Dollar til leger - Hva legemiddelfirmaer betaler din lege (Dollars for Docs - What Drug Companies are Paying Your Doctor (propublica.org)

ProPublica is an independent, non-profit newsroom that will produce investigative journalism in the public interest. Our work will focus exclusively on truly important stories, stories with “moral force.” We will do this by producing journalism that shines a light on exploitation of the weak by the strong and on the failures of those with power to vindicate the trust placed in them. (...)

Investigative journalism is at risk. Many news organizations have increasingly come to see it as a luxury. [Read Article] Today's investigative reporters lack resources: Time and budget constraints are curbing the ability of journalists not specifically designated “investigative” to do this kind of reporting in addition their regular beats. This is therefore a moment when new models are necessary to carry forward some of the great work of (...) (propublica.org)

Pulitzer til stiftelsen ProPublica (tv2nyhetene.no 19.4.2011)

Inside Chicago's Maxwell Manor nursing home, Dr. Michael Reinstein's patients suffered from side effects so severe that they trembled, hallucinated or lost control of their bladders. (propublica.org 10.11.2009)

On the other, some worried that his research findings might be too good to be true. (chicagotribune.com 11.11.2009)

- Dagens undersøkende journalister mangler ressurser

Today's investigative reporters lack resources (Dagens undersøkende journalister mangler ressurser)
azcentral.com 28.5.2007
Aviser bryr seg om undersøkende journalistikk, men de følger det ofte ikke opp med ressurser som journalister sier de trenger for å gå i dybden. (Newspapers care about investigative stories, but they frequently don’t back that up with resources that reporters say they need to do in-depth work.)

Det er det viktigste funnet i en undersøkelse utført i fjor høst av journaliststudenter ved Arizona State University. Studentene tok del i en oppgave som klassen fikk om å skrive om 30-årsdagen for drapet på Don Bolles, en undersøkende jouranlist i The Arizona Republic som dekket mafiametoder og svindel med landområder i Arizona. Det er allment antatt at hans drapsmenn ønsket å bringe ham til taushet. (...) (That’s the major finding of a survey conducted last fall by Arizona State University journalism students. The students were part of an in-depth reporting class assigned to write about the 30th anniversary of the murder of Don Bolles, an investigative reporter for The Arizona Republic who covered mob dealings and land fraud in Arizona. It is widely believed that his murderers wanted to silence him.)

(Anm: Forskning og ressurser (mintankesmie.no).)

(Anm: Det digitale menneske er lykkeligt uvidende. (…) Smartphonerevolutionen har sat fordybelse og refleksion på standby. (…) Mennesket er overhalet af guldfisken med ét sekund, hvad angår evnen til at fokusere opmærksomhed. (…) Katrine K. Pedersen er forfatter til bogen 'Phono Sapiens – det langsomme pattedyr på speed’, som udkom i foråret. (politiken.dk 1.8.2016).)

- Eksperter advarer: Smartphones stjæler vores dagdrømme. I 10 år har verden haft smartphones, og ifølge eksperter kan telefonerne være på vej til at ændre vores måde at bruge hjernen på.

(Anm: Eksperter advarer: Smartphones stjæler vores dagdrømme. I 10 år har verden haft smartphones, og ifølge eksperter kan telefonerne være på vej til at ændre vores måde at bruge hjernen på. For 30 sekunder siden tog jeg min mobiltelefon i hånden, trykkede på Facebook-ikonet og skrev en opdatering. Jeg ved ikke helt, hvorfor jeg gjorde det, måske fordi Facebook jo spurgte mig: Hvad er du optaget af her til morgen?, måske fordi jeg faktisk havde lyst til at ”tale” med nogen om, hvordan jeg har det, eller også var det for at få den der tilpas milde følelse af spænding og forventning, som breder sig i kroppen nu. Den kan vel bedst kan sammenlignes med følelsen af at have sidde... (jyllands-posten.dk 9.7.2017).)

(Anm: Med et tastetrykk kan de vinne valget for Trump eller Clinton (aftenposten.no 16.9.2016).)

(Anm: - Nesten skremmende gode tall fra Facebook. Håver inn nesten 7 milliarder dollar fra annonsemarkedet i kvartalet. (kampanje.no 3.11.2016).)

(Anm: Det usagte i norsk presse. NINA WITOSZEK, professor og forfatter. SELEKTIV OPPMERKSOMHET. Det er talløse «ikke-eksisterende» tragedier som fortjener mer oppmerksomhet i pressen enn ikke-begivenheter og Mikke Mus-problemer. (aftenposten.no 9.3.2009).)

(Anm: Nina Hjerpset-Østlie. Leserne burde kunne forvente at mediene prioriterer bedre enn tilfellet er i dag. Mens noen driver gravejournalistikk, prioriterer NRK og andre et 42 år gammelt programkonsept. Det er så enkelt som at saker av stor samfunnsinteresse bør prioriteres fremfor en fugledrapsmann og at en norsk iskremfabrikk skifter eier. Hensikten med nyheter er jo å opplyse, ikke å underholde? (aftenposten.no 6.4.2016).)

(Anm: - Hemmelige aksjeeiere er et demokratiproblem. (- Stortingspolitikere har lobby-møter om politikkutvikling og investeringer med selskapene der de selv eier aksjer.) (- Selger aksjer etter Dagblad-avsløring.) (dagbladet.no 28.9.2015).)

(Anm: - Overdreven selvtillit er problematisk. (- Så dumt er det med FOR mye selvtillit.) (illvit.no 31.3.2016).)

(Anm: Kronikk: «Sitt stille, gjør jobben din og hold munn!» | Maria Amelie, Dag Yngve Dahle. Det brukes sjokkerende metoder for å få ansatte på norske arbeidsplasser til å tie stille. (…) Utfrysningstriks og overvåking. Vi var ikke ukjent med at dette forekommer, men ble like fullt overrasket over vreden, aggresjonen og den vonde viljen i arbeidsgivernes handlemåte.  (aftenposten.no 15.1.2016).)

(Anm: Lar Hollywood finansiere gratis gravejournalistikk. Hollywood har kjøpt filmrettighetene til 25 av Joshua Davis og Joshuah Bearmans magasinartikler. De kaller det «en ny businessmodell for journalistikk». Hollywood har kjøpt filmrettighetene til 25 av Joshua Davis og Joshuah Bearmans magasinartikler. De kaller det «en ny businessmodell for journalistikk». (dn.no 22.1.2016).)

(Anm: Visitors are using US website to search for high prescribing doctors. BMJ 2016;353:i2756 The US investigative journalism website ProPublica has found that many visitors to its online database that provides information on US physicians’ prescribing practices seem to be searching for doctors who freely prescribe opioids and other widely misused drugs. (Published 16 May 2016).)

- Pulitzer til stiftelsen ProPublica. (- Pulitzer Prize-suksess for online nyhetsnettsteder)

Pulitzer til stiftelsen ProPublica
tv2nyhetene.no 19.4.2011
Den uavhengige mediestiftelsen ProPublica er for andre gang blitt hedret med en Pulitzer-pris for sin undersøkende journalistikk.

ProPublica får den prestisjetunge prisen for en serie artikler om hvordan aktører i finansnæringen i USA bidro til den økonomisk krisen. Artiklene ble aldri trykket i noen papiravis, og det er første gang en Pulitzer tildeles for saker som kun er publisert i andre kanaler.

Også kjente amerikanske aviser som New York Times, Washington Post og Wall Street Journal ble hedret under prisutdelingen mandag. Los Angeles Times fikk to Pulitzer-priser, blant annet for artikler som avslørte omfattende korrupsjon i en liten by i California.

Det deles også ut Pulitzere for litteratur, drama og musikk, og Jennifer Egan fikk skjønnlitteratur-prisen for sin bok «A Visit from the Goon Squad».

ProPublica ble startet i 2008 og fikk sin første Pulitzer-pris i fjor for artikler om situasjonen ved et sykehus i New Orleans i etterkant av orkanen Katrina. (...)

(Anm: Undersøkende (gravende) journalistikk (mintankesmie.no).)

(Anm: Her skjønner journalisten Sarah Ryley at hun har vunnet Pulitzer - verdens mest anerkjente journalistpris. Pulitzer-prisen i 2017 går til New York Daily News og ProPublica for avsløringen av hvordan politiet i New York kastet fattige ut av boligene sine. (medier24.no 11.4.2017).)

(Anm: Her kan du lese årets beste journalistikk. (…) Pris for Panama Papers. The New York Times fikk priser i kategoriene Internasjonal reportasje og Feature. Avisen fikk også en pris sammen med ProPublica for avsløringen av hvordan politiet i New York kastet fattige minoriteter ut av boligene sine. (aftenposten.no 11.4.2017).)

