U of Iowa responds to our criticism of oregano ‘cure’ — and reveals a broken process for promoting its research

Here’s some free advice for public universities facing journalists’ scrutiny about how they promote their research:  Be open and transparent and above all, engage!

Few things motivate journalists more than public officials – or public institutions – stonewalling honest questions. Journalists rarely get tired and just go away, regardless of how much those officials or institutions may hope they would.

It’s a lesson that has fresh relevance following our critique of a University of Iowa news release earlier this month. The release claimed that a scientist at the university discovered that compounds in two common cooking spices – oregano and thyme – “may hold the cure for wasting syndrome disease.” They were talking about cachexia, a condition faced by patients with cancer, AIDS and a host of other serious diseases that can dangerously increase the risk of death.

The release was shockingly incomplete and misleading. The “cure” claim was based on unpublished animal research. There had been no human clinical trials, no discussion of possible risks or adequate explanation of what possible benefits this new approach might offer. Moreover, the lead researcher stood to profit from the increased interest a news release might bring, given that he was listed on a patent application for the technology and it had been licensed to a pharmaceutical firm.

Initial silence and a troubling follow-up

We contacted a senior public relations person at Iowa, Jeneane Beck, asking some simple questions: What polices at Iowa control the approval of research news releases to insure accuracy?  Do Iowa research news releases require that the work undergo peer review prior to distribution?  Who funded this research?  Do you require that such releases include information on conflicts of interest?

The institution’s initial response, which we reported on in a follow-up blog post, was hardly adequate and failed to address those questions.

Now, more than two weeks after our inquiries about the release, Beck offered a more thorough response that raises a number of fresh concerns – not least of which is why it would take more than two weeks to answer a handful of simple questions for a reporter on deadline.  (You can read her complete response here.)

Beck cited Iowa’s commitment to “sharing the results of its research and scholarship with the general public accurately and with appropriate context” including both peer-reviewed work as well as unpublished research, “and research licensed by commercial entities who see potential in the research, whether it’s published or unpublished“ (emphasis added).

It’s that last statement which we find terribly misguided. The fact that a company may see some potential in unpublished research is absolutely no reason for a public university to tout the work as news!  That’s especially true when it comes to health care and medical research – where promotion of preliminary findings that haven’t been peer reviewed has the potential to misinform vulnerable patients and their families.  It violates best practices at a multitude of research institutions and runs contrary to what the University of Maryland concluded last year after a months-long investigation into a similar situation.

Beck’s response to our question about conflicts of interest also should raise alarm bells.  She wrote:

“We make every effort to put any research or scholarship we write about in appropriate context, and that includes noting if there is any potential conflict of interest.”

and:

“Although there is potential for the university and the researcher to receive income from commercialized research, a license does not guarantee this will happen . . .” (emphasis added)

This response betrays a fundamental misunderstanding of how disclosure of conflicts of interest is supposed to work.  A conflict — either real or perceived – can exist regardless of whether the researcher or the institution ultimately gains income from it.  Simply saying that the work hasn’t paid off yet is not a defense for lack of disclosure. In fact, the desire to create an eventual payoff may increase the perceived pressure to promote research beyond what is prudent, making disclosure even more important in these cases.

Does Beck’s response signal an intent to disclose such financial conflicts only when there is a “guarantee” of income related to a licensing deal? If that’s the case, we can expect that future news releases about Iowa’s commercial partnerships also will lack crucial context about researchers’ financial incentives.

Iowa policy blasted as ‘jumping the shark’

Our concerns about Iowa’s approach to promotion are shared by a number of prominent experts in the fields of ethics and science communication. This includes New York University bioethicist Arthur Caplan, PhD, who reacted to Iowa’s statement via e-mail:

It is utterly irresponsible to report promise based on unpublished research or work not presented at peer reviewed meetings. The industry and conflict-of-interest aspects only make a bad situation worse. You ought not be attaching a public university’s name to hype and to fluffing up the interest of patients who are easily misled by their illness to hear promise as cure.

Caplan also objected to Iowa’s characterization of when it is appropriate to disclose conflicts of interest.

Conflict of interest is not about when money is made, it is about the danger that the prospect of making money might influence research or the spin put on early reports of “promise”. Conflict of interest may be well managed but transparency is a minimal requirement.

Similarly, Rick Borchelt, who has managed communications for a number of top federal science institutions and was special assistant for public affairs at the National Cancer Institute, said that there were only a handful of rare situations where a university might be justified in publicizing research before it has been peer-reviewed and published —  one example being “clear evidence of a finding that will improve quality of life and therefore there is a moral obligation to share the information quickly and widely. This was not the case on the oregano finding — whatever that actual finding was.”

Borchelt expanded on the thought process that he believes should drive decisions about issuing news releases:

One litmus test I’ve always found helpful personally is to ask, “Would I have been as quick to write a release about this research if it had been a negative finding?” If the answer is yes (and it seldom is but probably ought to be), then I am conscientiously doing my job of informing the public of all the research at my institution that is funded by public investments. If the answer is no, then I have to decide why I believe the research in question needs to be shared with the public at large, and when, or whether it is sufficient in my role as a PIO to let the process of scientific peer review and publication provide the first tranche of public communication about research. Seldom indeed does a research finding arise that is so immediately beneficial to the public that there is justification to jump the shark and rush to a press release. This was not such a case. (emphasis added)

Joann Rodgers, a science journalist who was formerly executive director of Johns Hopkins Medicine’s science communications, media relations and public affairs division, said she “understood the pressures on university PR offices to promote their efforts at technology transfer and satisfy rising demands by funders (both governmental and corporate) to account for how their dollars are spent.” Nevertheless, she called for a bright line between speculative business PR and legitimate university research news.

The over-riding criterion for promotion of research is that it is credible, evidence-based news that has been published and peer reviewed in some form. That’s a fairly low bar as it is, but without that, the opportunities for misleading or confusing information to reach the scientific community, media and the public multiplies rapidly, especially when it can trigger false hope in people who are sick or worried well.

U of Iowa must take responsibility for the impact of its PR

Beck’s note claims that “the UI press release is accurate” and says that it was the pharmaceutical firm, Innovus Pharma, that saw the possible cachexia link in the Iowa research. The suggestion seems to be that Innovus Pharma – not the university – should shoulder the blame for overstating the scope of the research.

But that reasoning ignores the fact that it was the University of Iowa – not the company — that chose to issue not one but two news releases touting these compounds as a possible treatment or cure. Shifting blame to the company suggests that the university is just a rubber stamp for whatever the company wants to promote. University press offices should not view themselves as the marketing arms of private companies.

Bottom line: It sounds to us like there is a lot of confusion and misunderstanding at the University of Iowa regarding how to responsibly communicate its research findings to the public.

When similar confusion was highlighted at the University of Maryland, top university officials literally said, “This doesn’t seem right” and launched an investigation to find what was broken.

We urge the University of Iowa to initiate a similar review of its policies and practices.