More Evidence Peer Review is Broken
More than half of peer reviewers receive industry payments.
Two years ago, we discussed the lack of evidence supporting the idea that peer review improves the quality of scientific research.
Peer review is meant to guarantee the publication of high-quality research and enhance the quality of published manuscripts. The process should involve independent experts evaluating and assessing research for its quality and reliability.
However, a recent JAMA publication questions the integrity and independence of peer review. The research letter addresses the Payments by Drug and Medical Device Manufacturers to US Peer Reviewers of Major Medical Journals.
The authors identified peer reviewers for The BMJ, JAMA, The Lancet, and The New England Journal of Medicine (NEJM) using each journal’s 2022 reviewer list. They then used a US Open payments database to identify whether reviewers had received industry payments.
What did they find?
Between 2020 and 2022, 1155/1962 peer reviewers (59%) received at least one industry payment. More than half (54%) accepted general payments, while 32% received research payments.
Between 2020 and 2022, reviewers received over $1.2 billion in industry payments, including $1 billion to individuals or their institutions. Over the three years, the median general payment was $7,614.
What does this mean?
Journals such as the BMJ pride themselves on their competing interest policy. Readers should know the author's competing interests if they publish an article. They ask reviewers to provide a fair, honest, and unbiased assessment of the manuscript's strengths and weaknesses. But how is that possible if you're on the payroll of pharma?
Furthermore, no one can identify who is being paid as there is no central database like the US where you can look up who is paying who. The voluntary nature of the system means companies can often conceal payments. For example, the drug industry’s self-regulatory body reprimanded Novo Nordisk for failing to disclose approximately 500 payments worth £7.8m to over 150 recipients between 2020 and 2022.
This latest publication further enhances the status of peer review: it is broken.
A system that dates back over 200 years persists because no one can be bothered to address its shortcomings, and too many journals make hefty profits out of its inadequacies to affect the status quo.
THE JAMA authors consider that ‘additional research and transparency regarding industry payments in the peer review process are needed.” We think this will be another smokescreen to permit the current system to limp on.
Editorial peer reviews are largely untested; their effects are uncertain and tainted by industry influence. The system needs a radical overhaul which starts with abandoning the current journal system that sucks in vast amounts of cash and distorts the research agenda.
The main reasons for the survival of a broken system are tied to the biomedical publication industry. For editors, peer review is a Kevlar shield, a sloping shoulders device - “it ain’t me guv” cop-out clause. For academic authors who have to climb the greasy pole, it’s a system that works both ways; for industry and all those who have to sell something, it’s a cheap advert chance. You only need to read our Antivirals series to understand how the system works and how the public was sold and continues to sell dummies. Rotten decision-makers only have to point to ghost-written trials in mega journals to justify their decisions.
You only have to look at our recent Zum Zum posts to see the devastating effects of this broken system. Or look up the Comirnaty series, which was written without data published in journals—it was regulatory data, the closest we are ever going to get to reality.
This post was written by two old geezers who have been peer-viewed and have peer-reviewed countless times.
References
Jefferson T, Alderson P, Wager E, Davidoff F. Effects of editorial peer review: a systematic review. JAMA. 2002 Jun 5;287(21):2784-6. doi: 10.1001/jama.287.21.2784.
Jefferson T, Wager E, Davidoff F. Measuring the quality of editorial peer review. JAMA. 2002 Jun 5;287(21):2786-90. doi: 10.1001/jama.287.21.2786.
Peer review existed before it was called that, and was conducted by honest, properly-qualified people committed to impartiality. Peer review today is compromised by conflicts of interest, some of which are monetary, but others of which arise from membership of academic cliques - informal groups which work to secure publication space and academic appointments for each other, an aim partly achieved by excluding others.
In light of the emerging evidence of corruption of the broad biomedical literature corpus it’s no wonder there are rising numbers of patients who distrust our advice, even when informed by “evidence.” This is a crisis at a deep level, which demands solutions. Recognition and reporting of these abuses by our colleagues such as “Trust the Evidence” is far better than hearing partial truths from some of the so-called fringe journalists. I’m looking forward to serious suggestions and solutions to save medical science from impending implosion.