- Her kan du lese årets beste journalistikk. (- Avisen fikk også en pris sammen med ProPublica for avsløringen av hvordan politiet i New York kastet fattige minoriteter ut av boligene sine.)

Her kan du lese årets beste journalistikk
aftenposten.no 11.4.2017
Trump-avsløring og graveprosjektet Panama Papers, som Aftenposten deltok i, er blant årets vinnere av den prestisjetunge Pulitzer-prisen. (…)

Pris for Panama Papers
The New York Times fikk priser i kategoriene Internasjonal reportasje og Feature. Avisen fikk også en pris sammen med ProPublica for avsløringen av hvordan politiet i New York kastet fattige minoriteter ut av boligene sine.

Den internasjonal organisasjonen for gravende journalistikk, ICIJ, fikk sammen med Miami Herald prisen for «forklarende reportasje» for sitt arbeid med Panama Papers, et arbeid som også Aftenposten deltok i fra norsk side.

– Panama Papers var et banebrytende samarbeidsprosjekt mellom mediehus over hele verden. Vi delte all informasjon og kilder, og hver enkelt redaksjon gravde frem egne journalistiske saker. For Aftenposten var samarbeidet av stor betydning, og vi er glade for at avisen Süddeutsche Zeitung tok initiativet til samarbeidet, sier Tone Tveøy Strøm-Gundersen, nyhetsredaktør i Aftenposten. (…)

Pulitzer Prize success for online news websites (Pulitzer Prize-suksess for online nyhetsnettsteder)
bbc.co.uk 12.4.2010
Online news organisations have for the first time won coveted Pulitzer Prizes, the top awards in US journalism.

A journalist writing in a collaboration between online news service ProPublica and the New York Times magazine won an award for investigative reporting.

Meanwhile, Mark Fiore of the San Francisco Chronicle's website won the award for editorial cartooning.

Pulitzer Prizes are awarded annually by Colombia University to honour the best in US literature, journalism and music. (...)

(Anm: Undersøkende (gravende) journalistikk (mintankesmie.no).)

- ProPublica gjør det lettere å se kilder bak historien

ProPublica makes it easier to see sources behind a story (ProPublica gjør det lettere å se kilder bak historien)
poynter.org 15.12.2011
ProPublica introduserer i dag en ny funksjon som viser leserne reporterens kilder til informasjon uten å forlate historien. (ProPublica is debuting a new feature today that enables readers to view the reporter’s sources of information without leaving the story.)

"Utforsk kilder"-knappen lar folk som er spesielt interessert i emnet muligheten til å granske dokumentene selv. Det gjør journalisten ansvarlig for fakta i historien hans. Og - selv om det ikke var meningen - skaper det nok en mulighet for faktasjekking. (The “Explore sources” button enables people who are deeply interested in the topic to explore documents themselves. It holds the reporter accountable for the facts in his story. And — although it wasn’t intended to — it creates another layer of fact-checking.)

Den nye funksjonen er et resultat av et samarbeid mellom reporter Marshall Allen, som bruker DocumentCloud mye i sin rapportering, og programutvikler Al Shaw, som laget et nytt verktøy som gjør det mulig for Allen å integrere alle disse notater inn i en historie. (The new feature is a result of collaboration between reporter Marshall Allen, who is using DocumentCloud extensively in his reporting, and news applications developer Al Shaw, who built a new tool to enable Allen to integrate all those notes into a story.)

Shaws verktøy gjør at alle kan kommentere en historie, ingen HTML kunnskap er nødvendig, og eksporterer det til et standard innholdspubliseringssystem. (Shaw’s tool enables anyone to annotate a story, no HTML knowledge needed, and export it to a standard Web content management system.)

«Al bygde dette for å være repeterende," sier Scott Klein, redaktør for nyhetsprogrammer, "så vi ser det absolutt som noe vi kommer til å bruke igjen." (“Al built this to be repeatable,” said Scott Klein, editor of news applications, “so we absolutely see it as something we’re going to use again.”)

Primary sources in context
Today’s story, “Why can’t Linda Carswell get her husband’s heart back?,” looks like any other. The difference is that when the reader clicks a link labeled “Explore Sources,” about 50 passages in the story are highlighted.

Clicking any of those highlighted words or phrases causes a box to pop up displaying the portion of a document that substantiates the language.

The pop-ups provide a way for people to “see behind the scenes and explore the information further, if that’s something that interests them,” Allen said. (...)

- Undersøkelse av kilder: En ny funksjon til å "Vise vårt arbeid" (“Show Our Work”)

Explore Sources: A New Feature to “Show Our Work” (Undersøkelse av kilder: En ny funksjon til å "Vise vårt arbeid" (“Show Our Work”))
propublica.org 15.12.2011
Marshall Allen historie inneholder vårt nye Explore Sources feature ("Utforsk kilderkarakteristikker"). (Marshall Allen's story is annotated with our new Explore Sources feature.)

We’re debuting a new feature today as part of Marshall Allen’s story about one woman’s fight with a Texas hospital to find out how her husband died.

In the course of reporting the piece, Marshall made over 500 annotations in 64 documents he uploaded to DocumentCloud, many of which were sources of facts in his story. We thought readers would find these annotations useful, and may even use them to explore the documents on their own. However, we didn’t want to show them in a separate graphic or interactive feature, but rather sprinkled throughout the story itself.

So we made a special feature we’re calling Explore Sources. To try it, click the “ON” button next to “Explore Sources” at the beginning of the article. Words and phrases throughout the piece will turn yellow. Click these yellow highlights to see the portion of the source document from which Marshall got that fact. Once the annotation is visible, click the document image inside of the popup to go to the full document in DocumentCloud, or anywhere else to dismiss it.
Behind the Scenes

To speed up the process of adding the links, we built a small web application which let Marshall select snippets of text in his story, just as he would in a word processor, and associate it with a DocumentCloud annotation via a point-and-click interface. The tool exports code that we can easily paste into our content management system. (...)

- Ekstrainntekter og skjulte interessekonflikter i forskningen (- Skyggekontoer)

US doctors earn speaking and consulting fees from drug companies that sponsor their research (Leger mottar penger for foredrag og rådgivning fra legemiddelfirmaer som sponser deres forskning)
BMJ 2014;348:g2410 (Published 27 March 2014) Cite this as:

Medical researchers in the United States often accept thousands of dollars in speaking and consulting payments from drug companies that also sponsor their research, the investigative journalism nonprofit organization ProPublica reported on 25 March.1

In their investigation Charles Ornstein and Ryann Grochowski Jones, reporters for ProPublica, used a searchable database called Dollars for Docs, which tracks payments made to doctors by 15 drug companies.

In their analysis the reporters looked at the payments made by nine companies in the database in 2012: Allergan, Cephalon, Eli Lilly, Forest Laboratories, GlaxoSmithKline, Merck, Novartis, Pfizer, and ViiV Healthcare.

They found that about 10% of the scientists that received funding for research from these companies also received money for speaking or consulting or both.

All told, in 2012 the researchers received more than $90m (£54m; €65m) in research grants, nearly $13m for speaking engagements, and another $4m for consulting, the reporters found.

Of the companies they looked at, Pfizer had the lowest rate of dual relationships among its researchers, at about 7%, while Novartis and ViiV Healthcare had the highest, at more than 15%, the reporters wrote.

One researcher, an expert in infectious disease at Tufts Medical Center in Boston, Massachusetts, received speaking, consulting, and research payments from three companies in 2012: $51 000 for research, $125 000 to speak about the companies’ drugs, and $13 000 for consulting, ProPublica reported. (...)

(Anm: Double dip: doctors paid to advise, promote drug companies that fund their research. ProPublica. 25 March 2014.).)

(Anm: "Solskinn" treffer Europa: Utbetalinger fra legemiddelfirmaer til leger er nå tilgjengelige, men tallene er langt fra altomfattende ('Sunshine' hits Europe: Pharma's doc payments now available, but numbers are far from comprehensive) (…) The ProPublica numbers include payments to physicians and teaching hospitals, excluding royalties and research deals. The idea is to zero in on marketing-related payments. They cover the last 5 months of 2013, the most recent data available; the feds recently said they would roll out new Sunshine Act data once a year. - here's the ProPublica database and top 10 list (fiercepharma.com 25.7.2016).)

- Facebook begrenser annonsestyring basert på rase. (- Den uavhengige journalistiske stiftelsen ProPublica har avdekket praksis som stiftelsen mener bryter med loven, melder Reuters. Blant annet fant ProPublica at raseinndeling ble brukt i reklamer for boliger, jobber og kredittkort.)

Facebook begrenser annonsestyring basert på rase
digi.no 14.11.2016
Beskyldes for lovbrudd.

San Francisco (NTB-Ritzau): Annonsører på Facebook kan rette reklamen sin mot spesifikke etniske grupper. Etter beskyldninger om lovbrudd, begrenser Facebook denne muligheten.

