturers of cholesterol drugs.



Another first year student said: "Before coming here, I had no idea how much influence companies had on medical education. And it's something that's purposely meant to be under the table, providing information under the guise of education when that information is also presented for marketing purposes."

The fact is, no one is keeping track of faculty income from industry, or covert marketing pitches infiltrating the classroom: "The school said it was unable to provide annual measures of the money flow to its faculty.." One Harvard professor's disclosure in class listed 47 company affiliations.

On one side of the confrontation: the administration and most of the faculty who admittedly loath to "tighten the spigot" of cash from industry:

"school officials see corporate support for their faculty as all the more crucial, as the university endowment has lost 22 percent of its value since last July and the recession has caused philanthropic contributors to retrench."

An outspoken supporter of ties between industry and academia--who served on numerous pharmaceutical advisory boards, Professor Thomas Stossel who is unconcerned about industry influence. He views industry support as "a huge opportunity we ought to mine." A smaller faction of students calls for "continued interaction between medicine and industry at Harvard." They are led by Vijay Yanamadala, 22.

On the other side: students such as Kirsten Austad, 24, a first-year Harvard Medical student who is one of the movement's leaders, who said: "Harvard needs to live up to its name. We are really being indoctrinated into a field of medicine that is becoming more and more commercialized."


The students are joined by Dr. Marcia Angell, a faculty member and former editor in chief of the New England Journal of Medicine who has vigorously advocated for an end to liaisons between academia and Big Pharma: "Too many medical schools have struck a 'Faustian bargain' with pharmaceutical companies. If a school like Harvard can't behave itself, who can?"

Posted by: Vera Hassner Sharav

MORE:


http://www.nytimes.com/2009/03/03/business/03medschool.html


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[limelady]

I wish these students all the very best, but since modern "allopathic" medicine has been owned by big pharma for so long now, its going to be very hard for them to even make a dent in such an entrenched and corrupted system, particularly at the very prestigious Harvard School of Medicine..

But its good to at least see some young med students are waking up to the fact they will be practising medicine within a very closed system as little more than drug pushers in white coats.

I doubt Dr. Marcia Angell will hold her position on the faculty for much longer as they generally get rid of out-spoken dissenters fairly swiftly.

[bob_jones]

This article underscores the basic problems with pure genetic research. It may also add some insight into the phenomenon of why things like this grab headlines, devour enormous piles of money, but essentially go nowhere.

While its way too early to put this kind of research into perspective, one must wonder if the world hasn't had some bizarre recurrence of the Tulipmania that demolished the Dutch economy in the 1700s.


There has been much effort in the past hundred years to link serious mental illness with genetics: and an enormous effort in the past few years to use the Genomic model in a simplistic and reductionist quest to "prove" this concept.



Because all such notions of mental illness are rooted in psuedoscientific construct, and carefully nurtured by a self-serving, well-heeled industry, and not in actual medicine; I really wonder what this process hopes to produce?


If the scientists doing the work of trying to connect these illusive dots are coming up blanks when searching for causes of catastrophic physical diseases; who the hell are we trying to kid by looking for things that are
artificially contrived hypotheticals?



Vince

[1] Wageningen Tulip Portal, an extensive collection of historical resources, including scanned images of seventeenth century Dutch tulip books and pamphlets, from Wageningen UR Library"





http://www.nytimes.com/2009/04/16/health/research/16gene.html?_r=1&ref=health

RESEARCH


April 16, 2009
Genes Show Limited Value in Predicting Diseases
By NICHOLAS WADE
The era of personal genomic medicine may have to wait. The genetic analysis of common disease is turning out to be a lot more complex than expected.

Since the human genome was decoded in 2003, researchers have been developing a powerful method for comparing the genomes of patients and healthy people, with the hope of pinpointing the DNA changes responsible for common diseases.

This method, called a genomewide association study, has proved technically successful despite many skeptics’ initial doubts. But it has been disappointing in that the kind of genetic variation it detects has turned out to explain surprisingly little of the genetic links to most diseases.

