JAMA Conflict Dispute Turns Catfight

I had so hoped that I'd heard the last of the flap over unreported conflicts on interest in a Lexapro study published in JAMA last year. I cannot even make myself type the back ground out once more, so read it here.

Anyway, now the primary author of the study, University of Iowa psychiatrist Robert Robinson, has written a letter to the BMJ, complaining about the role that journal's website had in all of this and then questioning the potential bias of the researchers (Jonathan Leo and Jeffrey Lacasse) who brought his conflict to the attention of JAMA's editors and then he bitches about bloggers who wrote about the JAMA fracas. Yes, it's a big old catfight now, complete with Robinson accusing Leo of having an "ideological agenda." Robinson points out that Leo is on the board of the International Center for the Study of Psychiatry and Psychology (ICSPP), which has been around since 1971 and is well-known as being a dissident group within mental health circles. Many people within the mental health industry perceive ICSPP as being against the use of medications, but that's not true.

The problem with Robinson's argument is that Leo hasn't been on the board of ICSPP for two years. While he might have identified in his and Lacasse's initial letter to JAMA that he was a past board member that hardly compares with the kinds of financial conflicts researchers often have. What's more, almost anyone who's read the medical literature in the psych world over the last decade or so knows who Leo is--along with Lacasse, he's become the most persistent critic of conflicts of interest, shabby scientific evidence and pharmaceutical advertising. But, then, maybe psychiatrists don't stay up on the medical literature as they should.

Robinson also notes:

"Bloggers, who knew nothing about the biases of the letter writers or about my relationship (or more accurately, lack of relationship) with Forest Laboratories, have publicly criticized me."

I'm not sure which bloggers Robinson means, but most of my criticism has been reserved for JAMA's editors. I was however aware of Leo and Lacasse's biases. I've been reading their journal articles for four years. Their biases seem to be ones of researchers interested in helping clean up a dirty evidence base, helping limit conflicts of interest with pharma companies and of preventing psychiatry from making false and exaggerated claims like asserting that a chemical imbalance causes depression (an alleged true "fact" that remains unproven). I can handle those biases. Besides, I've not known them to make false assertions about conflicts in the research world.

It'll be interesting to see how this all gets resolved once the AMA board president's call for an investigation of JAMA's editors is answered. (Via the Wall Street Journal's Health blog.)