En av årsakene til Facebooks suksess som annonseplattform er at den som kjøper reklame kan definere veldig spesifikke målgrupper. Dette inkluderer å sortere på etnisk bakgrunn.
Lovbrudd
Den uavhengige journalistiske stiftelsen ProPublica har avdekket praksis som stiftelsen mener bryter med loven, melder  Reuters. Blant annet fant ProPublica at raseinndeling ble brukt i reklamer for boliger, jobber og kredittkort.

– Vi har besluttet at den beste måten å beskytte våre brukere mot diskriminering er å stanse denne typen reklamer, sier Facebooks direktør for privatliv, Erin Egan. Facebook fastholder samtidig at det er mange ikke-diskriminerende måter å bruke verktøyet på.

Ifølge Reuters analyserer Facebook brukernes bilder for å fastslå hudfargen deres. (©NTB)

(Anm: ProPublica (Journalism in the Public Interest). (mintankesmie.no).)

(Anm: Pulitzer til stiftelsen ProPublica. (- ProPublica gjør det lettere å se kilder bak historien) Den uavhengige mediestiftelsen ProPublica er for andre gang blitt hedret med en Pulitzer-pris for sin undersøkende journalistikk. (tv2nyhetene.no 19.4.2011).)

(Anm: Morten Øverbye mener norske redaktører bør bekymre seg over at Facebooks kjerne er å servere deg det du liker. – Journalistikk har aldri vært en popularitetskonkurranse, sier Morten Øverbye. Etter at Facebook sparket alle redaktørene, og lot algoritmen styre saksutvelgelsen alene har falske nyheter blitt promotert bredt, fordi de har bidratt til engasjement på nettstedet. Under den amerikanske valgkampanjen opprettet flere makedonske tenåringer falske nyhetssider om Hillary Clinton. Disse sakene ble delt mot Trump-supportere som igjen delte de videre fordi de skapte engasjement, ifølge Buzzfeed. (journalisten.no 14.11.2016).)

(Anm: Trenger tillitsforskning. I debatten om mistillit til mediene og falske nyheter trenger vi også medieforskning som vi kan stole på. En undersøkelse fra 2014 viste at folk hadde størst tillit til mediene i land som Kina og De forente arabiske emirater der pressen er kontrollert av myndighetene. Her en kinesisk avisforside om Donald Trumps valgseier i november 2016. (dn.no 17.1.2017).)

(Anm: Hillary Clinton om fejknyheter: "Liv är i fara". Hillary Clinton uttalar sig för första gången om vilka konsekvenser fejknyheter kan få med hänvisningar till "pizzagate". "Liv är i fara", sa hon under ett tal. Sedan en undersökning visade att fejknyheter var de mest delade nyheterna på Facebook under det amerikanska valet, har kritiken mot det sociala nätverket duggat tätt. Nu uttalar sig även Hillary Clinton om fejknyheterna under en hyllning till Demokraternas avgående senatledar Harry Reid, skriver The Guardian. (nyteknik.se 9.12.2016).)

(Anm: Facebook vurderer å merke mistenkelige nyheter. Facebook vurderer om de skal merke tvilsomme artikler med en advarsel for å begrense spredningen av falske nyheter. (…) Les også: Falske nyheter på Facebook er et problem – fire studenter løste det på 36 timer Les også: Spredte falske nyheter i USA-valget: - Jeg tror Trump vant valget på grunn av meg. Facebook-sjef Mark Zuckerberg avviste noen dager etter valget blankt at deres spredning av nyheter uten faktasjekk kan ha påvirket utfallet, og kalte det for en «sprø idé». (nettavisen.no 20.11.2016).)

(Anm: Disse styrer reklameindustrien. Fem menn med en gjennomsnittlig godtgjørelse på godt over 200 millioner kroner styrer det meste i den globale reklameindustrien. Sir Martin Sorrell (71) tjener over 800 millioner kroner i året som toppsjef i den globale reklame- og mediebyråkjempen WPP, som i Norden opererer under navet Group M. (dn.no 12.6.2016).)

(Anm: Advarer mot Google-politi. Teknologigiganter har havnet midt i en hissig diskusjon om ytringsfrihet og blokkering av annonsekroner på nettet. Reklametopp Bjarte Humborstad mener annonsørene selv må bestemme hvor merkevarene deres skal eksponeres. (dn.no 2.12.2016).)

(Anm:  - Hvor er visdommen vi har mistet i kunnskapen, og hvor,” spurte T S Eliot, “er kunnskapen vi har mistet i informasjonen?” Der er muligens 30 000 biomedisinske tidsskrifter i verden, og de har jevnlig økt med 7 % per år siden det syttende århundre.1,2 Ikke desto mindre er bare omtrent 15 % av medisinske intervensjoner støttet av solide vitenskapelige bevis. (Leder. BMJ 1991;303:798-9).)

- Tre trender fra 2011 som vil endre digitale nyheter i 2012

Three trends from 2011 that will reshape digital news in 2012 (Tre trender fra 2011 som vil endre digitale nyheter i 2012)
pointer.org 30.12.2011
If you’re like me, by now you’ve read more than enough uninspired recaps of what happened in 2011 or wild guesses at what’s in store for 2012. So here’s something a little different.

I looked back at the world of digital journalism to find just a few trends and ideas that started small in 2011 and will grow larger in 2012. Here’s what I found. (...)

Another budding storytelling trend got much less attention than Storify in 2011: context layers. Digital news publishers experimented with way to give readers extra background information on top of the basic narrative news story.

The “explore sources” context layer in this ProPublica story shows the evidence supporting specific phrases in the report.

ProPublica used DocumentCloud to integrate primary source information in an “explore sources” layer. When a reader turns it on, she can click on highlighted passages in the story to see a popup annotation from supporting documents.

ESPN’s new Grantland site for long-form sports journalism also added context. It uses term-paper-inspired footnotes to annotate its stories, though notes appear next to the story instead of beneath it. It’s a brilliant way to pack in an extra historical anecdote, statistical curiosity, caveat or explanation without disrupting the main narrative.

Expect to see more experimentation with story formats and context layers in 2012 and beyond, as more people realize digital news is no longer bound by the constraints of two-dimensional paper. (...)

- Amerikanske medisinske skoler bryter fremdeles regler for interessekonflikter, ifølge rapport

US medical school faculty still break conflict of interest rules, report says (Amerikanske medisinske skoler bryter fremdeles regler for interessekonflikter, ifølge rapport)
BMJ 2010; 341:c7435 (30 December)
ProPublica, an independent, non-profit investigative journalism project, reported that although medical schools have strengthened their rules about faculty members’ interactions with drug companies, some doctors still break their institutions’ conflict of interest rules.

The report is part of ProPublica’s Dollars for Docs project, which it launched in October 2010 (BMJ 2010;341:c6026; doi:10.1136/bmj.c6026).

The recent report said that some medical schools with tough conflict of interest policies were not checking to make sure faculty members followed the rules. It pointed to Stanford University, among others, saying that faculty members had not disclosed ties to drug and device companies. (...)

- Legemiddelfirmaer betalte NJ-leger millioner av dollar for å promotere deres produkter

Drug companies paid N.J. doctors millions to promote their products (Legemiddelfirmaer betalte NJ-leger millioner av dollar for å promotere deres produkter)
nj.com 7.11.2010
When pharmaceutical giant GlaxoSmithKline noticed Les Burns, an obstetrician-gynecologist from Wayne, was ordering a lot of its products, company officials contacted him.

"They asked, ‘Did I want to talk about it?’ " recalled Burns, who said he has always counseled his patients about getting vaccinated against cervical cancer and hepatitis.

Burns agreed — and the drug company paid him $136,150 for talking up its products at medical conferences and conventions from January 2009 to June 2010, according to a database created by the independent investigative journalism organization ProPublica. (...)

- Leger med dårlig rykte arbeider for legemiddelfirmaer som bondefangere

Tainted doctors serve as pharma company shills (Leger med dårlig rykte arbeider for legemiddelfirmaer som bondefangere)
fiercepharma.com 20.10.2010
On its latest fact-finding mission looking for doctors with skeletons in their closets, nonprofit investigative journalism group ProPublica has uncovered hundreds of physicians on big pharma company payrolls who are touted as experts, but whose records are tainted. Some have been accused of professional misconduct. Others lack credentials as researchers or specialists or were disciplined by state boards.

Here is a sampling of what reporters turned up:

  • The FDA ordered Dr. James McMillen to stop "false or misleading" promotions of the painkiller Celebrex, because he minimized risks and touted it for unapproved uses. He later raked in $224,000 from three other drug companies for speaking about their drugs.
  • 88 Eli Lilly speakers were sanctioned and another four received FDA warnings.
  • After Dr. Tulio Ortega pleaded no contest to faking records to say that he had treated four patients when he had not, New York's medical board put him on two years' probation in 2008. In 2009 and 2010, Lilly and AstraZeneca paid him $110,900.

