In 2004, four advocates of genetically modified (GM) foods published a study in the
British Food Journal that was sure to boost their cause
[1] According to the peer-reviewed paper, when shoppers
in
a Canadian farm store were confronted with an informed and unbiased
choice between GM corn and non-GM corn, most purchased the GM variety.
This finding flew in the face of worldwide consumer resistance to GM
foods, which had shut markets in
Europe,
Japan,
and elsewhere. It also challenged studies that showed that the more
information on genetically modified organisms (GMOs) consumers have,
the less they trust them.
[2]
The study, which was funded by the biotech-industry front group,
Council for Biotechnology Information
and the industry’s trade association, the Crop Protection Institute of Canada (now
Croplife Canada), was given the Journal’s prestigious Award for Excellence for the Most Outstanding Paper of 2004 and has been cited often by biotech advocates.
Stuart Laidlaw, a reporter from
Canada’s
Toronto Star, visited the farm store several times during the study and described the scenario in his book
Secret Ingredients. Far from offering unbiased choices, key elements appeared
rigged to favor
GM corn purchases. The consumer education fact sheets were entirely
pro-GMO, and Doug Powell, the lead researcher, enthusiastically
demonstrated to Laidlaw how he could convince shoppers to buy the GM
varieties. He confronted a farmer who had already purchased non-GM
corn. After pitching his case for GMOs, Powell proudly had the farmer
tell Laidlaw that he had changed his opinion and would buy GM corn in
his next shopping trip.
Powell’s interference with shoppers’ “unbiased” choices was nothing compared to the effect of the signs placed over the corn bins.
The
sign above the non-GM corn read, “Would you eat wormy sweet corn?” It
further listed the chemicals that were sprayed during the season. By
contrast, the sign above the GM corn stated, “Here’s What Went into Producing Quality Sweet Corn.”
It is no wonder that 60% of shoppers avoided the “wormy corn.” In fact, it may b
e a testament to people’s distrust of GMOs that 40% still went for the “wormy” option.
Powell
and his colleagues did not mention the controversial signage in their
study. They claimed that the corn bins in the farm store were “fully
labelled”—either “genetically engineered Bt sweet corn” or “Regular
sweet-corn.”
When Laidlaw’s book came out, however, Powell’s “wormy” sign was featured in a photograph,
[3]
exposing what was later described by Cambridge University’s Dr. Richard Jennings
as “flagrant fraud.”
Jennings, who is a leading researcher on scientific ethics, says, “It
was a sin of omission by failing to divulge information which quite
clearly should have been disclosed.”
[4]
Jennings is among several scientists and outraged citizens that say the paper should have been withdrawn, but the
Journal
refused. Instead, it published a criticism of the methods by Canadian
geneticist Joe Cummins, and allowed Powell to respond with a lengthy
reply.
[5]
In
his defence, Powell claimed that his signs merely used the language of
consumers and was “not intended to manipulate consumer purchasing
patterns.” He also claimed that the “wormy” corn sign was only there
for the first week of the trial and was then replaced by other
educational messages. But eye witnesses and photographs demonstrate the
presence of the sign long after Powell’s suggested date of replacement.
[6]
This
incident illustrates how so-called scientific papers can be manipulated
to force conclusions favorable to authors or funders and how
peer-reviewed journals may be complicit. While the subject of this
particular study provided ammunition in the battle to deny choice to
consumers in
North America, there is similar “cooked” research in the more critical area of GMO safety assessments.
|
SECRET, INADEQUATE, AND FLAWED |
|
THE
UNPUBLISHED INDUSTRY STUDIES SUBMITTED TO REGULATORS ARE TYPICALLY KEPT
SECRET BASED ON THE CLAIM THAT IT IS “CONFIDENTIAL BUSINESS
INFORMATION.” THE ROYAL SOCIETY OF CANADA IS ONE OF MANY ORGANIZATIONS
THAT CONDEMN THIS PRACTICE. THEY WROTE: |
|
IN
THE JUDGMENT OF THE EXPERT PANEL, THE MORE REGULATORY AGENCIES LIMIT
FREE ACCESS TO THE DATA UPON WHICH THEIR DECISIONS ARE BASED, THE MORE
COMPROMISED BECOMES THE CLAIM THAT THE REGULATORY PROCESS IS ‘SCIENCE
BASED.’ THIS IS DUE TO A SIMPLE BUT WELL-UNDERSTOOD REQUIREMENT OF THE
SCIENTIFIC METHOD ITSELF—THAT IT BE AN OPEN, COMPLETELY TRANSPARENT
ENTERPRISE IN WHICH ANY AND ALL ASPECTS OF SCIENTIFIC RESEARCH ARE OPEN
TO FULL REVIEW BY SCIENTIFIC PEERS. PEER REVIEW AND INDEPENDENT
CORROBORATION OF RESEARCH FINDINGS ARE AXIOMS OF THE SCIENTIFIC METHOD,
AND PART OF THE VERY MEANING OF THE OBJECTIVITY AND NEUTRALITY OF
SCIENCE.”
