At "Why I Sent It Is a Mystery - More About Avandia, Conflicts of Interest, and Confused Thinking" Roy Poses documents a response from a prominent biomedical researcher, Steven Haffner of the University of Texas Health Science Center at San Antonio, as to why he rather blatantly breached scientific reviewer's code of conduct. This code of conduct is not a mystery and is quite explicit.

It is crystal clear he should not have FAXed anything or communicated about the paper he was reviewing in any way whatsover to GlaxoSmithKline (GSK):

'Why I sent it is a mystery,' Haffner told Nature . 'I don't really understand it. I wasn't feeling well. It was bad judgement.'

This statement is simply not credible on its face, coming from a scientist with high ability, a large number of federal grants, and who probably sits on many study sections where the rules are emphatically stated at every session - and where participants have to sign off in writing, as I do before a section.

I review papers too. Hypothetically speaking, what might motivate me, if I were not strongly ethical, to do something like this? Something else is likely going on here for someone to risk their reputation, and it is not credible to believe it is ideological or random due to "having a bad day." If this person was having a bad day, it was in "spin generation" upon confrontation. That response rates about a "0.2 out of 10" on the MedInformaticsMD Plausible Deniability Scale.

Let's not beat around the bush. This person could have slowed or halted publication through comments in his review. Something more was at stake. What would it plausibly take for a person to assume such risk? It would take a significant quid pro quo.

Again, hypothetically speaking, knowing how people (e.g., people I saw in my occupational medicine role in highly-unionized heavy industries) who get caught doing things that "they should not be doing" react, my concern is that this person of some type (including and/or over and above the promise of speaking engagements), or could have had an explicit or implicit agreement to be (money, stock options, internal information related to investing, etc.).

Of course, a pharma engaged in such activities would make sure their tracks were well-covered and create a situation of "plausible deniability." It would therefore be quite difficult to investigate this type of arrangement.

I emphasize that I have no knowledge of such activity, nor am I making an accusation. I'm just thinking as a Sherlock Holmes in a "mystery" novel might think, from the "means, motive, opportunity" angle.

That said, I hope this issue will be investigated. This affair raises a number of questions:

• Could there be other instances of leaks to pharmas regarding other scientific papers reviewed by this individual?
• Just how widespread is this problem?
  
• Could other scientists also be "leaking" and we just have not discovered it yet?
  
• Could pharmas have created a network of "advance scouts" in the biomedical/academic industry, i.e., people who have agreements to tip them off about negative publicity pre-publication ?
• Could such a "pre-emptive strike force" be utilized for quiet montoring of the writings of a pharma "enemies list"?
• Could compromised reviewers be affecting or manipulating the career advancement of scientific authors behind their backs (either negatively or positively, depending on their "alignment" to the interests on pharma), e.g., via conversations with formal or informal connections, without the authors knowing about it?
  

An unscrupulous consultant advising pharma marketing and strategic planners on methods to "pave the road" in the biomedical literature would probably tell them to do something like this.

Considering what goes on in pharma and academia (such as at another southern university of high renown), such a discovery would disappoint me, but not at all surprise me.

-- SS

Addendum: to those who might think me a flaming leftwing totalitarian anti-pharma Pajamablogger, my "Political Compass" questionnaire results are here.