Drug companies apparently aren't vigilant about vetting the doctor-speakers who educate their peers, which worried Lisa Bero, a pharmacy professor at University of California, San Francisco. "If they did things in their background that are questionable, what about the information they're giving me now?" she said, referring to their roles as drug company speakers.

To be sure, some of the top-paid drug company speakers have impressive resumes that demonstrate their expertise as researchers or specialists. But, 45 who earned more than $100,000 for speaking on behalf of drug companies did not have board certification in any specialty. Others had not published or held academic appointments.

The drug industry's main trade group, Pharmaceutical Research and Manufacturers of America, wasn't able to say what behavior would disqualify physician speakers. "We look at it from the affirmative--things that would qualify physicians," Diane Bieri, the group's general counsel and executive vice president, told ProPublica. Apparently she took some flack for a feeble response. See her voluminous 579-word comment at the top of the list of contentious remarks.

To learn more:
- read the ProPublica story
- check out the Dollars for Doctors database which lists some doctors and how much drug companies paid them

Related Articles:
Big drug companies wield too much influence over doctors
Dangerous caregivers missing from federal database due to poor state-level reporting
Doctor group challenges limits on pharma-physician relationships
National database riddled with holes: Records missing on disciplined healthcare workers (...)

Drug companies pay 17,000 U.S. doctors, report finds (Legemiddelfirmaer betaler 17 000 amerikanske leger, ifølge studie)
reuters.com 19.10.2010
(Reuters) - More than 17,000 doctors and other healthcare providers have taken money from seven major drug companies to talk to other doctors about their products, a joint investigation by news organizations and non-profit groups found.

More than 380 of the doctors, nurses, pharmacists and other professionals took in more than $100,000 in 2009 and 2010, according to the investigation released on Tuesday. The report said far more doctors are likely to have taken such payments, but it documented these based on information from seven drugmakers.

The payments are not illegal and usually not even considered improper. But the investigation by journalism group ProPublica, Consumer Reports magazine, NPR radio and several publications showed doctors were sometimes urged to recommend "off-label" prescriptions of drugs, meaning using them for conditions they are not approved for.

And the report points to several studies showing that even small gifts and payments to doctors can affect their attitudes, and many companies have stopped giving out once-common gifts such as pens, cups and other objects carrying drug brand names.

"Tens of thousands of U.S. physicians are paid to spread the word about pharma's favored pills and to advise the companies about research and marketing," the group says in its report, available here.

The groups used information from seven drugmakers -- AstraZeneca, Cephalon, GlaxoSmithKline, Johnson & Johnson, Eli Lilly, Merck and Pfizer.

"Some of the companies were forced to disclose this information as a result of legal settlements; others released it voluntarily," Consumer Reports said. (...)

- In Chicago’s Nursing Homes, a Psychiatrist Delivers High-Risk Meds, Cut-Rate Care

In Chicago’s Nursing Homes, a Psychiatrist Delivers High-Risk Meds, Cut-Rate Care (På sykehjem i Chicago, deler en psykiater ut legemidler med høy risiko...)
propublica.org 10.11.2009
This story was co-published with the Chicago Tribune.

Dr. Michael Reinstein is one of the most prolific providers of psychiatric care in Chicago-area nursing homes and mental health facilities. But he is trailed by lawsuits and complaints while getting government reimbursement for seeing a large number of patients. Photo of his strip mall office by Alex Garcia/Chicago Tribune.

Inne på sykehjemmet Maxwell Manor i Chicago, led dr. Michael Reinsteins pasienter av så sterke sideeffekter at de skalv, hallusinerte eller mistet kontroll over sine urinblærer. (Inside Chicago's Maxwell Manor nursing home, Dr. Michael Reinstein's patients suffered from side effects so severe that they trembled, hallucinated or lost control of their bladders.)

Staffers told state investigators that so many patients were clamoring to complain to Reinstein about their medications that a security guard was assigned to accompany him on his visits. In addition, staffers said Reinstein had induced patients to take powerful antipsychotic drugs with the promise of passes to leave the home.

Though state officials shut that facility in 2000 for inadequate care and wretched conditions, Reinstein, the home's lead psychiatrist, continued to practice. Today he is one of the most prolific providers of psychiatric care in Chicago-area nursing homes and mental health facilities, even as he is trailed by lawsuits and complaints like the ones at Maxwell Manor [1] (...)

Doctor-drugmaker ties: Psychiatrist Dr. Michael Reinstein received nearly $500,000 from antipsychotic drug's manufacturer (Bånd mellom lege og legemiddelfirma: Psykiater Michael Reinstein mottok nærmere 500 000 dollar fra produsenter av antipsykotika)
chicagotribune.com 11.11.2009
Company paid him to promote Seroquel despite misgivings about his research

Executives inside pharmaceutical giant AstraZeneca faced a high-stakes dilemma.

På den ene side, innbrakte psykiater Michael Reinstein fra Chicago firmaet en liten formue på salg og utførte forskning som fikk et av firmaets mest lovende legemidler til å fremstå som oppsiktsvekkende. (On one hand, Chicago psychiatrist Dr. Michael Reinstein was bringing the company a small fortune in sales and was conducting research that made one of its most promising drugs look spectacular.)

På den annen side, var noen bekymret for at forskningsresultatene var for gode til å være sanne. (On the other, some worried that his research findings might be too good to be true.)

As Reinstein grew irritated with what he perceived as the company's slights, a top executive outlined the scenario in an e-mail to colleagues.

"If he is in fact worth half a billion dollars to (AstraZeneca)," the company's U.S. sales chief wrote in 2001, "we need to put him in a different category." To avoid scaring Reinstein away, he said, the firm should answer "his every query and satisfy any of his quirky behaviors." (...)

- Leger slipper straff i søksmål mot medisinske firmaer

Doctors Avoid Penalties in Suits Against Medical Firms (Leger slipper straff i søksmål mot medisinske firmaer)
propublica.org 16.9.2011
This story was co-published with the Washington Post

Two years ago, drugmaker Eli Lilly pleaded guilty to illegally marketing [1] its blockbuster antipsychotic Zyprexa for elderly patients. Lilly paid $1.4 billion in criminal penalties and settlements in four civil lawsuits.

But a doctor named as a co-defendant in one suit—for allegedly taking kickbacks to prescribe the drug extensively at nursing homes—never was pursued.

Last year, Alpharma paid $42.5 million to settle federal allegations [2] that it paid kickbacks to doctors to prescribe its painkiller Kadian.

"Health-care decisions must be based solely upon what is best for the individual patient and not on which pharmaceutical company is paying the doctor the biggest kickback," Rod J. Rosenstein, U.S. attorney for the District of Maryland, said in a statement announcing the settlement.

But the doctors accused of trading prescriptions for paid speaking gigs faced no consequences. (...)

- Novartis agrees to pay $390m in US kickback case.

U.S. sues Novartis over kickbacks
reuters.com 26.4.2013
(Reuters) - The U.S. government on Friday announced its second civil fraud lawsuit against Novartis AG in four days, accusing a unit of the Swiss drugmaker of paying multimillion-dollar kickbacks to doctors in exchange for prescribing its drugs.

Authorities said the Basel-based company for a decade lavished healthy speaking fees and "opulent" meals, including a nearly $10,000 dinner for three at the Japanese restaurant, Nobu, to induce doctors to prescribe its drugs.

They said this led to the Medicare and Medicaid programs paying millions of dollars in reimbursements based on kickback-tainted claims for medication such as hypertension drugs Lotrel and Valturna and the diabetes drug Starlix.

The charges are detailed in a whistleblower lawsuit first filed against Novartis Pharmaceuticals Corp by a former sales representative in January 2011 and which the U.S. government has now joined. (...)

(Anm: Novartis agrees to pay $390m in US kickback case. Novartis AG, the Swiss drug company, has agreed to pay $390m (£255m; €352m) to settle a lawsuit in which the US government claimed that the company had paid kickbacks to specialty pharmacies to boost sales of its drugs. The lawsuit filed by the US Department of Justice had initially sought $3.35bn in fines and damages, charging that the kickback scheme had led the pharmacies to submit false claims for tens of millions of dollars to Medicare and Medicaid programs. BMJ 2015;351:h5784 (Published 28 October 2015).)

- Uten obduksjoner begraver sykehusene feilene sine. (- Dødsårsak: ukjent.) (- Diagnostiske feil, som studier viser er vanlig, forblir uoppdaget, og tillater at leger kan fortsette sin praksis på andre pasienter med en falsk følelse av trygghet. (- Mulighetene for å lære om effektiviteten av medisinske behandlinger og progresjon av sykdommer går tapt. Unøyaktig informasjon ender opp i dødsattester, og undergraver påliteligheten for avgjørende helsestatistikk.)

