Wednesday, June 30, 2010

Insel Admits His Statements "May be Viewed as Misleading"

Dr Bernard Carroll has posted several times, most recently here, about shenanigans by "key opinion leaders" in psychiatry whose apparently academic writing and speeches have conveyed messages in line with the marketing agendas of drug and device companies, while they downplayed or concealed their financial ties to these companies.  Lately, Dr Carroll noted how the current director of the US National Institute for Mental Health (NIMH), Dr Thomas Insel, has defended Dr Charles Nemeroff, whose recent move to the University of Miami let him shed sanctions imposed by Emory University for his failure to disclose conflicts of interest while he was there. Dr Carroll wrote, "For the past three months, Insel has been trying to put some distance between himself and Nemeroff, but the public isn’t buying it. I have called his statements disingenuous...."

Dr Carroll is on vacation, so in his absence, I note the following from a brief article in the Chronicle of Higher Education:
The director of the National Institute of Mental Health, Thomas R. Insel, has softened his denial of a mutually helpful relationship with Charles B. Nemeroff, a university researcher found to have repeatedly collected undisclosed corporate payments. In an update to his official blog posting, Dr. Insel said his initial denial of job assistance from Dr. Nemeroff 'may be viewed as misleading,' and acknowledged that Dr. Nemeroff served in key positions related to Dr. Insel's hiring by Emory University.

This seems to corroborate Dr Carroll's skepticism. I wonder what other statements by Dr Insel, or Dr Nemeroff for that matter, ought to be "viewed as misleading?"

We have said repeatedly that commercially sponsored "key opinion leaders" are really part-time drug marketers disguising themselves as academics or distinguished practitioners. The deceptions inherent in these roles seem to lead to a certain habitually elastic approach to the truth.

Medical academics and practitioners will need a renewed commitment to honesty and transparency if they want to regain the respect of an increasingly skeptical, if not cynical public.

1 comment:

jnardo said...

Actually, this exchange is "misleading:"
Dr. Goldschmidt: Charlie Nemeroff has shown interest for a job at the Miller School of Medicine. He mentioned that you may be willing to provide me with a confidential opinion. If indeed you do, I would call you whenever convenient.
Dr. Insel: I cannot provide a written, formal recommendation by NIH rules. However, I can discuss informally by phone. Happy to do this. Best for your office to schedule through my assistant Ann Graham who can find a time for us to talk.

Yet, in his informal conversation, Insel obvious spoke about Nemeroff and his NIMH status.
In this case, the Dean had a specific question about Dr. Nemeroff’s eligibility to apply for NIH grants. I explained that the penalties were imposed by Emory and according to the current policy, Dr. Nemeroff was not prevented by NIH from applying for grants.

and then intent in this conversation was to explain a federal policy, not to exploit a policy that would help any investigator avoid penalties.

and further
Note however, that I must comply with the current policy which permits someone to apply for NIH funding unless they have been de-barred.

He says that he can only comment informally to the request for a confidential opinion. Yet in that phone call, Insel gives an opinion relying on NIMH policy. So it wasn't so informal after all. For that matter, it wasn't confidential either since Goldschmidt broadcasted it as a formal opinion to the universe.
Dr. Insel "confirmed to me that Charlie was absolutely in fine standing" with the NIH, Pascal J. Goldschmidt, dean of the University of Miami’s medical school, said of a July 2009 phone call he made to Dr. Insel just before hiring Dr. Nemeroff.

Good old boy backroom talk, off the record, for the record, in the record, informally formal, confidentially public - quacking like a duck.

misleading is just a start...