Thread by @dnunan79

@carlheneghan mindfully preparing for his talk on why we need a UK Sunshine Act to help solve the problem of conflicts of interest in medicine @OxEBHC @CebmOxford @EBM_Live @OxPrimaryCare

#COI #EBM

Starts with the story of Rofecoxib (Vioxx).
Presents the evidence that didn’t get into the NEJM because one of the study authors was a paid consultant on the drug company producing Vioxx.

#COI #EBM #EBMmanifesto

Carl recalls that he prescribed Vioxx and is vexed by the probability of harm he may have caused. Due to a COI impacting on the evidence he used to inform his medical practice.

And this was preventable if a better system was in place.

This slide is always revealing.

“Conflicts don’t impact on me. But they do on my peers”.

amjmed.com/article/S0002-…

Another great paper on the impact of bias and blind spots on interpretations of evidence resulting from COI.

A great slide on the efforts that have been made to date on tackling COIs in research.

Introducing the Sunshine Act in the US.

bmj.com/content/347/bm…

The UK doesn’t have the equivalent of the Sunshine Act. What was agreed was the ABPI proposal. The key issue = it’s VOLUNTARY.

That presents problems, as @bengoldacre neatly points out.

Voluntary systems DO NOT WORK.

Others have realised this. And acted.

Look at this list. All countries outside the US who have a Sunshine Act on DOIs. It’s revealing based on OMISSIONS not inclusions.

#COI #EBM #EBMmanifesto

Carl’s paper with @mgtmccartney in @TheLancet puts the issues forward.

And they are starting this website (will share link if I find it). Just a small matter of waiting for @GOVUK and @gmcuk to make this standard practice. #whatareyouwaitingfor

#COI #EBM #EBMmanifesto