Welcome to Scribd, the world's digital library. Read, publish, and share books and documents. See more
Download
Standard view
Full view
of .
Look up keyword
Like this
4Activity
0 of .
Results for:
No results containing your search query
P. 1
Conflicts of Interest by Joe Pizzorno, ND

Conflicts of Interest by Joe Pizzorno, ND

Ratings: (0)|Views: 157 |Likes:
Over the past decade, we repeatedly have seen disquieting revelations on research authors having undisclosed financial associations with companies whose products they are supposed to be objectively testing. Even worse is the more recent revelation involving the Journal of the American Medical Association (JAMA) among others that some authors, for a fee, simply put their names on research articles written by drug companies. One wonders how a researcher can truly claim credit for publishing 500 original research studies over a lifetime, much less over 10 years. The disclosure form is now posted on the website of the
International Committee of Medical Journal Editors (www.icmje.org/coi_disclosure.pdf ) and includes instructions and examples to help authors provide the needed information
Over the past decade, we repeatedly have seen disquieting revelations on research authors having undisclosed financial associations with companies whose products they are supposed to be objectively testing. Even worse is the more recent revelation involving the Journal of the American Medical Association (JAMA) among others that some authors, for a fee, simply put their names on research articles written by drug companies. One wonders how a researcher can truly claim credit for publishing 500 original research studies over a lifetime, much less over 10 years. The disclosure form is now posted on the website of the
International Committee of Medical Journal Editors (www.icmje.org/coi_disclosure.pdf ) and includes instructions and examples to help authors provide the needed information

More info:

Published by: InnoVision Health Media on Dec 18, 2009
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as PDF, TXT or read online from Scribd
See more
See less

07/03/2014

pdf

text

original

 
Integrative Medicine • Vol. 8, No. 6 • Dec 2009/Jan 2010
8
  Pizzorno—The Path Ahead 
bed with the pharmaceutical com-panies, we may now become uncon-sciously less rigorous when evaluat-ing CAM research—in particularresearch from natural health manufacturers—that proves theefficacy of their products.The issue of unfair advantage for Bioclinics Naturals is easyto handle as I can simply recuse myself by handing off to othereditors any studies submitted by the Factors Group and can besure to not mention them or their products in any future editori-als. (Interestingly, in early 2009, the Factors Group submitted anarticle that is currently going through peer-review. I will, of course,recuse myself from the acceptance decision.) On a more subtlenote, when Bioclinic Naturals advertises in any Innovision HealthMedia publications, my name and image will not be in the ads.The issue of unfair treatment of competitors is going to bemuch more difficult to handle.
 IMCJ 
has for many years had aneditorial priority of strongly encouraging natural health productmanufacturers to conduct direct research on their own products.We are very concerned that many manufacturers use borrowedresearch—ie, they assert that research done by other companiesapplies equally to their products. The problem with this is thatthere are so many variables in how, for example, an herbal medi-cine is processed that there is real doubt about just how compa-rable products manufactured by different companies really are.Another problem is that many formulations are put together bysome very smart people who read the research and determinewhat should work. But really, how do you know that this appar-ently wonderful blood sugar–lowering formula really will dowhat it says it does without actually trying it on real people? (Oneexcellent article we recently ran on borrowed research was“Quality Assurance: The Difference Between Quality Control andQuality Assurance Using an Example of Pomegranate Extract” byRick Liva [
 IMCJ.
2009;8.3:48-50].)At
 IMCJ 
, we have spent a lot of time and editorial resourceshelping to encourage, teach, and guide manufacturers to engagein real research. I realize this has not often been visible to you, thereader, but I think you will agree that this is desirable.Unfortunately, in spite of all our efforts, most of the researchsubmitted to us needs further refinement before it can be consid-ered as original research. Happily, fellow editor David Riley,
MD
,editor in chief of 
 Alternative Therapies in Health and Medicine
, oneof our sister publications, has made the excellent suggestion thatwe add the category of Research Letters to accommodate suchsubmissions as another tier of research articles. (These letters willbe reports on original research that are between 600 and 1500words of original text not published elsewhere.)My intent is to continue to encourage manufacturers toengage in research, and since
 IMCJ 
will welcome such research
I
n its
 