Without Autopsies, Hospitals Bury Their Mistakes (Uten obduksjoner begraver sykehusene feilene sine)
propublica.org 15.12.2011
Da Renee Royak-Schaler uventet kollapset og døde 22. mai beordret ingen obduksjon. (When Renee Royak-Schaler unexpectedly collapsed and died on May 22, no one ordered an autopsy.)

Not the doctors at Howard County General Hospital in Columbia, Md., where the 64-year-old professor and cancer researcher was pronounced dead.

In collaboration with the Investigative Reporting Program at the UC Berkeley Graduate School of Journalism

Not the Maryland Office of the Chief Medical Examiner, which passed on the case because no foul play was involved.

And not Royak-Schaler’s physicians at Johns Hopkins University School of Medicine who had diagnosed cancer in her hip two days beforehand but acknowledged they didn’t know what had caused her unforeseen death.

A half-century ago, an autopsy would have been routine. Autopsies, sometimes called the ultimate medical audit, were an integral part of American health care, performed on roughly half of all patients who died in hospitals. Today, data from the Centers for Disease Control and Prevention show, they are conducted on about 5 percent of such patients. (...)

Som Royak-Schaler mann, Jeffrey Schaler, oppdaget, utløser ikke engang plutselige uventede dødsfall obduksjoner. (As Royak-Schaler’s husband, Jeffrey Schaler, discovered, even sudden unexpected deaths do not trigger postmortem reviews.)

Diagnostiske feil, som studier viser er vanlig, forblir uoppdaget, og tillater at leger kan fortsette sin praksis på andre pasienter med en falsk følelse av trygghet. Mulighetene for å lære om effektiviteten av medisinske behandlinger og progresjon av sykdommer går tapt. Unøyaktig informasjon ender opp i dødsattester, og undergraver påliteligheten for avgjørende helsestatistikk. (Diagnostic errors, which studies show are common, go undiscovered, allowing physicians to practice on other patients with a false sense of security. Opportunities are lost to learn about the effectiveness of medical treatments and the progression of diseases. Inaccurate information winds up on death certificates, undermining the reliability of crucial health statistics.)

Det var bare på grunn av Royak-Schaler forbindelser at hennes tilfelle endte annerledes. Hennes kolleger ved University of Maryland School of Medicine oppfordret hennes mann til å godkjenne en obduksjon og frivillig utføre den gratis. (It was only because of Royak-Schaler’s connections that her case ended differently. Her colleagues at the University of Maryland School of Medicine urged her husband to authorize an autopsy and volunteered to conduct it for free.)

I hennes tilfelle, som i så mange, avdekket obduksjonen en overraskelse: Royak-Schaler, den anerkjente kreftforskeren, hadde kreften herjet i kroppen hennes - i hennes lunger, nyrer, mage og hennes beinmarg. En blodpropp sannsynligvis relatert til svulstene, forårsaket hennes plutselige død. (In her case, as in so many, the autopsy revealed a surprise: Royak-Schaler, the renowned cancer researcher, had cancer ravaging her body — in her lungs, kidneys, abdomen and the marrow of her bones. A blood clot, likely related to the tumors, caused her sudden death.)

Jeffrey Schaler har kjempet med sinne fordi hans kone ikke ble diagnostisert tidligere, men at det å vite hvordan hun døde var bedre enn ikke å vite. (Jeffrey Schaler has wrestled with anger that his wife wasn’t diagnosed sooner but said knowing how she died was better than not.)

“Det er en følelse av fred som følger med denne kunnskapen,” sa han. (“There’s a sense of peace that accompanies that knowledge,” he said.)

(Anm: Obduksjoner, dødstall og dødsårsaker (- Dødsårsak: ukjent.). (mintankesmie.no).)

– Frykter for fremtiden til toksikologifaget. (- Miljøgifter i mat, vann og luft antas å være en årsaksfaktor til utvikling eller forverring av en rekke multifaktorelle sykdommer, som astma og allergier, diabetes, hjerte- og karsykdom, nevrologiske sykdommer som Alzheimers og Parkinson samt ulike typer kreft», understreker NSTF i bekymringsbrevet.)

(Anm: – Frykter for fremtiden til toksikologifaget. (...) Vi er mer eksponert for kjemikalier nå enn noen gang. (...) «Miljøgifter i mat, vann og luft antas å være en årsaksfaktor til utvikling eller forverring av en rekke multifaktorelle sykdommer, som astma og allergier, diabetes, hjerte- og karsykdom, nevrologiske sykdommer som Alzheimers og Parkinson samt ulike typer kreft», understreker NSTF i bekymringsbrevet, og derfor er det viktig at vi har eksperter som har høy kompetanse på hvordan mennesker blir påvirket av kjemiske stoffer, og som kan foreta risikovurderinger av potensielt farlige kjemikalier, sier Hubert Dirven, toksikolog ved Folkehelseinstituttet og leder av toksikologi-seksjonen i Norsk Selskap for Farmakologi og Toksikologi (NSTF).) (dagensmedisin.no 26.4.2017).)

Post Mortem
Death Investigation in America
How to Investigate Coroners and Medical Examiners
propublica.org 2.2.2011
Reporters covering the criminal justice system rarely look at coroners or medical examiners -- instead we focus on cops and prosecutors and defense attorneys and defendants.

I began to look more closely at the Tyvek-clad doctors who staff America's morgues when I started finding cases in which they made repeated errors, or failed to document obvious injuries or reached conclusions challenged by their peers.

The coroner or medical examiner in your area may merit the type of examination that could lead to stories.

Here are a few things I'd encourage you to scope out: (...)

Post Mortem
Death Investigation in America
Second Chances Underscore Flaws in Death Investigations
propublica.org 1.2.2011
Watch Frontline's documentary produced in conjunction with this story. And listen to NPR's All Things Considered for more on this story.

Chris Reynolds vividly remembers his first encounter with the work of forensic pathologist Dr. Thomas Gill.

It was 2001. Reynolds, a Santa Rosa private investigator, was hired by a Sonoma County man accused of killing his wife. Gill, who conducted the wife's autopsy, was the prosecution's key witness, having determined the death was a "textbook" case of suffocation.

Reynolds' client's prospects looked grim. But when Reynolds dug into Gill's background, he unspooled a history in which Gill landed post after post despite a lengthening trail of errors and, in one instance, drinking on the job.

Gill had been forced out of a teaching position at an Oregon university, and then fired for inaccurate findings and alcohol abuse by the coroner in Indianapolis, Reynolds discovered. Demoted for poor performance as a fellow for the Los Angeles County Coroner, he resurfaced at a private autopsy company in Northern California.

Reynolds learned that Gill had missed key evidence in the Sonoma County case and that he had been coached by prosecutors to downplay his past, prompting the dismissal of the murder charge.

Yet, in the decade since, Gill has continued to do thousands of autopsies and to serve as an expert witness in criminal cases. He landed a job as the No. 2 forensic pathologist in Kansas City, Mo., where his work again drew fire, and then returned to Forensic Medical Group Inc., the Fairfield firm that handled the case investigated by Reynolds. (...)

Frontline takes on autopsies
vancouversun.com 1.2.2011
"When I was treating live patients, I spoke with them," Dr. Marcella Fierro, one of the U.S.'s leading forensic pathologists says in Post Mortem, tonight's PBS Frontline expose of so-called "death investigations" throughout North America. "And when I have dead patients, I talk to them, too."

Frontline's Lowell Bergman says, "But they don't talk back."

They talk back through the science of forensic pathology, she replies.

And yet ... as the harrowing, eye-opening Post Mortem shows, miscarriages of justice such as the case of disgraced former Ontario pathologist Charles Smith, a pediatric forensic specialist once considered the dean of his profession, happen more often than you think.

Post Mortem shows that, in case after case, errors by coroners and forensic pathologists have caused innocent people to be convicted of crimes they didn't commit and, just as troubling, allow guilty perpetrators to go undetected. (PBS -9 p.m.) (...)

Flawed Autopsies Send Two Innocent Men To Jail (Feil ved obduksjoner sendte to uskyldige menn i fengsel)
npr.org 1.2.2011
(...) Levon Brooks and Kennedy Brewer are Mississippi men who spent a combined 30 years in prison for crimes they didn't commit. They were separately charged with sexually assaulting and murdering two 3-year-old girls — in two separate crimes — two years apart.

The pathologist who conducted both autopsies said he suspected the girls had been bitten. The forensic dentist who testified in both trials said the teeth marks found on both girls matched that of Brooks and Brewer.

After an investigations led by the Mississippi Innocence Project, Brooks and Brewer were exonerated through DNA evidence in 2008. The lab that cleared the men also generated a DNA profile of a new suspect – Justin Albert Johnson. He confessed to both crimes and is currently awaiting trial. (...)

