The Carlat Psychiatry Blog contacted psychiatrist Prof C. Lindsay DeVane about an article on antidepressant drug interactions he apparently co-authored for the medical journal CNS Spectrums. In reply, DeVane noted that the article was ghost-written on behalf of a drug company and denounced it as “piece of commercial crap” and ‘ridiculous’, ‘inaccurate’ and ‘simplistic’.
DeVane was apparently persuaded to take part in a round-table discussion on the interactions between antidepressant drugs, for which attendees could gain ‘CME’ or ‘Continuing Medical Education’ points, needed for doctors to demonstrate that they are keeping their skills and knowledge updated.
After the discussion, the a commercial medical education company i3CME, produced an article based on a video tape of the session with the participants names listed as authors.
Ghostwriting, the practice where drug companies or medical writing agencies create scientific articles to which established researchers add their names, still occurs, despite recent attempts to clamp down on it.
It relies on an academic system where researchers’ careers depend on the number of publications, and on drug companies’ need to boost the profile of their products by adding the names of high-profile scientists to the relevant research.
It’s a big business, and there are a number of agencies that just specialise in writing scientific articles for commercial companies that later get handed to ‘star’ researchers for, at best, checking, and at worst, just signing.
In this case, it seems the article was written without DeVane’s agreement, so it’s refreshing to see someone disown it, rather than simply add it as another gold star to their CV.
Importantly, DeVane notes that his views on the topic had already been accurately and fairly represented in an earlier article [pdf] which he had personally authored.
The Carlat post has more details on the affair, including DeVane’s own description of what occurred.
Link to further details (via Furious Seasons).
Mind Hacks 
Dr. Danny Carlat has done a wonderful job in bringing potential CME-sponsored conflicts of interest to the forefront—which you recently reported.
Now that many of the problems have been noted, perhaps it is time for your readers to undertake a vigorous debate on how they would change CME it was up to them?
For whatever it’s worth, here are my two cents worth: For decades now, people a lot smarter than I am have built this (CME) thing into a behemoth of complexity. Everyone has a different take on it. GSK will sponsor something that Pfizer won’t, and vice versa. There is even profound disagreement in the U.S. Senate. So, I would tear the whole thing up and focus on the group of people that all of these regulations are supposed to help: Physicians.
First, merge Category 1 and Category 2 CME. Period! There’s no need for both. If society cannot trust physicians to abide by the honor system, than we have bigger problems than medical education can cure. When you read a journal or attend a symposia, put the pretest, posttest and answer key in a file in your office. If you’re audited you have the proof that you have been continuing your education. The medical community is a much better over-seer than the ACCME. As an MD, if you don’t keep up with new science, patients‚Äîsome of whom walk and talk like doctors as it is‚Äîwill flush that out and make your life miserable. God forbid if you are litigated against. The amount of continuing education, or lack thereof, can come into play in court. So, it is in your personal, professional, and, perhaps, legal interest to get together with colleagues at meetings to hash things over. Enforcement becomes moot.
My second change would be that only teaching institutions can offer CME. The private medical education companies can still set-up the program, but it must pass muster from the university. Remember that all of the test grading, etc., the university would normally do has been waived, since the physician is now keeping her own records. So, the university is saving money which can be passed on to the end-user. The ACCME can monitor the universities if they so choose, and—most importantly—standardize fees. Yes, BMS should pay a larger fee for putting on a program than should a small association or patient advocacy group. But the fee should be on a standardized, sliding scale that is universal throughout the University CME system. The end result is that the doctor gets the CME for free. That should be axiomatic—no matter who sponsors the program.
James M. La Rossa Jr.
Editorial Director & Publisher
MEDWORKS MEDIA GLOBAL, LLC
Los Angeles, CA.