Professional Documents
Culture Documents
But in defence of editors, I would point out that we rarely recognize this, and do our best to stamp it out. The
if ever have access to raw data, and in many cases we lack spin experts (we won’t call them “spin doctors”: that
the expertise to conduct a valid assessment. We rely heavily has another connotation) have promised to disseminate
on the good intentions of authors and the shrewdness of guidelines to help in recognizing and eliminating this
reviewers. That combination usually works. potentially dangerous hoodwinking. We can best deal
with conflicts of interest by recognizing that we all have
But not always. Another presentation at the Peer Review them; we at JOGC, like the British Medical Journal,1 label
Congress described a study of “spin” and its effect on them “competing interests” rather than “conflicts,” in
how readers interpreted reports of RCTs in the field of order to reduce the stigma associated with the latter term.
cancer. Spin was defined as a specific way of reporting The prevailing culture should be to declare all potential
with the aim of convincing readers that the beneficial conflicts whenever there is any hint that they might have
effect of an experimental treatment is greater than shown a bearing on behaviour. Regrettably, at least as far as
by the results. We think this shouldn’t happen, but it does; Canadian medical schools go, ensuring that conflicts are
it may be a result of ignorance of the science under study, declared is still a work in progress.7
unconscious bias, or a wilful desire to deceive.5 In a study
published in 2010 of RCTs with a clearly identified primary
REFERENCES
outcome showing statistically non-significant results, 50%
of 72 eligible studies showed spin in the Conclusion, and 1. Smith R. Conflicts of interest: how money clouds objectivity. J R Soc Med
29% even had spin in the Results.6 So it does happen. 2006;99(6):292–7.
2. The Danish Association of the Pharmaceutical Industry. Collaboration
In the presentation at the Peer Review Congress, 300 agreement between the Danish Medical Association and the Danish
established authors of clinical trials in the field of cancer Association of the Pharmaceutical Industry on clinical trials. Available at:
http://www.laeger.dk/portal/pls/portal/!PORTAL.wwpob_page.show?_
were randomized to assess an abstract with spin or the docname=5642847.pdf. Accessed September 14, 2013.
same abstract rewritten to remove spin. The findings were
3. Angell M. Drug companies & doctors: a story of corruption. New York
not surprising: reviewers of the abstract with spin were Review of Books, 15 January 2009. Available at: http: //www.nybooks.com/
more likely to feel that the treatment it described would articles/22237. Accessed on September 15, 2013.
be beneficial for patients than were reviewers of the no- 4. Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R. Selective
spin abstract (Isabelle Boutron, INSERM, Paris, oral publication of antidepressant trials and its influence on apparent efficacy.
N Engl J Med 2008;358:252–60.
communication). This is an alarming finding, because the
5. Fletcher RH, Black B. ‘‘Spin’’ in scientific writing: scientific mischief and
abstract is the only portion of an article indexed in many
legal jeopardy. Med Law 2007;26:511–25.
electronic databases, and is for many readers the only part
6. Boutron I, Dutton S, Ravaud P, Altman DG. Reporting and interpretation
of an article they actually read. Conceivably a small amount of randomized controlled trials with statistically nonsignificant results for
of spin can have far-reaching consequences. primary outcomes. JAMA 2010;303:2058–64.
7. Shnier A, Lexchin J, Mintzes B, Jutel A, Holloway K. Too few, too weak:
Whether or not spin is allowed to appear in medical conflict of interest policies at Canadian medical schools. PLoS ONE
journals is ultimately the responsibility of editors. We 2013;8(7):e68633.