The following is a guest post from Andrew Holtz, one of our longtime contributors and a past president of the Association of Health Care Journalists.
Editor’s note: See “Update” section below for the latest response.
“The cornerstone for managing conflicts of interest is transparency…” That phrase introduces the University of Houston’s Policy on Conflict of Interest in Research. It’s a statement with which we strongly agree. And it certainly encompasses researchers holding a patent related to research the university promotes with a news release, wouldn’t you think?
“I don’t routinely include that, as the news release is aimed at a general audience who is just interested in the more detailed look,” wrote University of Houston Senior Media Relations Specialist Jeannie Kever. It’s a disheartening and confusing response. More on that after some background.
On August 8, 2016, the university announced “Researchers propose new treatment to prevent kidney stones”. The key point of the news release was that lab experiments indicated a fruit extract called hydroxycitrate might be more effective than a chemical cousin, citrate, which is often recommended as a dietary supplement for people prone to kidney stones. Our review of the news release rated it satisfactory on 6 of 10 criteria. But one “unsatisfactory” rating was spectacularly so.
After I took my first look at the release, co-reviewer Yoni Freedhoff, M.D. did something that should be part of every health beat reporter’s routine. He performed a simple online search for the names of the researchers and the word “patent”. And he got a hit: “Organic acids as agents to dissolve calcium minerals in pathological calcification and uses thereof”. The patent application notes that hydroxycitrate could become a treatment for kidney stones. Freedhoff’s search result was a good catch. “That the authors have a patent on the use of hydroxycitrate in the treatment of kidney stones is an important piece of context given the clear cut conflict of interest,” he said. Keep in mind, the point here is not whether researchers should apply for patents, only whether we should be told about them.
[Editor’s note: As clarified below, the study authors disclosed that they have filed a provisional patent application, which establishes an interest in the technology and suggests that they stand to benefit should the patent be awarded. However, it does not appear that the patent has yet been granted.]
I hadn’t known of the patent (I’m going to use Freedhoff’s search tip from now on) because it wasn’t noted in either the news release or the draft copy of the Nature journal article we had in hand when we did the review. I sent a note to Kever at the University of Houston asking if they had complied with their disclosure policy. She contacted researcher Prof. Jeffrey Rimer, who quickly responded that although it wasn’t mentioned in the manuscript PDF, the final online Nature article did disclose the patent:
“Competing financial interests: J.D.R. and J.R.A. have filed a provisional patent application on the use of organic acids as growth inhibitors of pathological calcification.”
That still left the matter of the news release’s failure to disclose the patent and Kever’s response that, “I don’t routinely include that, as the news release is aimed at a general audience who is just interested in the more detailed look.”
I sharply disagree with the idea that conflict of interest disclosures shouldn’t be included in a release aimed at a “general audience”; that is, anyone not digging down into the footnotes of journal articles, including many reporters and the public. And I’m befuddled by the phrase “who is just interested in the more detailed look.” Maybe there’s a typo in that phrase. I don’t know, because Kever has not responded to several emails and a telephone message asking for clarification.
HealthNewsReview.org publisher Gary Schwitzer notes funding and conflicts of interest are often omitted from news releases. “Only 48 percent of the 224 releases we’ve reviewed as of this moment get a satisfactory score on this criterion: Does the news release identify funding sources & disclose conflicts of interest? So for readers it’s a coin toss whether they’re going to get proper disclosure or not,” he points out.
The omissions in news releases rob the public of important information. In this case, the patent held by the researchers means they have a vested interest in reporting a positive outcome. Studies have shown time and again that, despite researchers’ good faith attempts to remain objective, such financial conflicts of interest may impact the findings of their studies in important ways.
Sad to say, but too few reporters are checking original sources. Indeed, in this case I could not find any mention of the patent in stories available online about the potential kidney stone treatment, even though the disclosure is there for anyone who takes a careful look at the Nature article online. Last week, I tried contacting reporters or editors who worked on stories at the Houston Chronicle, HealthDay/WebMD, the Daily Mail, and HealthNewsline to find out if they knew of the patent and decided not to tell readers, or didn’t know about it, perhaps because they never looked beyond the news release.
Emails to these news organizations haven’t produced clarity. A staffer at the Daily Mail wrote that the reporter is away on vacation, but he believes they were not aware of the patent. Nothing substantive yet from the other outlets.
So there we are… a tale of conflict of interest disclosure that reveals technical compliance, routine omissions and weak reporting. The result: health news readers who are not given the context they need to fully understand the research and its implications.
The same day our original post was published, I received a response to my emails and calls asking why the University of Houston did not disclose a relevant patent in the news release about kidney stone prevention. Michael Rosen, Executive Director of Media Relations, wrote:
“The University of Houston discloses any financial interest required by both federal law and the University’s Financial Conflict of Interest (FCOI) policy. The press release you referenced is no exception.”
However, apparently that doesn’t mean the university believes it should note that researchers hold a patent when inviting media coverage of their work… even though Nature required a disclosure, because medical journal editors believe it is important for those who read research reports to know if the authors stand to gain from producing positive results. Indeed, the International Committee of Medical Journal Editors specifically refers to patents in its policy about the responsibilities of authors regarding conflicts of interest. When I asked again about the lack of disclosure in the news release, Rosen replied:
“It is not required per federal law or university policy.”
The University of Houston Policy on Conflict of Interest in Research states that, “The University of Houston is committed to maintaining a research environment that promotes attention to the highest ethical standards for all sponsored and non-sponsored research.” I asked Rosen to explain how failing to disclose a patent conforms with a university policy that aspires to the “highest ethical standards.”
I have not received a response.