May 26, 2024

Medical journal fights to defend reputation

JAMA attacks whistleblower
Detachment and objectivity are the hallmarks of the model scientist. Alas!
how difficult they are to achieve — as a spat involving one of the world’s
leading medical journals, the Journal of the American Medical Association,
shows. A few days ago it took the unusual step of publishing a very long editorial
explaining the ins and outs of a painful quarrel with a conflict-of-interest

As reported with barely-suppressed glee by the Wall Street Journal, the story
runs like this. Dr Leo Alexander, a professor of neuroanatomy at Lincoln
Memorial University in Harrogate, Tennessee, discovered on Google that the
author of an article in JAMA about an anti-depressant had not observed JAMA’s
guidelines for declaring conflict of interest.

He wrote to JAMA in October and they began to investigate – a long and
tedious process. Frustrated by the delay, he published a letter in a rival
journal, the BMJ
, with stinging words about conflict of interest: "The
medical community strives to make decisions based on evidence, but as this case
illustrates we have unfortunately arrived at a point where taking the
conclusions of clinical trials at face value is apparently a sign of naivete."

The editors of JAMA were not happy. They felt that publication in the BMJ
constituted a serious breach of confidentiality, that it made an impartial
investigation difficult and that it harmed JAMA’s reputation. The executive
deputy editor, Dr Phil Fontanarosa, rang Dr Leo. According to Dr Leo, Dr
Fontanarosa was irritated: "He said, ‘Who do you think you are?’ He then said,
‘You are banned from JAMA for life. You will be sorry. Your school will be
sorry. Your students will be sorry." ("Inaccurate", according to Dr

In an interview with The Wall Street Journal, JAMA editor-in-chief Catherine
also called Dr Leo "a nothing and a nobody" (erroneously reported, according to
JAMA). The dean of Dr Leo’s medical school told the WSJ that Dr DeAngelis
threatened in a telephone conversation that she would "ruin the reputation of
our medical school" if he did not force Dr Leo to retract the BMJ letter and
stop talking to the media. (Dr DeAngelis denies threatening the dean.)

As a result of this dust-up, JAMA has changed its policy on complaints about
conflict of interest. From now on, whistleblowers will be told to remain silent
about the allegation while the journal investigates the charge. The new policy
has been criticised by a former editor of the New England Journal of Medicine
and the editor of the BMJ as excessive. ~ Wall
Street Journal, Mar 24
; Wall
Street Journal, Mar 13
; statement
from Leo Alexande