[7] |
Whenever private submissions
are
made public through lawsuits or Freedom of Information Act Requests, it
becomes clear why companies benefit from secrecy. The quality of their
research is often miserable, incompetent, and unacceptable for
peer-review. In 2000, for example, after the potentially allergenic
StarLink corn was discovered in the food supply, Aventis CropScience
presented wholly inadequate safety data to the EPA’s scientific
advisory panel. One frustrated panel member, Dean Metcalfe, MD,—the
government’s top allergist—said during a hearing, “Most of us review
for a lot of journals. And if this were presented for publication in
the journals that I review for, it would be sent back to the authors
with all of these questions. It would be rejected.”
[8]
Submissions
to the US Food and Drug Administraion (FDA) may be worse than in other
countries, since the agency doesn’t actually require
any data.
Their policy—overseen by Monsanto’s former attorney who later became
the company’s vice president—says that biotech companies can determine
if their own foods are safe. Anything submitted is voluntary and,
according to former Environmental Protection Agency scientist Doug
Gurian-Sherman, “often lack[s] sufficient detail, such as necessary
statistical analyses needed for an adequate safety evaluation.” Using
Freedom of Information Requests, Gurian-Sherman analyzed more than a
fourth of the data summaries (14 of 53) of GM crops reviewed by the
FDA. He says, “Our evaluation found that the biotechnology companies
provide inadequate data to ensure their products are safe.”
[9]
|
UNSCIENTIFIC ASSUMPTIONS ARE THE BASIS OF APPROVALS |
“Most
or all of the conclusions of food safety for individual GM crops are
based on inferences and assumptions, rather than on actual testing,”
says Professor E. Ann Clark, who analyzed submissions to Canadian
regulators. For example, rather than actually testing to see if the
amino acid sequence produced by their inserted gene is correct, “the
standard practice,” according to research analyst William Freese, “is
to sequence just 5 to 25 amino acids, even if the protein has more than
600 in total. If the short sample matches what is expected, they assume
that the rest are also fine. If they are wrong, however, a rearranged
protein could be quite dangerous.”
Monsanto’s
submission to Australian regulators on their high lysine GM corn
provides several examples of optimistic assumptions used in place of
science. The GM protein produced in the corn is also found in soil. The
company claimed that since people consume small residues of soil on
fruits and vegetables, the protein has a history of safe consumption.
An independent calculation by the Centre for Integrated Research on
Biosafety (INBI), however, reveals the weakness of this argument. Based
on the amount of GM corn protein an average US citizen would consume
(if all their corn were Monsanto’s variety), “for equivalent exposure”
of the protein from soil “people would have to eat between 80-800
million (males) or 60-700 million (females) kilograms of soil each day,
or nearly as much as 10,000kg/second 24 hours a day seven days a week.”
INBI estimated that the normal exposure to the protein from soil
residues was actually “about 30 billion-4 trillion times less than
exposure through [high lysine] corn.”
[10]
In
addition, certain nutritional components of this GM variety (i.e.
protein content, total dietary fiber, acid detergent fiber, and neutral
detergent fiber) lie far outside the normal range for corn. Instead of
comparing their corn to normal controls, which would reveal this
disparity, Monsanto compared it to obscure corn varieties that were
also substantially outside the normal range
on precisely these values.
Epidemiologist
Judy Carman points out that GM “experiments used some very unusual
animal models for human health, such as chickens, cows and trout. Some
of the measurements taken from these animals are also unusual measures
of human health, such as abdominal fat pad weight, total de-boned
breast meat yield, and milk production.” In her examination of the full
range of submittals to authorities in Australia and New Zealand, she
says that there was no proper evaluation of “biochemistry, immunology,
tissue pathology, and gut, liver and kidney function.”
