Charles B. Nemeroff, M.D., Ph.D., is a psychiatrist at Emory University alleged by congressional investigators to have failed to report a third of the $2.8 million (or more) he received in consulting fees from pharmaceutical companies whose drugs he was studying.
Why would congressional investigators care? For one thing, during the period of time when Nemeroff received these consulting fees, he also received $3.9 million from NIH to study the efficacy of five GlaxoSmithKline drugs in the treatment of depression. When the government ponies up money for scientific research, it has an interest in ensuring that the research will produce reliable knowledge.
GlaxoSmithKline, of course, has an interest in funding studies that show that its drugs work really well.
The two entities giving Nemeroff money here have quite different interests. This means that Nemeroff himself has a potential conflict of interest that needs to be disclosed. If the potential for bias from this conflict is judged to be serious enough, the conflict of interest needs to be managed — either by removing the funding from the drug company, or by removing Nemeroff as PI on the NIH funded drug studies.
Now maybe Nemeroff was confident in his ability to maintain his objectivity regardless of who was paying him. His own confidence in this situation doesn’t much matter. As the Los Angeles Times article on the story notes,
At issue is the safety and efficacy of the stream of new drugs undergoing clinical trials. Several studies have shown that researchers who receive money from drug companies are more likely to report positive results from such trials.
It’s not enough to avoid conscious bias in favor of the drugs made by the company that pays you big consulting fees. Unconscious bias can skew your results, too. And this is why it’s not up to Nemeroff to decide whether consulting fees will undercut his objectivity. You have to disclose potential conflicts of interest because you are not conscious of your own unconscious biases.
However, Nemeroff must have been conscious of the rules about COI disclosure — and also of the fact that his consulting fees from pharmaceutical companies, in particular, we a concern — because he signed a paper at Emory that said so. Again from the a href=”http://www.latimes.com/news/nationworld/nation/la-sci-doctors4-2008oct04,0,5063741.story”>Los Angeles Times article:
Nemeroff continued to receive large amounts of money for delivering talks to other physicians even after he signed university documents pledging to accept no more than $10,000 a year from any one company, the inquiry found. …
In the letter from [Sen. Charles E.] Grassley [who initiated the congressional investigation] to Emory, he said that Nemeroff consistently misrepresented the amount of money he received from Glaxo. In 2003, for example, Nemeroff said he received no more than $15,000 from the company, though the company says it paid him $119,756. In 2002, he reported receiving $15,000, but the company says it paid him $232,248.
Some of those payments were made within days of his signing a letter to Emory stating that he would limit his fees from Glaxo to $10,000 a year.
Crossing the $10,000 threshold would have required Emory to inform the National Institute of Mental Health and take steps to manage the conflict of interest — including removing Nemeroff as principal investigator.
An aside: Psychiatrists need to be numerate, don’t they? You’d figure if they’re administering drugs they’d understand the problems of being off by an order of magnitude, right?
Even in the event that it somehow slipped Nemeroff’s mind that he’d signed that pledge, it cannot have escaped his attention that failure to disclose a potential conflict of interest could get him into trouble, since, as DrugMonkey details, Nemeroff has gotten into trouble for it at least twice before.
To be sure, money is useful (as it can be exchanged for goods and services), but so is one’s credibility as a scientist.
Scientists are trying to be objective, to arrive at results that reflect how things really are, rather than what they (or their funders) want to see. Scientists disclose their potential conflicts of interest so their scientific peers can help them with this, bringing a critical eye to results that may have been shaped by bias, whether conscious or unconscious.
In their efforts to be objective, scientists take seriously clues from others that they might be more biased (at least potentially) than they think they are. And, at least in theory, they strive for transparency about their potential sources of bias rather than secrecy.
What could be the motivation if you elect not to disclose a potential conflict of interest? Perhaps you worry that disclosing your connections to drug companies will hurt the credibility of your results in the estimation of other scientists. However, seeking to bury that potential conflict hurts your credibility even more. It amounts to saying, I don’t trust my scientific peers to make a fair evaluation of the facts and of my findings. I know better than they do that I’m unbiased and my findings are sound.
Unfortunately, you need help from others to avoid self-deception. Again, this is one of the reasons there are rules about disclosing and managing conflicts of interest.
Finally, you might be inclined to give Nemeroff a pass on the theory that maybe he’s the kind of guy who just doesn’t have a head for official university policy. If the internal emails posted at Pharmalot are authentic (and I have no basis for judging this one way or another), then Nemeroff seems quite fond of the details of university policy — at least when it comes to members of the Emory Department of Psychiatry communicating with the press through the media relations office rather than answering reporters’ queries directly.