Industry-Driven Medical Research Challenges Physicians to Place Patient Interests First Debate -- VEITHsymposium™
"First, do no harm" is one of the cornerstones of a physician's education, meant as a reminder that even the best-intended interventions can go awry. In an era dominated by industry-supported medical research, physicians are forced to carefully examine their treatment decisions to ensure that they are truly acting in patients' best interests. Today at the 33rd annual VEITHsymposium™, distinguished vascular surgeons explored the ethical pressures doctors face as a result of the rapid rise of industry-driven medical research, and the best tools available to them to help ensure objective decision-making.
New York (PRWEB) November 17, 2006
"First, do no harm" is one of the cornerstones of a physician's education, meant as a reminder that even the best-intended interventions can go awry. In an era dominated by industry-supported medical research, physicians are forced to carefully examine their treatment decisions to ensure that they are truly acting in patients' best interests. Today at the 33rd annual VEITHsymposium™, distinguished vascular surgeons explored the ethical pressures doctors face as a result of the rapid rise of industry-driven medical research, and the best tools available to them to help ensure objective decision-making.
Dr. Timothy M. Sullivan, a Professor of Surgery at the Mayo Medical School and a Mayo Clinic Consultant (Rochester, MN), spoke eloquently about dramatic changes to the physician-medical device industry relationship in recent years. Previously, few products existed, so industry had little part in surgeons' decision-making. Today, the opportunity to become involved in high-profile device trials is extremely desirable to vascular surgeons and their practices. The balance of the physician-industry relationship has shifted in favor of device manufacturers, who often seek influence over the design, conduct, analysis and publication of trial results, sometimes discouraging physicians from publishing negative findings. Physicians also increasingly rely on industry for training instead of academia, developing a dependence that colors their ability to view new technology with objectivity. "As physicians become more involved with industry and serve on Boards of Directors, they face both fiduciary responsibilities to investors and a responsibility to remain neutral regarding outcomes for the good of patients; these two responsibilities cannot be reconciled," said Dr. Sullivan.
How can physicians resolve these ethical and moral dilemmas? Dr. Thomas E. Brothers, Program Director in Surgery at the Medical University of South Carolina (Charleston, SC), points vascular surgeons to the use of Markov models, which can help them rely less on subjective decision-making and more on the objective analysis of data. A Markov model enables the analysis of complex problems by finding "hidden" data in variables that can be readily observed. In a recent trial of 206 patients with symptomatic lower extremity arterial disease, Markov model estimates of treatment outcome probabilities were compared to actual treatment plans provided by vascular surgeons.
The study found that the Markov model treatment plans offered significantly better quality of life outcomes for patients in the most severe pain and among those undergoing bypass. In addition, patients for whom the model disagreed with the surgeon's initial treatment plan were 17% more likely to undergo bypass, and were generally less likely to report a favorable quality of life one year later.
"Our findings confirm the complexity of surgical decision-making for patients with symptoms of chronic lower extremity arterial occlusive disease. Routinely treating all lesions that are discovered, as increasingly seems to be advocated by some cardiovascular specialists who have recently included peripheral intervention to their scope of practice, without a profound understanding of the implications of their actions in view of the natural history of the disease, cannot be supported. As has always been the case, restraint and careful case selection with the patients' best interests in mind must remain the hallmark of the vascular specialist."
Physicians seeking the best way to "do no harm" in the complicated environment of modern industry-driven medicine may increasingly turn to objective measures like the Markov model in order to provide the best possible treatment for patients.
About VEITHsymposium™: Now entering its fourth decade, VEITHsymposium™ provides vascular surgeons, interventional radiologists, interventional cardiologists and other vascular specialists with a unique and exciting format to learn the most current information about what is new and important in the treatment of vascular disease. The 5-day event features 300 rapid-fire presentations from the world's most renowned vascular specialists with emphasis on the latest advances, changing concepts in diagnosis and management, pressing controversies and new techniques.
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