This video is part of our series Post Mortem: Death Investigation in America, a partnership with ProPublica and PBS Frontline. (...)

- Amerikansk mediaorganisasjon bruker Facebook til å styrke interessen for pasientskader

US media organisation uses Facebook to build interest in patient harm (Amerikansk mediaorganisasjon bruker Facebook til å styrke interessen for pasientskader)
BMJ 2012;344:e3840 (30 May)
ProPublica (www.propublica.org/about/), a not for profit media organisation based in New York, has launched a Facebook page (www.facebook.com/groups/209024949216061/) for patients who have been harmed by healthcare.

The ProPublica Patient Harm Community, which is also open to health professionals, regulators, service managers, and the wider community, has gained more than 600 members since launching in early May.

ProPublica says it wants this “experiment in social media” to build a community interested in discussing patient harm, its causes, and solutions. It plans to post questions and answers with experts and provide links to reports, research, and policy proposals.

According to a report from the Nieman Journalism Lab (www.niemanlab.org/2012/05/from-cold-calls-to-community-building-propublica-tries-to-make-crowdsourcing-more-meaningful/), the initiative is not simply about enabling ProPublica to mine the site for stories but is a type of “service journalism” that aims to help develop a community of interest that participants can make their own.

In an email interview, one of the journalists moderating the site, Marshall Allen, told the BMJ the project aims to help connect people and to raise awareness of healthcare harms.

“We also want to use this as a method to have people tell us their stories in a way that we can organise, so we can identify trends and stories that we or other reporters might want to look at on a deeper level,” he wrote.

Community members are asked to fill in a “patient harm questionnaire” (https://docs.google.com/spreadsheet/viewform?formkey=dENZT2ZxZ0FGUmlmYkQwN2FrNG9KYmc6MQ#gid=0) to help inform such reporting.

Clifford Hughes, chief executive officer of the Clinical Excellence Commission, which works to improve patient safety in New South Wales, welcomed the initiative and expected it could help clinicians to better understand patient perspectives.

“Any tool that allows us to hear the patients’ side of the story is extremely useful,” he told the BMJ. “I will be interested to see what we can learn from the site.” (...)

Diverse artikler

ProPublica Finds Tie between Prescribing Practices, Financial Relationships with Pharma
postscript.communitycatalyst.org 30.8.2013
According to research reported earlier this summer by ProPublica, top prescribers of a drug (under Medicare Part D) frequently receive payments from the that drug’s manufacturers, sometimes a lot of money.

For example, 17 of the 20 doctors who prescribed the high blood pressure drug Bystolic most frequently (approximately 530 prescriptions each) were also paid a combined $283,450 by Forest Pharmaceuticals (Bystolic’s manufacturer) to give speeches about the drug to their peers in 2010.

Although some drug companies state that they don’t choose speakers based on whether they prescribe their products, the ProPublica analysis shows that doctors who do prescribe such medications often receive significant amounts of money from manufacturers– more than $16,000 each, on average. Given that Forest Pharmaceutical’s earnings on Bystolic doubled to $348 million last year, compared to its sales in 2010, it appears this marketing tactic is helping the company generate a hefty return on investment.

Overall, ProPublica found the practice of paying doctors who are high-volume prescribers of a manufacturer’s products to be widespread across many drug and device manufacturers. ProPublica reported that 9 out of the top 10 prescribers of Exelon (to treat Alzheimer’s) received funding from the drug’s manufacturer, Novartis. Similarly, 7 of the top 10 prescribers of Advair Dsikus (an asthma medication) received funding from the manufacturer, GlaxoSmithKline, with one doctor receiving more than $100,000 between 2009 and 2012. (...)

Top Medicare Prescribers Rake In Speaking Fees From Drugmakers
propublica.org 25.6.2013
This story was co-published with NPR.

When the blood pressure drug Bystolic hit the market in 2008, it faced a crowded field of cheap generics.

So its maker, Forest Laboratories, launched a promotional assault on the group in the best position to determine Bystolic's success: those in control of prescription pads. It flooded the offices of health professionals with drug reps, and it hired doctors to persuade their peers to choose Bystolic — even though the drug hadn't proved more effective than competitors.

The strategy worked. In the 2012 fiscal year, sales of Bystolic reached $348 million, almost double its total from two years earlier, the company reported.
Now, data obtained and analyzed by ProPublica suggest another factor in Bystolic's rapid success: Many of the drug's top prescribers have financial ties to Forest.

At least 17 of the top 20 Bystolic prescribers in Medicare's prescription drug program in 2010 have been paid by Forest to deliver promotional talks. In 2012, they together received $283,450 for speeches and more than $20,000 in meals.

Nearly all those doctors were again among the highest prescribers in 2011, the most recent year for which Medicare data are available. Forest began disclosing its payments only last year; the company didn't specify which drugs doctors spoke about.

Dr. Bernard Lo, who was chairman of a national panel examining conflicts of interest in medicine, said he doesn't believe the findings are coincidental. (...)

U.S. Medical Schools make great strides in quest for professionalism of tomorrow’s doctors
postscript.communitycatalyst.org 10.3.2012
Yesterday, the American Medical Student Association (AMSA) released their 2011-2012 PharmFree Scorecard, now in its fifth iteration. The Scorecard evaluates conflict-of-interest policies at the 152 medical schools in the U.S. and Puerto Rico, as well as a number of affiliated academic medical centers. With growing consumer and government scrutiny of the relationships between doctors and pharmaceutical companies (see, e.g., ProPublica’s series Dollars for Docs and the Physician Payment Sunshine Act), the Scorecard takes a unique look at how well professional standards are being introduced to the next generation of doctors. We don’t doubt the importance of education about pharmaceutical interventions and treatments, but it is also important to learn to question the veracity of information presented at industry-funded events, and understand the pharmaceutical marketing machine before a doctor begins her practice.

The Scorecard assesses policies that seek to reduce drug industry influence on the educational and clinical environment in which physicians do their training—including bans or limits on industry provision of gifts, meals speaker’s bureaus and samples; on industry influence on medical education and drug purchases by hospitals; on drug reps’ access to clinical areas; and, disclosure of industry relationships. This year’s grades demonstrate that medical schools are taking important measures to control the interaction between students or faculty and the pharmaceutical industry. Twenty-eight schools received an A (28 percent), 74 schools received a B (49 percent), 15 schools received a C (10 percent), and 13 schools received a D (9 percent). That leaves 9 schools with an F, and 15 “In Progress” schools. Despite progress overall, challenges remain, especially with policies on disclosure of financial ties with industry, samples, and access by sales representatives. (...)

(Anm: Feds to Withhold One-Third of Sunshine Act Data. (medpagetoday.com 15.8.2014).)

FDA Under Scrutiny For Appointment Of 3 Scientists With Ties To Industry
kaiserhealthnews.org 13.1.2012
Fiscal Times looks at concerns about conflicts of interest on FDA advisory committees. Also, ProPublica examines a bill that would make results from NIH-financed studies harder to get.

The Fiscal Times: Conflict of Interest Scandal Rocks FDA

Much has been made of Health and Human Services Secretary Kathleen Sebelius' decision last month to overrule Food and Drug Administration scientists and prohibit the over-the-counter sale of the morning after pill to minors. ... Now there is the possibility politicians on Capitol Hill are also influencing some choices being made at the FDA. It involves the agency's decision last month to appoint at least three scientists to a high-profile drug safety advisory committee without disclosing they had conflicts of interest with the company – Bayer – whose product – birth control pills – was up for review (Goozner, 1/12).

ProPublica: New Bill Would Put Taxpayer-Funded Science Behind Pay Walls

Right now, if you want to read the published results of the biomedical research that your own tax dollars paid for, all you have to do is visit the digital archive of the National Institutes of Health. ... A new bill in Congress wants to make you pay for that. ... The Research Works Act would prohibit the NIH from requiring scientists to submit their articles to the online database (Groeger, 1/12). (...)

Drug Companies Reduce Payments to Doctors as Scrutiny Mounts (Legemiddelfirmaer reuserer utbetalinger til leger idet undersøkelser tiltar)
propublica.org 3.1.2012
This is part of our year-end series, looking at where things stand in each of our major investigations.

Some of the nation's top medical schools cracked down on professors who give paid promotional talks for drugmakers last year, and the firms themselves cut back on such spending in the wake of mounting scrutiny. (...)

Tracking the Money

Our Dollars for Docs Database

We compiled tens of thousands of records from all the companies that have disclosed their payments to doctors so far. Search for your physician. (...)

Last year began with the University of Colorado Denver and its affiliated teaching hospitals launching an overhaul of conflict-of-interest policies after ProPublica found that more than a dozen of its faculty members had given paid promotional talks.

"We're going to just have to say we're not going to be involved with these speakers bureaus because they're primarily marketing," Dr. Richard Krugman, vice chancellor for health affairs, said in an interview in January 2011.

