Category: Tools of the trade

By: Arielle Dryer, Vincent Santiago, and Aleksandra Usyatynsky

You lurch awake in the early hours of the morning with a searing pain in your lower back. Being so sedentary during the pandemic has been making your muscle pain worse. You pull out your ibuprofen bottle from your nightstand and are surprised to see it’s running low. “Maybe I’ll see my doctor, just in case,” you think.

As you arrive at the doctor’s office later that day, you notice a new poster on display. “Missing out on your life because of pain? Relief is just a pill away, so you can get back to what really matters.” The logo in the corner looks familiar but you can’t remember where you’ve seen it before… A moment later your doctor glides in.

“Pain acting up again? Today I’m going to try a new drug instead of the over-the-counter stuff. It’s called ‘Strainadol’, you might have seen the poster in the waiting room. They just did a large clinical trial and it’s supposed to be really effective. Is that all for today?”

You leave the office put at ease; the new medication sounds promising!

Research can become biased when one research question or result is favoured over another, intentionally or not. When research is biased it lessens how much we can trust the findings. How can you tell if research is biased? Well, the source of research funding can be an important sign. Like any other project, research often does not happen without the proper funds. Scientists need to buy equipment, pay research participants, and pay the salaries of research staff. Research is often funded by government agencies and non-profit organizations, but it is also funded by private industries. Industry funding is a major way that bias can creep into scientific research.

Have you ever questioned the findings of public health research? You may not have, because we usually trust that scientific research is objective. But when research has the power to influence our policies and the choices set before us in our day to day lives, it’s important to consider who has the power to influence our research.

There are a number of ways that this bias can affect research findings. Let’s say I am a researcher funded by a pharmaceutical company to test their new drug. Compared to my colleague funded by the government, I am more likely to design my study in a way that shows that the drug is effective.¹ I am more likely than my colleague to draw stronger conclusions about the drug’s effectiveness, even if we have the same set of results. I am also more likely to only publish the findings that support the drug’s effectiveness.¹

Industry funding can also influence research agendas, or the types of questions scientists ask in the first place. This type of bias is less studied, but can be powerful because it influences the rest of the research process and changes what information is available to us. To better understand this type of bias, in 2018 Fabbri and colleagues² reviewed and brought together studies on how industry sponsorship has affected research agendas across a number of fields like medicine, tobacco, and food. The information presented here is the sum of findings from 36 studies between 1986 and 2017. With the information they reviewed, they answered 3 questions.

1) Does industry sponsorship impact research topics?

The review found that studies with industry funding tended to focus on research with commercial applications that results in more profits for the company. Within the health field, industry sponsorship means more research focused on money-making drugs and devices, rather than on talk therapy, physical activity, or dietary changes.

For example, most industry funded diabetes research focuses on oral medication or devices to measure blood glucose.³ In comparison, non-commercially funded studies research things like the causes, consequences, and complications of diabetes, and nonmedical ways of managing the disease.

One concern is that over-reliance on drugs to solve public health problems can have severe and unintended consequences. For example, the prescription opioid epidemic is partly due to the lack of existing non-drug alternatives to manage pain.⁴ Now, more than ever, we need to invest in deeper understandings of public needs and problems, rather than quick “band-aid” solutions. Due to the industry focus on their own interests, governments and nonprofits are left as the main sources of funding for these projects.

2) How do industries change what we research?

Industries have a few research tricks up their sleeves to make their products sell. One industry tactic is to focus research attention away from their product’s flaws. For decades the tobacco industry funded research focusing on how genetics puts certain people at risk of becoming addicted to smoking. This helped them make their case against claims that smoking causes cancer.⁵

Another industry tactic is presenting research results so that they appear believable and trustworthy. The tobacco industry reported that its second-hand smoke research was determined by experts in the field who select research projects based on scientific value. It was revealed that some of these projects were actually chosen by tobacco industry executives and lawyers.⁶ As you can imagine, these individuals were not as likely to fund projects that could reveal the negative health effects of second-hand smoke. The tobacco research available at the time was used to inform policies that have directly impacted public health.

3) What are scientists doing with the money? What are their opinions?

For scientists who receive industry funding, their research agendas tend to shift away from basic research, which aims to understand the world around us (“Why does this exist?”), towards more applied research with specific commercial applications (“How can we use this?”). In fact, every 10% increase in private funding is associated with a 1.2% drop in a program’s basic research.⁷ Asking “why” questions is so important because it lays down a foundation for other science to build on.⁸ As an example, mathematical models used in basic psychological research have been applied to understand how people who use substances make decisions.⁹

But what do the scientists doing the work think about this shift? It depends on who you ask. Fabbri and colleagues² found that across a few studies, scientists in academia and industry agreed that there is a risk of research becoming more commercial and applied with industry funding. In one study, industry funded researchers were more likely to think that the funding would lead to new and promising areas of research, whereas those who were not funded by industry were more likely to think the funding would lead to quick fixes, rather than long-term basic research.¹⁰

Nonetheless, some laboratories have collaboratively set a research agenda with their industry funders that was both basic and applied, with oversight by company executives and an academic research director.¹¹ Such collaborations may be the key to balancing industry involvement in the future.

What can I do as a research participant?

You might be thinking, “So scientists know that their research is likely being influenced by industry research. What can I do about it?” Here are some tips.

