Circulation 76,548 • Volume 20, No. 4 • Winter 2005   Issue PDF

Full Disclosure Recommended

Jeff Mueller, MD

To the Editor

The Fall 2005 issue of the Anesthesia Patient Safety Foundation (APSF) Newsletter includes the article “DepoDur™: A New Drug Formulation With Unique Safety Considerations.” It is disclosed that the author is a paid scientific advisor for Endo Pharmaceuticals, the U.S. marketer of DepoDur™, and has also received research support from Endo. Most of the article describes the putative benefits of DepoDur™. A smaller portion deals with safety issues and presents generic advice common to intravenous and neuraxial opioids. The opposing views of an unbiased author are not presented. Given the tone of the article, one could mistake it as marketing literature. This cynical but realistic view could be avoided if APSF would select authors who are not influenced by such conflicts of interest.

It is more concerning that the article does not clearly state that Endo is a financial supporter of the APSF. The financial relationship between APSF and Endo Pharmaceuticals should have been clearly revealed in the article. It is reasonable to ask if Endo’s financial support played a role in the APSF decision-making and editorial process, especially since that support was not clearly disclosed.

The specific concern expressed in this letter should not be generalized to other APSF activities or publications. However, since APSF’s credibility and reputation could be seriously damaged with only one mistake or ethical lapse, any indiscretion is important. It is also relevant that the American Society of Anesthesiologists (ASA) is a long-time provider of significant financial support to the APSF. Since many APSF Newsletter readers are also the dues-paying ASA members providing that support, the APSF has an important obligation to maintain editorial objectivity and avoid even the perception of bias or inappropriate influence.

Jeff Mueller, MD
Scottsdale, AZ

Editor’s Response:

Dr. Mueller raises points to which the APSF and the Newsletter Editorial Board are sensitive. We believe we carefully attempt to avoid commercial bias in safety articles that are written by our invited authors. However, if informed readers such as Dr. Mueller conclude otherwise, we will reexamine our approach. As Dr. Mueller points out, the article in question disclosed that the author has received investigative grant support from, and has been compensated as a scientific advisor by, Endo Pharmaceuticals. In the future, the APSF Newsletter will also include, as appropriate, a statement that the APSF receives financial support from an industry sponsor who could be perceived to benefit from a given article. This statement will be in addition to our current practice of listing all corporate sponsors on the donor page. The APSF thanks Dr. Mueller for his interest and letter.