A set of commentaries in this week’s issue of The New England Journal of Medicine appears to be the first public attempt by scientists to make sense of this puzzling result.

One issue of debate among researchers is whether, despite the prospect of diminishing returns, to continue with the genomewide studies, which cost many millions of dollars apiece, or switch to a new approach like decoding the entire genomes of individual patients.

The unexpected impasse also affects companies that offer personal genomic information and that had assumed they could inform customers of their genetic risk for common diseases, based on researchers’ discoveries.

These companies are probably not performing any useful service at present, said David B. Goldstein, a Duke University geneticist who wrote one of the commentaries appearing in the journal.

“With only a few exceptions, what the genomics companies are doing right now is recreational genomics,” Dr. Goldstein said in an interview. “The information has little or in many cases no clinical relevance.”

Unlike the rare diseases caused by a change affecting only one gene, common diseases like cancer and diabetes are caused by a set of several genetic variations in each person. Since these common diseases generally strike later in life, after people have had children, the theory has been that natural selection is powerless to weed them out.

The problem addressed in the commentaries is that these diseases were expected to be promoted by genetic variations that are common in the population. More than 100 genomewide association studies, often involving thousands of patients in several countries, have now been completed for many diseases, and some common variants have been found. But in almost all cases they carry only a modest risk for the disease. Most of the genetic link to disease remains unexplained.

Dr. Goldstein argues that the genetic burden of common diseases must be mostly carried by large numbers of rare variants. In this theory, schizophrenia, say, would be caused by combinations of 1,000 rare genetic variants, not of 10 common genetic variants.

This would be bleak news for those who argue that the common variants detected so far, even if they explain only a small percentage of the risk, will nonetheless identify the biological pathways through which a disease emerges, and hence point to drugs that may correct the errant pathways. If hundreds of rare variants are involved in a disease, they may implicate too much of the body’s biochemistry to be useful.

“In pointing at everything,” Dr. Goldstein writes in the journal, “genetics would point at nothing.”

Two other geneticists, Peter Kraft and David J. Hunter of the Harvard School of Public Health, also writing in the journal, largely agree with Dr. Goldstein in concluding that probably many genetic variants, rather than few, “are responsible for the majority of the inherited risk of each common disease.”

But they disagree with his belief that there will be diminishing returns from more genomewide association studies.

“There will be more common variants to find,” Dr. Hunter said. “It would be unfortunate if we gave up now.”

Dr. Goldstein, however, said it was “beyond the grasp of the genomewide association studies” to find rare variants with small effects, even by recruiting enormous numbers of patients. He said resources should be switched away from these highly expensive studies, which in his view have now done their job.

“If you ask what is the fastest way for us to make progress in genetics that is clinically helpful,” he said, “I am absolutely certain it is to marshal our resources to interrogate full genomes, not in fine-tuning our analyses of common variations.”

He advocates decoding the full DNA of carefully selected patients.

Dr. Kraft and Dr. Hunter say that a person’s genetic risk of common diseases can be estimated only roughly at present but that estimates will improve as more variants are found. But that means any risk estimate offered by personal genomics companies today is unstable, Dr. Kraft said, and subject to upward or downward revision in the future.

Further, people who obtain a genomic risk profile are likely to focus with horror on the disease for which they are told they are at highest risk. Yet this is almost certain to be an overestimate, Dr. Kraft said.

The reason is that the many risk estimates derived from a person’s genomic data will include some that are too high and some that are too low. So any estimate of high risk is likely to be too high. The phenomenon is called the “winner’s curse,” by analogy to auctions in which the true value of an item is probably the average of all bids; the winner by definition has bid higher than that, and so has overpaid.

Dr. Kari Stefansson, chief executive of deCODE Genetics, an Icelandic gene-hunting company that also offers a personal genome testing service, said deCODE alerted clients to pay attention to diseases for which testing shows their risk is three times as great as average, not to trivial increases in risk.

Dr. Stefansson said his company had discovered 60 percent of the disease variants known so far.

“We have beaten them in every aspect of the game,” he said of rival gene hunters at American and British universities.