October12issue, the
 British Medical Journal 
(
 BMJ 
) pub-lished a relevant editorial on conflicts of interest as the termapplies to medical research publications.
 BMJ 
is to be con-gratulated for proposing a very stringent policy, complete with aform for authors to fully disclose potential commercial conflictsof interest. (And I might add,
 IMCJ 
also asks authors for such aform, albeit a less comprehensive one. You can find our Conflictof Interest form on our website www.imjournal.com by clickingon “Submissions.”)Over the past decade, we repeatedly have seen disquietingrevelations on research authors having undisclosed financialassociations with companies whose products they are supposedto be objectively testing. Even worse is the more recent revelationinvolving the
 Journal of the American Medical Association
(
 JAMA
)among others that some authors, for a fee, simply put theirnames on research articles written by drug companies. One won-ders how a researcher can truly claim credit for publishing 500original research studies over a lifetime, much less over 10 years.The disclosure form is now posted on the website of theInternational Committee of Medical Journal Editors (www.icmje.org/coi_disclosure.pdf) and includes instructions and examplesto help authors provide the needed information.The bottom line appears to be full disclosure as well as hon-est revelation of who actually has done the research.However, readers of 
 IMCJ 
may recall my editorial “How DoWe Get Better?” (
 IMCJ.
2008;7.4:8-10) where I cited an articlefrom
 JAMA
that showed a more subtle form of conflict of inter-est: The more drug research advertising a journal accepts, the lesslikely it is to publish a study on CAM, and, if it does, the study isalmost always a negative one.This issue of potential conflict of interest is extremely chal-lenging and should apply not only to the authors of journal arti-cles but also to those editors and peer reviewers associated withthe journal as well.
My Own Conflict of Interest Disclosure
So, time for my own full disclosure: I have become a consul-tant to the Factors Group to develop a line of natural healthproducts for healthcare professionals under the Bioclinic Naturalsbrand. You may shortly see my name and image with that of mylong-time friend and coauthor, Michael Murray,
 ND
, in advertise-ments for the Bioclinic Naturals.
 
This relationship, of course, poses a potential conflict of interest for me as the editor in chief of 
 IMCJ 
. The obvious con-cern is that the journal might give unfair advantage to Bioclinic Naturals in editorials, peer review, or article selection. Or per-haps, as editor in chief, I will become biased against competitors.A more subtle concern is that, just as so many of us have cri-tiqued conventional medicine journals for being apparently in
Conflicts of Interest
 Joseph Pizzorno,
 ND
 , Editor in Chief 
THE PATH AHEAD
This article is protected by copyright. To share or copy this article, please visit
.Use ISSN#1543953X. To subscribe, please visit
.
 
Integrative Medicine • Vol. 8, No. 6 • Dec 2009/Jan 2010
9
 Pizzorno—The Path Ahead 
letters—clearly identified as such—I will actually be acceptingmore research from supposed competitors.In regard to unfair favoritism to the industry, all I can say isthat
 IMCJ 
has published more than 50 editorials, articles, andcolumns on quality control problems with natural health prod-ucts. While I expect to continue to receive the occasional iratecall or letter from a manufacturer, I can say with considerabledetermination that
 IMCJ 
will continue to be a force for improve-ment in the quality, safety, and efficacy of the agents we pre-scribe for our patients.I also want to be clear that if my association with theFactors Group is perceived to be a conflict of interest or in anyway taints the integrity and/or professionalism of the journal, Iwill step down as the editor in chief. It is actually a great oppor-tunity to bring this issue to the forefront, and I am proud that
 IMCJ 
can once again be on the leading industry edge and openup such a discussion. I am utterly committed to continuing to bean unbiased advocate for both the journal and the advancementof good medicine.A last point of consideration: There is also a reality factor forall editorial disclosures. The vast majority of medical profession-als who are associated with journals—including authors,researchers, and editors—generally do so on a part-time basis.This leaves time and finances that need to be filled. Liaisons withcommercial interests can be a win:win for both parties, so it is a joining we will likely see continued in this field.So, what do YOU think? Letters to the editor, please.Write
 IMCJ 
, 2995 Wilderness Place, Suite 205, Boulder, CO80301; e-mail imcjsubmissions@innovisionhm.com; or send afax to 303.440.7446.Please be assured that if there are letters expressing concernover my involvement with the Bioclinic Naturals brand, theseresponses will be blinded before coming to me so I won’t knowwho sent them. We want to keep the conversation as open andreceptive as possible.
In This Issue
In this issue, we have a special report on women’s reproduc-tive issues. Bethany Hays,
MD
, starts us off with another of herincredibly insightful articles, this time on infertility. She focuseson 4 mitigating factors in infertility: the external environment, theinternal environment, the intracellular environment, and thepsycho-social-spiritual environment. Ways to address these areasinclude cleaning up the patient’s environment with a diet of pri-marily organic vegetables and animal products; normalizinginsulin resistance, obesity, and inflammation with a balancedantiinflammatory diet; and evaluating vitamin deficiency with thegoal to replenish missing vitamins and minerals with a balancedmultivitamin, activated B-vitamins, and omega-3 fatty acids.Associate Editor Tori Hudson,
 ND
, chimes in with another of her clinically useful articles: “Botanicals for Managing Menopause-Related Symptoms—State of the Science.” Approximately two-thirds of women develop perimenopausal and menopausalsymptoms. Vasomotor symptoms are reported as the most com-mon, followed by anxiety, mood changes (such as sadness ordepression), sleep disruption, body aches, fatigue, and more.Botanical alternatives to hormone replacement therapy are of increasing interest to this group of women, and, in fact, peri-menopausal and postmenopausal women are among the mostfrequent users of botanical and dietary supplements. Usefulherbs include black cohosh (
Cimicifuga racemosa
), chasteberry,vitex (
Vitex agnus-castus
), dong quai (
 Angelica sinensis
), ginseng(
 Panax ginseng 
), kava (
 Piper methysticum
), kudzu (
 Pueraria mirifi-ca
), maca (
 Lepidium meyenii
), red clover (
Trifolium praetense
),rhubarb (
 Rheum rhaponticum
), St John’s wort (
 Hypericum perfora-tum
), burdock root (
 Arctium lappa
), licorice root (
Glycyrrhiza glabra
), motherwort (
 Leonurus cardiaca
), wild yam root (
 Dioscoreavillosa
), and pycnogenol.I am always intrigued by clinician/researchers who cre-atively conceptualize models to help us more deeply understandour patients.
 
