Financial ties not revealed in hip study

CHICAGO -- A new study showing that padded hip protectors didn’t prevent fractures in the elderly has renewed questions about hidden drug industry ties to medical research.

Three of the authors of the study on bone breaks didn’t tell editors of the Journal of the American Medical Assn., which published their research Wednesday, that they had consulted for or received research money from the makers of bone-strengthening drugs. That potential conflict was discovered by the Associated Press.

Editors of the journal, which has tough rules on financial disclosure, had asked the authors about any conflicts and were told there were none. The researchers said later they didn’t believe their industry connections were relevant because the study of hip fractures didn’t involve bone drugs and didn’t recommend them.

The editor of JAMA agrees. Dr. Catherine DeAngelis said that in this case, the drug company connections didn’t violate the journal’s detailed financial disclosure policy.

DeAngelis said her journal was being unfairly scrutinized by the Associated Press, which found the researchers’ ties to drug companies through searches on the Internet and through a consumer database.

“This has nothing to do with drugs,” she said. “At what point do you say, ‘Come on, is this a witch hunt’?”

Undisclosed corporate ties by scientists affect other journals too. Yet editors of JAMA essentially made the journal a lightning rod for the issue last year when they toughened their financial disclosure for authors and announced the changes in an editorial.

A close reading of JAMA’s guidelines suggests the fracture study authors’ ties to drug makers are “clearly relevant,” said Dr. Michael Callaham, president of the World Assn. of Medical Editors.

A consumer advocate with the Center for Science in the Public Interest agrees. Readers could easily interpret the study to say that since hip protectors don’t work, “I guess I better take the drugs,” even if that’s not what the authors intended, said Merrill Goozner. The consumer advocacy group runs a database on scientists’ financial ties.

In this case, reporting such ties “seems to me to be a no-brainer,” Goozner said.

The study involved 1,042 nursing-home residents who were each assigned to wear a cushiony pad on only one hip. Results over several months showed just as many fractures on the padded hip as on the unprotected side.

The hip pad in the study is no longer on the market, but lead author Dr. Douglas Kiel, a Harvard Medical School researcher, said the results probably would be similar for other “energy absorbing” cushion-like pads still being sold.

Previous studies on hip protectors and fractures have produced conflicting results.

A JAMA editorial called the new study’s results inconclusive. Hip protectors are designed to be worn on both hips; wearing them on only one side might increase chances of a fall onto the protected hip, the editorial said.

Kiel said the study was broadened to examine an improved pad and that results were due soon.