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Advisory panels' objectivity questioned

The FDA announced a plan to clarify the conflict-of-interest rules for its committee members.

By Susan J. Landers, amednews staff. Aug. 14, 2006.

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Washington -- From warnings or guidance on prescription drug labels to advice on treating cancer survivors, health information flows from federal health advisory committees. But the debate over the credibility of these directives is gaining attention.

Some argue that physicians and other scientists who serve on the committees often have such close ties to industry that findings are skewed. Others contend that these players in the research and practice fields provide the expertise required. Representatives from both sides of the issue assembled July 24 in Washington, D.C., for a discussion hosted by the Center for Science in the Public Interest.

Advisory committees are plentiful in the federal government. The Food and Drug Administration has dozens that grapple with such high-profile topics as the dangers posed by popular arthritis drugs and antidepressants. The National Academies rely on hundreds of committees to produce reports on such topics as childhood obesity or health literacy.

In such instances, the panels' work impacts the day-to-day care of patients.

Consider a panel's conclusions carefully, cautioned Steven E. Nissen, MD, president of the American College of Cardiology and former chair of an FDA advisory panel. As an insider, Dr. Nissen has strong feelings on the need for impartiality in research. For example, he decided five years ago to refrain from accepting industry funding for his research. He advises physicians to turn to practice guidelines drafted by professional societies for clinical advice. "They usually do a pretty good job of weighing the evidence," he said. But with an Institute of Medicine report, for example, "unless you know the players, it's hard to judge whether a report is good."