W. John Diamond,
MD
, writes on the sympatheticand parasympathetic nervous systems in “Allostatic Medicine:Bringing Stress, Coping, and Chronic Disease into Focus.” Thisarticle is not light reading. I found his discussion of the centralnervous system as the preeminent regulatory influence on somat-ic physiology useful. He suggests a newly coined anticipatoryregulatory concept called allostasis that permits bodily efficiencyby matching resources to perceived or anticipated need. If thisneed is not met, stress results. In turn, if the stress reaction iscontinuously activated, the allostatic system of stress-associatedreactions is also chronically activated, and this prolonged arousalleads to a wear and tear on the body, resulting in an inefficient,“bad” stress response.Our interview is with Mary Hardy,
MD
, and Anne Coscarelli,
PhD
, of the Simms/Mann Center for Integrative Oncology, whichis part of the Jonsson Comprehensive Cancer Center at theUniversity of California, Los Angeles. My friend Dr Hardy is themedical director and Dr Coscarelli is the director of the center. Thecenter was created based on the understanding that patients withcancer have diverse psychosocial needs, and many of those needswere not being met in other places. At the clinic, a patient’s needsare assessed in a variety of areas: psychological, social support,nutrition and dietary supplementation, mind-body techniques forstress management, and physical appearance assistance. Based onthis assessment, the clinic offers services such as psychological andnutrition counseling, guided imagery and mindful meditationtechniques, and a detoxification program.Sadly, Andrea McCloud,
MFA
, who has done such a good jobconducting these interviews for us the past several years, is leavingto start a promising career in screenwriting. We will all miss her. Joel Kreisberg,
DC
, continues his Green Medicine Tips, thistime considering indoor pollution. Tobacco smoke, mold, pesti-cides, chemical cleaners, radon, carbon monoxide, asbestos,formaldehyde, and lead are the “short” list of the most commonhousehold contaminants.
 
Reading his article, I was reminded of apatient I saw 30 years ago who became sick every summer but bylate winter was again symptom free. It turns out he worked as apainter until he got too sick and then would go back to collegeuntil his funds ran out and he had to start painting again. I fol-lowed his toxic metals levels (using hair analysis) for several yearsand found a remarkably consistent biphasic toxicity pattern. He
 
became so intrigued by the health effects of toxic exposure that he

Activity (4)

You've already reviewed this. Edit your review.
1 thousand reads
1 hundred reads
No Tan Lines liked this
sana35 liked this

You're Reading a Free Preview

Download
scribd
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->