1. Whenever you’re participating in research, look out for funding disclosures in the consent forms. Who funded the study? Governmental agencies? Private companies?
2. If you’re unsure, have a discussion with the research staff and principal investigator. Ask about the influence of their funding on the design and publication of the study.
3. You can also inquire with the institutional Research Ethics Board (REB). The REB is meant to protect the rights and safety of research participants. Their contact information is typically listed on consent forms.
4. Advocate for greater independent research funding (e.g., by governmental agencies) by lobbying local government officials. In Canada, the government pledged $4 billion in 2018 over 5 years for science across its main funding agencies.¹²
5. According to the Government of Canada’s 2018 Panel of Research Ethics,¹³ REBs are required to have one community member with no affiliation to the institution, so consider joining an REB to represent community voices that are not influenced by industry.
   • Examples include: Health Canada,¹⁴ hospitals,¹⁵ public health departments,¹⁶ and academic institutions.¹⁷
6. If you’re reading the results from a study in the media, check to see if the funding disclosures are reported. This may mean finding the original publication and/or getting in touch with the researchers.

Remember, researchers are always looking for study participants and you can choose which studies you participate in. Your participation may ultimately guide the development of new products, drugs, therapies, and treatments. So next time you’re at your doctor’s office, wondering about your treatment options, ask yourself: Why is this my best treatment option? Where did this claim come from? Who may be benefiting from me choosing this option?

This doesn’t mean you should be suspicious of all science, but if you follow the money, you might be surprised at what you find.

As you leave the doctor’s office to pick up a bottle of that new “Strainadol” drug that your doctor prescribed, you take another look at the poster. You realize the logo in the corner might be for a pharmaceutical company you saw in the news recently. You think, “Maybe I’ll look up what that clinical trial was all about and ask my doctor more about it.”

References

1. Lundh, A., Lexchin, J., Mintzes, B., Schroll, J. B., & Bero, L. (2017). Industry sponsorship and research outcome. Cochrane Library, 2017(2), MR000033. http://dx.doi.org/10.1002/14651858.mr000033.pub3
2. Fabbri, A., Lai, A., Grundy, Q., & Bero, L. A. (2018). The influence of industry sponsorship on the research agenda: A scoping review. American Journal of Public Health, 108(11), e9-e16. https://doi.org/10.2105/ajph.2018.304677
3. Arnolds, S., Heckermann, S., Heise, T., & Sawicki, P. T. (2015). Spectrum of diabetes research does not reflect patients’ scientific preferences: A longitudinal evaluation of diabetes research areas 2010–2013 vs. a cross-sectional survey in patients with diabetes. Experimental and Clinical Endocrinology & Diabetes, 123(05), 299-302. https://doi.org/10.1055/s-0034-1398591
4. Phillips, J. K., Ford, M. A., Bonnie, R. J., & National Academies of Sciences, Engineering, and Medicine. (2017). Evidence on Strategies for Addressing the Opioid Epidemic. In Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK458653/
5. Gundle, K. R., Dingel, M. J., & Koenig, B. A. (2010). ‘To prove this is the industry’s best hope’: Big tobacco’s support of research on the genetics of nicotine addiction. Addiction, 105(6), 974-983. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911634/
6. Barnes, D. E., & Bero, L. A. (1996). Industry-funded research and conflict of interest: An analysis of research sponsored by the tobacco industry through the Center for Indoor Air Research. Journal of Health Politics, Policy and Law, 21(3), 515-542. https://doi.org/10.1215/03616878-21-3-515
7. Buccola, S., Ervin, D., & Yang, H. (2009). Research choice and finance in university bioscience. Southern Economic Journal, 1238-1255. https://ideas.repec.org/a/sej/ancoec/v754y2009p1238-1255.html
8. Lee, C. (2019, January 28). Not so basic research: The unrecognized importance of fundamental scientific discoveries. Harvard University. http://sitn.hms.harvard.edu/flash/2019/not-so-basic-research-the-unrecognized-importance-of-fundamental-scientific-discoveries/
9. Narayana Chernoff, N. (2003, February 13). Basic research translates to addiction treatment. Association for Psychological Science. https://www.psychologicalscience.org/observer/basic-research-translates-to-addiction-treatment
10. Harman, G. (1999). Australian science and technology academics and university-industry research links. Higher Education, 38(1), 83-103. https://doi.org/10.1023/A:1003711931665
11. Webster, A. (1994). University-corporate ties and the construction of research agendas. Sociology, 28(1), 123-142. https://doi.org/10.1177/0038038594028001008
12. Owens, B. (2019, April 24). Why are Canada’s scientists getting political? Nature. https://www.nature.com/articles/d41586-019-01244-0
13. Government of Canada (2019, September 23). TCPS 2 (2018) – Chapter 6: Governance of research ethics review. Panel on Research Ethics. https://ethics.gc.ca/eng/tcps2-eptc2_2018_chapter6-chapitre6.html
14. Government of Canada (2020, March 20). Recruitment of external research ethics board members. Health Canada. https://www.canada.ca/en/health-canada/services/scienceresearch/science-advice-decision-making/research-ethics-board/recruitment-regularalternate-external-members.html
15. SickKids (n.d.). Research ethics board. http://www.sickkids.ca/Research/Research-Ethics/REBoffice/membership/reb-membership.html
16.  Public Health Ontario. (2019, October 1). Ethics review board. https://www.publichealthontario.ca/en/about/research/ethics/ethics-review-board
17. Ryerson University. (n.d.). Research ethics. https://www.ryerson.ca/research/resources/ethics/

Image References

Cytonn Photography (n.d.) [Photograph of hand signing a paper]. https://unsplash.com/photos/GJao3ZTX9gU

National Cancer Institute (n.d.). [A woman reading a booklet at a pharmacy counter while a pharmacist works in the background]. https://unsplash.com/photos/jqBOb3IThyA

Stanford Research. (n.d.). [Photograph of 1949 Viceroy Cigarette Advertisement]. https://metro.co.uk/2018/09/12/these-are-the-insane-adverts-that-told-people-smokingwas-good-for-them-7936951/?ito=cbshare