4 ms·
(I work in this field and have met the subject of the article.) There isn't much to say except he couldn't be bothered. The article tries to find some kind of a
by Gatsky 8y ago
(I work in this field and have met the subject of the article.)
There isn't much to say except he couldn't be bothered. The article tries to find some kind of angle to make this more interesting, but fails. It's sloppy for someone in such a high position, but that's about it.
If he had disclosed all his conflicts, the same research would have been published in the same places with the same people. Nothing would have changed. At conferences academic oncologists get up and flash a slide with many conflicts of interest at the start of their talk. Nobody really cares or pays much attention.
When it comes to clinical trials, there are many checks and balances that prevent a 'rogue' conflicted investigator from influencing the results. Not the least of these are the other investigators on the study which put their name on the paper, who are free thinking individuals. The data is also collected and analysed by an independent data monitoring committee, who will for example stop the study early if it is looking futile, whatever the drug company thinks should happen. Independent clinical trial staff will also send out teams to hospitals running the trial and inspect the data and talk to the staff. For trials going for regulatory approval of the drug, there is often a formal independent audit which goes even deeper, to the point of interviewing staff in a confidential setting and asking them if they have been coerced for example.
- sixstringbudha 8y ago>If he had disclosed all his conflicts, the same research would have been published in the same places with the same people. Nothing would have changed. Speculation. > Nobody really cares or pays much attention. Maybe they should. >When it comes to clinical trials, there are many checks and balances that prevent a 'rogue' conflicted investigator from influencing the results. And you think these checks and balances work good enough, most of the time?
- rrock 8y agoHe has to declare his conflicts annually to his institution, and has to provide updates with any new conflicts within 90 days. They would almost certainly have a conflict management plan in place for this situation
- TangoTrotFox 8y agoYou seem to be ignoring the fact that preclinical trials are experiencing abysmal replication rates in studies geared towards that end. There's ongoing work on replication of clinical studies, but I would hypothesize that we are going to see the same problem there. The point here being that the systems in place do not seem be working as an effective system of checks and balances, and so bias in part of the individuals and organizations involved is rather important.
- Gatsky 8y agoNo, Baselga is primarily a clinical trialist, so it isn’t relevant to this discussion. Clinical trials have standardised designs and procedures, the number of experimental subjects is large (compared to preclinical lab experiments), and orthogonal outcome measures are collected to enhance validity (like response rate and survival outcomes). Most doctors are trained and experienced in interpreting clinical trials, and are well aware of the limitations, which are constantly highlighted in conference discussions and the literature. Finally, clinical trials are replicated all the time (surprised you would suggest otherwise?). A drug is tested in phase 1, phase 2 and phase 3 trials of increasing size, and drugs from the same class are also tested in competing trials.
- Josh379 8y agoWe should take this with a grain of salt because your reputation is tied to his. This is the cascade effect that occurs when someone very powerful behaves inappropriately-the people below them must defend it to protect what they have. Having come from acedemia, I disagree with just about everything in this post. People do care about conflicts of interest and when very powerful people are being reviewed, they get greater leeway because of the power of retribution.