A few months later, Stanford University took disciplinary action against five faculty members identified by ProPublica who had taken money to deliver drug company speeches, a violation of university policy.

And by last fall, there were indications that pharmaceutical companies were also reducing the money they spent on doctor speakers.

ProPublica first published its Dollars for Docs database in October 2010 listing payments to doctors from seven drug companies. When we updated it this September -- with data from five additional companies -- spending by some of the firms was down.

Cephalon, a relatively small Pennsylvania company that specializes in pain, cancer and central nervous system drugs, paid physicians nearly $9.3 million in 2009 for speaking and consulting. That figure dropped to $5 million in 2010.

AstraZeneca cut its spending on speakers from roughly $22.8 million in the first half of 2010 to about $9.2 million in the second half. Both companies cited business reasons for the decline.

Throughout 2011, ProPublica also examined the hefty financial support drug and medical-device makers give to medical societies and health advocacy groups and the impact it has on the groups' positions. (...)

Our Nation's Hidden Elderly Deaths Scandal
technorati.com 26.12.2011
Last week we reported about the shockingly deficient numbers of hospitals that do not conduct autopsies, and, as a result, miss important diagnostic and/or treatment lessons from the results.

In a related and equally disturbing reality, when elderly people die under suspicious circumstances, the reasons often remain unknown, because autopsies are seldom performed on people older than 65. The investigative report by ProPublica and PBS Frontline says that no one knows how many of these suspicious deaths have been ascribed to “natural” fatalities, and how many, in fact, were the result of elder abuse or mistreatment. The report quotes a U.S. Department of Justice researcher describing the situation as “a hidden national scandal.”

The system of investigating the cause of suspicious deaths is compromised by insufficient funds, a shortage of trained medical personnel and lack of national standards that, the writers conclude, sometimes have “helped to send innocent people to prison and allowed killers to walk free. When it comes to the elderly, the system errs by omission.”

Specifically, here’s how the system discourages appropriate scrutiny of senior citizen deaths: (...)

ProPublica makes it easier to see sources behind a story (ProPublica gjør det lettere å se kilder bak historien)
poynter.org 15.12.2011
ProPublica is debuting a new feature today that enables readers to view the reporter’s sources of information without leaving the story.

The “Explore sources” button enables people who are deeply interested in the topic to explore documents themselves. It holds the reporter accountable for the facts in his story. And — although it wasn’t intended to — it creates another layer of fact-checking.

The new feature is a result of collaboration between reporter Marshall Allen, who is using DocumentCloud extensively in his reporting, and news applications developer Al Shaw, who built a new tool to enable Allen to integrate all those notes into a story.

Shaw’s tool enables anyone to annotate a story, no HTML knowledge needed, and export it to a standard Web content management system.

“Al built this to be repeatable,” said Scott Klein, editor of news applications, “so we absolutely see it as something we’re going to use again.”

Primary sources in context
Today’s story, “Why can’t Linda Carswell get her husband’s heart back?,” looks like any other. The difference is that when the reader clicks a link labeled “Explore Sources,” about 50 passages in the story are highlighted.

Clicking any of those highlighted words or phrases causes a box to pop up displaying the portion of a document that substantiates the language.
The pop-ups provide a way for people to “see behind the scenes and explore the information further, if that’s something that interests them,” Allen said. (...)

- Undersøkelse av kilder: En ny funksjon til å "Vise vårt arbeid" (“Show Our Work”)

Explore Sources: A New Feature to “Show Our Work” (Undersøkelse av kilder: En ny funksjon til å "Vise vårt arbeid" (“Show Our Work”))
propublica.org 15.12.2011
Marshall Allen historie inneholder vårt nye Explore Sources feature ("Utforsk kilderkarakteristikker"). (Marshall Allen's story is annotated with our new Explore Sources feature.)

We’re debuting a new feature today as part of Marshall Allen’s story [1] about one woman’s fight with a Texas hospital to find out how her husband died.

In the course of reporting the piece, Marshall made over 500 annotations in 64 documents he uploaded to DocumentCloud [2], many of which were sources of facts in his story. We thought readers would find these annotations useful, and may even use them to explore the documents on their own. However, we didn’t want to show them in a separate graphic or interactive feature, but rather sprinkled throughout the story itself.

So we made a special feature we’re calling Explore Sources. To try it, click the “ON” button next to “Explore Sources” at the beginning of the article [1]. Words and phrases throughout the piece will turn yellow. Click these yellow highlights to see the portion of the source document from which Marshall got that fact. Once the annotation is visible, click the document image inside of the popup to go to the full document in DocumentCloud, or anywhere else to dismiss it.
Behind the Scenes

To speed up the process of adding the links, we built a small web application which let Marshall select snippets of text in his story, just as he would in a word processor, and associate it with a DocumentCloud annotation via a point-and-click interface. The tool exports code that we can easily paste into our content management system. (...)

Drug companies pay $25 million to Illinois doctors
chicagotribune.com 27.9.2011
Pharmaceutical firms disclose payments for speaking engagements, consulting that critics say can be ethical conflict

At least three dozen doctors in Illinois received payments and perks exceeding $100,000 from drug companies between 2009 and early 2011, according to an updated database that now includes information from a dozen pharmaceutical firms.

Doctors in the state received about $25 million in all from the companies for travel, meals, research, consulting and speaking engagements, the data show. Nationally, the eight companies who provided a full year's worth of payment information doled out more than $220 million in 2010 to promotional speakers for their products.

Portland (Multnomah, Oregon) The database of drug company disclosures was compiled by ProPublica, a national investigative news organization, and allows the public to search for individual physicians to see whether they've been on a drug company's payroll. (...)

How much are pharmaceutical companies paying your doctor?
mailtribune.com 25.9.2011
Rogue Valley physicians get paid for drug research, speaking engagements, meals, travel and consulting by big drug firms

Pharmaceutical companies have paid Rogue Valley doctors and researchers at least $396,448 for drug research, meals, travel and consulting, and for speaking to their colleagues about drugs in the past two years.

A new database created by the nonprofit investigative organization ProPublica offers details on $761.3 million in disclosed payments made nationwide by 12 drug companies from 2009 into this year. Nearly $6 million of those payments went to Oregon.

Some of the drug companies agreed to publicly report the payments after shelling out millions of dollars to settle lawsuits claiming they had improperly influenced doctors to prescribe drugs, often for off-label uses that hadn't been approved by the federal Food and Drug Administration.

All drug companies will be required to report payments to doctors in 2013 as part of the health care reform law.

In Jackson County, the Clinical Research Institute of Southern Oregon in Medford brought in the highest figure. GlaxoSmithKline paid the institute $195,833 to conduct research on drugs. (...)

More drug company payments go public, but trends tough to untangle (Flere utbetalinger fra legemiddelfirmaer offentliggjøres, men trender er vanskelige å avdekke)
postscript.communitycatalyst.org 8.9.2011
As more payment data from drugmakers to physicians went public this week, it seems that both industry and doctors are easing off the gas in promotional speaking and other marketing-related payments. With Propublica data, the Boston Globe compared several companies’ payments to Massachusetts providers in 2009 and 2010:

Eli Lilly and Co., one of the nation’s largest drug makers, paid health care providers here $866,919 in 2010 for speaking about their drugs, a 46 percent drop from 2009, according to an analysis by the Boston Globe and ProPublica, a nonprofit online investigative journalism organization. Payments from GlaxoSmithKline fell at least 29 percent to $884,850, and probably more because the company’s 2009 data did not include the first quarter.

And Propublica showed that payments by Cephalon, one of the companies required to disclose payments under a corporate integrity agreement with the U.S. Department of Justice, dropped from almost $9.3 million nationally in 2009 to $5 million last year.

But $5 million — part of the $220 million paid to providers last year by just eight companies — is still a chunk of change for an industry that’s owed billions of dollars over the last five years for illegally marketing to docs and is still struggling to reinvigorate its pipeline.

And though many medical schools around the U.S. have barred or limited faculty members from joining pharma speakers bureaus out of concern that the practice (in which physicians are paid to deliver company-generated talks to other doctors) creates bias or the appearance of it, some providers are still very willing to sign on. Pain physician Jeffrey Gudin from New Jersey, a speaker for J&J last year, talked to the Star-Ledger. (...)

Financial Ties Bind Medical Societies to Drug and Device Makers (Økonomiske bånd mellom medisinske foreninger og legemiddel- og utstyrsprodusenter)
propublica.org 5.5.2011
Billboards from a medical device company near Moscone Center in San Francisco, site of a Heart Rhythm Society convention. Photo by Robert Durell for ProPublica.

SAN FRANCISCO — From the time they arrived to the moment they laid their heads on hotel pillows, the thousands of cardiologists attending this week’s Heart Rhythm Society conference have been bombarded with pitches for drugs and medical devices.