[11]
Writing
on behalf of the Public Health Association of Australia, Carman says,
“The effects of feeding people high concentrations of the new protein
over tens of years cannot be determined by feeding 20 mice a single
oral gavage of a given high concentration of the protein and taking
very basic data for 13-14 days . . .The acute toxicity testing
proposed as adequate would simply not pick up cancer, teratology [birth
defects] or the long-tem effects of nutrient deficiencies or increases
in anti-nutrients.”
[12]
|
THE SCIENCE OF RIGGING STUDIES |
When
independent researchers published a study in July 1999 showing that GM
soy contains 12%-14% less cancer-fighting phytoestrogens, Monsanto
responded with its own study, concluding that soy’s phytoestrogen
levels vary too much to even carry out a statistical analysis.
Researchers failed to disclose, however, that they had instructed the
laboratory to use an obsolete method of detection—one that had been
prone to highly variable results.
[13]
WHEN
AVENTIS PREPARED SAMPLES TO SEE IF THE POTENTIAL ALLERGEN IN STARLINK
CORN REMAINED INTACT AFTER COOKING, INSTEAD OF USING THE STANDARD
30-MINUTE TREATMENT, THEY HEATED CORN FOR TWO HOURS.
![]()
|
TO
SHOW THAT PASTEURIZATION DESTROYED BOVINE GROWTH HORMONE IN MILK FROM
COWS TREATED WITH RBGH, THEY PASTEURIZED THE MILK 120 TIMES LONGER THAN
NORMAL. UNABLE TO DESTROY MORE THAN 19%, THEY THEN SPIKED THE MILK WITH
A HUGE AMOUNT OF THE HORMONE AND REPEATED THE LONG PASTEURIZATION,
DESTROYING 90%. (THE FDA REPORTED THAT PASTEURIZATION DESTROYS 90% OF
THE HORMONE.) |
TO
DEMONSTRATE THAT INJECTIONS OF RBGH DID NOT INTERFERE WITH COW’S
FERTILITY, MONSANTO APPARENTLY ADDED COWS TO THE STUDY THAT WERE
PREGNANT PRIOR TO INJECTION.
AND IN ORDER TO PROVE THAT THE PROTEIN FROM THEIR GM CROPS BREAKS DOWN
QUICKLY DURING SIMULATED DIGESTION, BIOTECH COMPANIES USED THOUSANDS OF
TIMES THE AMOUNT OF DIGESTIVE ENZYMES AND A MUCH STRONGER ACID COMPARED
TO THAT RECOMMENDED BY THE WORLD HEALTH ORGANIZATION.
METHODS USED TO HIDE PROBLEMS ARE VARIED AND PLENTIFUL. FOR EXAMPLE, RESEARCHERS:
USE HIGHLY VARIABLE ANIMAL STARTING WEIGHTS TO HINDER DETECTION OF FOOD-RELATED CHANGES
KEEP FEEDING STUDIES SHORT TO MISS LONG-TERM IMPACTS
TEST EFFECTS OF ROUNDUP READY SOYBEANS THAT HAVE NOT BEEN SPRAYED WITH ROUNDUP
AVOID FEEDING ANIMALS THE ACTUAL GM CROP, BUT GIVE THEM INSTEAD A
SINGLE DOSE OF THE GM PROTEIN THAT WAS PRODUCED INSIDE GM BACTERIA
USE TOO FEW SUBJECTS TO DERIVE STATISTICALLY SIGNIFICANT RESULTS
USE POOR STATISTICAL METHODS OR SIMPLY LEAVE OUT ESSENTIAL METHODS, DATA, OR STATISTICS
USE RIGGED OR IRRELEVANT CONTROL GROUPS, AND EMPLOY INSENSITIVE OR OBSOLETE EVALUATION TECHNIQUES |
Monsanto’s 1996
Journal of Nutrition study
[14]
,
[15]
provides
plenty of examples of scientific transgressions. Roundup Ready soybeans
are engineered to withstand the normally fatal effects of Monsanto’s
herbicide called Roundup. Monsanto scientists published a feeding study
that purported to test their soybeans’ effect on rats, catfish,
chickens, and cows. The study has been used often by the industry as
validation for safety claims. According to Dr. Arpad Pusztai, however,
“It was obvious that the study had been designed to avoid finding any
problems. Everybody in our consortium knew this.” Pusztai was
commissioned at the time by the UK government to develop rigorous
testing protocols on GM foods—protocols that were never implemented.
