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Smithereens are better than no Smith at all.

Posted by plosmedicine on 30 Mar 2009 at 23:42 GMT

Author: David Sackett
Position: Co-CEO
Institution: HARLOT plc
E-mail: sackett@bmts.com
Submitted Date: May 18, 2005
Published Date: May 19, 2005
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

It was grand to see Richard Smith in full-flight again, a raptor this time, relegating the RCTs he previously championed in the BMJ to the ether, to be replaced by printed "commentaries." In doing so, he laid three eggs. First, he shoved systematic reviews and meta-analyses, surely the least biased summaries of efficacy, out of the nest before he took off. Second, the canaries who write commentaries often live in gilded cages provided by the drug industry, and printing their pronouncements would make matters worse. Finally, the fledglings who conduct non-drug health care trials, especially in low and middle income countries, shouldn't have their careers stunted by not being able to publish their work in the paper journals.

Competing interests declared: Dave Sackett has been wined, dined, supported, transported, and paid to speak by countless pharmaceutical firms for over 40 years, beginning with two research fellowships and interest-free loans that allowed him to stay to finish medical school. Dozens of his randomised trials have been supported in part (but never in whole) by pharmaceutical firms, who never received or analysed primary data and never had veto power over any reports, presentations, or publications of the results. He has twice worked as a paid consultant to advise pharmaceutical firms whether their products caused lethal side-effects; on both occasions he told them yes. He has testified as an unpaid expert witness for a stroke victim who successfully sued a manufacturer of oral contraceptives, and as a paid expert in preparing a class-action suit against a manufacturer of prosthetic heart valves.
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