St. Jude Medical adorns every hotel key card. Medtronic ads are splashed on buses, banners and the stairs underfoot. Logos splay across shuttle bus headrests, carpets and cellphone-charging stations. (...)

Doctors' groups welcome medical company dollars
usatoday.com 5.5.2011
SAN FRANCISCO — From the time they arrived to the moment they laid their heads on hotel pillows, the thousands of cardiologists attending this week's Heart Rhythm Society conference have been bombarded with pitches for drugs and medical devices.

Last year's four-day event brought in more than $5 million, including money for exhibit booths the size of mansions and company-sponsored events. This year, there are even more "promotional opportunities," as the society describes them.

Concerns about the influence of industry money have prompted universities such as Stanford and the University of Colorado-Denver to ban drug sales representatives from the halls of their hospitals and bar doctors from paid promotional speaking.

Yet, one area of medicine still welcomes the largesse: societies that represent specialists. It's a relationship largely hidden from public view, said David Rothman, who studies conflicts of interest in medicine as director of the Center on Medicine as a Profession at Columbia University.

Professional groups such as the Heart Rhythm Society are a logical target for the makers of drugs and medical devices. They set national guidelines for patient treatments, lobby Congress about Medicare reimbursement issues, research funding and disease awareness, and are important sources of treatment information for the public.

Dozens of such groups nationwide encompass every medical specialty from orthopedics to hypertension. (...)

Medical Groups Shy About Detailing Industry Financial Support
propublica.org 5.5.2011
When it comes to the money they get from drug and device makers, many medical associations and health advocacy groups would rather not publicize who gave and how much.

In December 2009, Sen. Charles Grassley, R-Iowa, sent a letter asking 33 organizations to list their industry funding and note whether they made the information public.

ProPublica's review of the responses shows wide variations in the groups' reliance on such funding. Those with a heavy proportion of industry support often represented specialists who use pricey drugs and devices.

In contrast, larger advocacy groups reported accepting proportionately less money from industry sources.

Grassley, as well those who research conflicts of interest, say it's impossible to assess potential bias without knowing the scope of such relationships.

If a group gets millions from a company that makes a product used by its members, it is reasonable to wonder whether the guidance it offers on treatments would benefit that company, he said.

For example, federal agencies may want to take into account a group's donors when the group lobbies for new treatments or changes in Medicare coverage. That's only possible if a group's funding is disclosed.

"My feeling is it's not the total answer, but at least it does a lot of good," said Grassley, who is encouraging the groups to post their corporate donors online. "Transparency, the public's right to know, brings some accountability." (...)

Pharma caught off-guard again: big gaps between state payment data, company numbers (Legemiddelfirmaer tatt på fersken igjen: store gap mellom fremlagte data, og firmaenes tall)
postscript.communitycatalyst.org (16.12.2010)
An investigative outfit’s consolidation and analysis of payments that drug companies made to doctors has refocused attention on state efforts to shine light on the financial ties between doctors and drugmakers.

Currently three states—Minnesota, Massachusetts, and Vermont—require drug companies to disclose payments to prescribers and make some of that data public. While each of these states takes a different approach to collecting and making the payment data available to the public (more on that here), information from all three have been extremely valuable in demonstrating the dimensions and scope of these marketing relationships. And now a new value to the state data has emerged: demonstrating that pharma isn’t keeping very good track of who it’s been paying what.

The ProPublica report in Monday’s Minnesota Star Tribune and here online found a series of big discrepancies between what a company said it paid a doctor on its website and what it told the state of Minnesota it paid the same person. Right now, ProPublica can only crosscheck the seven companies that have posted payments on their own websites. (...)

Drug companies' reports aren't always accurate (Legemiddelfirmaenes rapporter ikke alltid riktige)
startribune.com 12.12.2010
A new federal plan will require drug and medical device companies to report all payments to U.S. physicians in 2013. The danger? As Minnesota found, some information may be incorrect.

Long before the rest of the country cared, Minnesota took aim at the pharmaceutical industry.

In 1993 it passed a novel law: If drug companies paid any of the state's health providers to push their pills, the money had to be publicly reported.

Two decades later, the federal government is poised to follow suit, promising a new era of openness.

But a ProPublica analysis of drug company disclosures in Minnesota provides a cautionary lesson: The information submitted may not be accurate.

To vet Minnesota's reports, ProPublica compared them to its Dollars for Docs database, a compilation of speaking fees and consulting payments reported by seven drug companies since 2009. (...)

Doctor-drug company database sheds light
seattletimes.nwsource.com 2.11.2010
Does your doctor have ties with a drug company?

CHICAGO — Late last month, after the launch of a new database detailing doctors' financial ties with drug companies, Dr. Daniel Carlat sat at his computer and began searching for information about colleagues.

He found several doctors who had potentially compromising relationships with the pharmaceutical industry. But he was surprised to find that several other physicians he considered "very ethical people" had received thousands of dollars in payments from pharmaceutical firms.

"You don't want to use a very broad brush to characterize all the physicians" listed in this database, said Carlat, an outspoken Massachusetts psychiatrist and frequent critic of his profession. Some may be top-notch clinicians or researchers, while others may have questionable credentials.

How, then, should consumers interpret information they find in the new ProPublica database, the first to make extensive information about drug company payments to doctors easily accessible? Here are things you should consider: (...)

Drug Maker Wrote Book Under 2 Doctors’ Names, Documents Say (Legemiddelprodusent skrev bok under to legers navn, ifølge dokumenter)
nytimes.com 2.12.2010
Two prominent authors of a 1999 book teaching family doctors how to treat psychiatric disorders provided acknowledgment in the preface for an “unrestricted educational grant” from a major pharmaceutical company.

But the drug maker, then known as SmithKline Beecham, actually had much more involvement than the book described, newly disclosed documents show. The grant paid for a writing company to develop the outline and text for the two named authors, the documents show, and then the writing company said it planned to show three drafts directly to the pharmaceutical company for comments and “sign-off” and page proofs for “final approval.”

“That doesn’t sound unrestricted to me,” Dr. Bernard Lo, a medical ethicist and chairman of an Institute of Medicine group that wrote a 2009 report on conflicts of interest, said after reviewing the documents. “That sounds like they have ultimate control.” (...)

GSK Hired Ghostwriters to Pen Scientific Papers (GSH hyret inn spøkelsesforfateere for å skrive vitenakspelige dokumenter)
By Marian Wang ProPublica
2 Dec | ProPublica – This isn’t news but according to newly released documents from GlaxoSmithKline, the pharmaceutical company often paid ghostwriters to pen medical studies, editorials and even a textbook that listed physicians as the authors.

The documents — some of which date back to late 1990s — were recently unsealed in litigation over a GlaxoSmithKline product. We saw them after they were attached to a letter released this week by a nonprofit watchdog group urging the National Institutes of Health to crack down on ghostwriting in medical academia. The documents and the letter by Project on Government Oversight together outline several examples of how a major drug company contributed to the funding, writing and approval of material published in medical journals and elsewhere. (...)

POGO Letter to NIH on Ghostwriting Academics
pogo.org 29.11.2010
The Project On Government Oversight (POGO) is a nonpartisan independent watchdog that champions good government reforms. POGO’s investigations into corruption, misconduct, and conflicts of interest achieve a more effective, accountable, open, and ethical federal government. We take a keen interest in strengthening the integrity of federally funded science, and have particular concerns involving the National Institutes of Health (NIH), which receives around
$30 billion a year in federal taxpayer dollars to fund biomedical research.[1]

We are writing to urge that NIH curb the practice of ghostwriting in academia. As the Director of the world’s largest and most prestigious funding source for biomedical research, you must set policies that require NIH-funded academic centers to ban ghostwriting to strengthen scientific integrity. (...)

New River doc worked for drugmaker GlaxoSmithKline
roanoke.com 23.10.2010
Dr. Jody Hershey, director of the New River Health District, received more than $188,000 for consulting work he did for one of the nation's largest drug companies.

The director of the New River Health District, known nationally for his expertise in promoting vaccines, was paid $188,350 for 15 months of consulting work by GlaxoSmithKline, one of the nation's largest drug manufacturing companies.

Dr. Jody Hershey, who earns a state salary of $140,920, said he doesn't believe his work for the drug company created a conflict of interest.

But on Friday, a day after an inquiry by The Roanoke Times, Hershey said he will no longer work for Glaxo or any other corporate entity.

"I was concerned about even an appearance of a conflict of interest," he said. "That would disturb me."

The extent of Hershey's work with Glaxo was discovered this week after the news organization ProPublica published a searchable database of doctors who have taken money from one of seven drug companies. Glaxo was one of the companies on the list, having had to make the information public as part of its 2008 settlement of lawsuits with the U.S. government involving the drugs Zocor and Vioxx. (...)

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