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JAMA editors embroiled in brouhaha over treatment of critic

The editors of the Journal of the American Medical Association (JAMA) may be in hot water for dissing a neuroscientist who criticized them for failing to flag a study author's ties to the manufacturer of a drug he reviewed favorably.

The flap stems from the findings of a trial conducted by Robert Robinson, a psychiatrist at Carver College of Medicine at the Univeristy of Iowa, published in the May 2008 issue of JAMA touting the supposed benefits of the antidepressant Lexapro (escitalopram) in warding off the blues in stroke victims. The problem, as critics would later point out, was that Robinson failed to disclose that he was a member of the speaker's bureau for Forest Laboratories, which makes Lexapro. That lack of disclosure was a clear violation of JAMA's conflict-of-interest policy, which has been in place since 1989 and requires all authors to sign a statement declaring all potential financial conflicts of interests in the past five years. 

Jonathan Leo, a neuroscientist at Lincoln Memorial University in Harrogate, Tenn., today told ScientificAmerican.com that he sent an email to the JAMA editors in October alerting them to Robinson's undisclosed ties and was told they would investigate the matter.

But months later when they still had not come clean, a frustrated Leo posted a letter on the British Medical Journal (BMJ) web site pointing out Robinson's drug company ties as well as flaws he perceived in the study, most notably that it failed to compare the effectiveness of the drug and counseling in combating depression in stroke patients.

Leo says he was perplexed by the fact that it took the JAMA editors five months to conduct a probe when it took him less than a day to get an email response from Robinson acknowledging that he had failed to report his drug company connection. "Everything I wrote about was in the public record that anyone with a computer and a Google search could have found," Leo says.

Medical journal editors occasionally find themselves in the awkward position of publishing letters acknowledging such a lack of disclosure by authors. (JAMA published a letter from Robinson doing just that in the March 11 issue.) But what made the situation unusual -- and what has led to widespread discussion on the web -- is that Leo says his BMJ piece elicited a string of angry phone calls from JAMA editor-in-chief Catherine DeAngelis and deputy editor Phil Fontanarosa.

He says that Fontanarosa called him and fumed: "Who do you think you are? You are banned from JAMA for life. You will be sorry. Your school will be sorry. Your students will be sorry.” Leo also confirmed a report by the Wall Street Journal that said DeAngelis then called his university and demanded a retraction of the BMJ letter. In the same report, DeAngelis called Leo “a nobody and a nothing."

A spokesperson for the American Medical Association (AMA) today confirmed that its board of trustees, which has the power to hire and fire editors, has asked the Journal Oversight Committee to investigate the incident. A JAMA spokesperson said that Fontanarosa and DeAngelis were not available for comment.

This is not the first time DeAngelis has made sharp comments about researchers to the press. In 2000, she told the New York Times, in a story about a JAMA policy barring researchers from releasing study results to the media before they were published: "Many scientists who submit manuscripts believe they are on to something that is the most important thing since sliced bread, and they want it out there. …Fine, put it out there, but don't submit it to JAMA."

It was 10 years ago in January that the AMA sacked George Lundberg, a pathologist who preceded DeAngelis as editor-in-chief. The AMA was furious because Lundberg had published a study about college students' definition of "having sex" in the middle of the Clinton impeachment hearings. Lundberg was at WebMD/Medscape until earlier this year, and there is now a petition circulating for him to be appointed U.S. Surgeon General.

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