Pusztai, who had published several studies in that same nutrition
journal, said the Monsanto paper was “not really up to the normal
journal standards.” Pusztai says that if he had been asked to referee
the paper for publication, “it would never have passed.” He’s confident
that even his graduate assistants would have taken the study apart in
short order. Some of the flaws include:
-
Researchers
tested GM soy on mature animals, not young ones. Young animals use
protein to build their muscles, tissues, and organs. Problems with GM
food could therefore show up in organ and body weight. But adult
animals use the protein for tissue renewal and energy. “With a
nutritional study on mature animals,” says Pusztai, “you would never
see any difference in organ weights even if the food turned out to be
anti-nutritional. The animals would have to be emaciated or poisoned to
show anything.”
-
Even
if there were an organ development problem, the study wouldn’t have
picked it up since the researchers didn’t weigh the organs.
-
In
one of the trials, researchers substituted only one tenth of the
natural protein with GM soy protein. In two others, they diluted their
GM soy six- and twelve-fold.
[16]
Scientists
Ian Pryme of Norway and Rolf Lembcke of Denmark wrote, the “level of
the GM soy was too low, and would probably ensure that any possible
undesirable GM effects did not occur.”
-
Pryme and Lembcke, who published a paper in
Nutrition and Health that
analyzed all peer-reviewed feeding studies on GM foods as of 2003, also
pointed out that the percentage of protein in the feed used in the
Roundup Ready study was “artificially too high.” This “would almost
certainly mask, or at least effectively reduce, any possible effect of
the [GM soy].” They said it was “highly likely that all GM effects
would have been diluted out.”
[17]
-
Proper
compositional studies filter out effects of weather or geography by
comparing plants grown at the same time in the same location. Monsanto,
however, pooled data from several locations, which makes it difficult
for differences to be statistically significant. Nonetheless, the data
revealed significant differences in the ash, fat, and carbohydrate
content. Roundup Ready soy meal also contained 27% more trypsin
inhibitor, a potential allergen, which might explain the sudden jump in
soy allergies in the UK beginning right after Roundup Ready soy was
introduced. Also, cows fed GM soy produced milk with a higher fat
content, demonstrating another disparity between the two types of soy.
-
One
field trial, however, did grow GM and non-GM plants next to each other,
but this data was not included in the paper. Years after the study
appeared, medical writer Barbara Keeler discovered the data that had
been omitted. It showed that Monsanto’s GM soy had significantly lower
levels of protein, a fatty acid, and phenylalanine, an essential amino
acid. Also, toasted GM soy meal contained nearly twice the amount of a
lectin—one that may interfere with the body’s ability to assimilate
other nutrients. And the amount of trypsin inhibitor in cooked GM soy
was as much as seven times higher than a cooked non-GM control.
-
The
study also omitted many details normally required for a published
paper. According to Pryme and Lembcke, “No data were given for most of
the parameters.”
-
And
when researchers tested the effects of Roundup Ready protein on
animals, they didn’t extract the protein from the soybeans. Instead,
they derived it from GM bacteria, claiming the two forms of protein
were equivalent. There are numerous ways, however, in which the protein
in the soy may be different. In fact, nine years after this study was
published, another study showed that the gene inserted into the
soybeans produced unintended aberrant RNA strands, meaning that the
protein may be quite different than what was intended.
[18]
In
Pryme and Lembcke’s analysis, it came as no surprise that this Monsanto
study, along with the other four peer-reviewed animal feeding studies
that were “performed more or less in collaboration with private
companies,” reported no negative effects of the GM diet. “On the other
hand,” they wrote, “adverse effects were reported (but not explained)
in [the five] independent studies.” They added, “It is remarkable that
these effects have all been observed after feeding for only 10–14 days.”
[19]
|
TOXIC GM FOODS COULD HAVE BEEN APPROVED |
Two
GM foods whose commercialization was stopped because of negative test
results give a chilling example of what may be getting through. Rats
fed GM potatoes had potentially precancerous cell growth in the stomach
and intestines, less developed brains, livers, and testicles, partial
atrophy of the liver, and damaged immune systems.
[20]
GM peas provoked an inflammatory response in mice, suggesting that the
peas might trigger a deadly anaphylactic shock in allergic humans.
[21]
Both
of these dangerous crops, however, could easily have been approved. The
problems were only discovered because the researchers used advanced
tests that were never applied to GM crops already on the market. Both
would have passed the normal tests that companies typically use to get
their products approved.
Ironically,
when Monsanto was asked to comment on the pea study, their spokesperson
said it demonstrated that the regulatory system works. He failed to
disclose that none of the company’s GM crops had been put through such
rigorous tests.
|
RAMPANT UNRELENTING INDUSTRY BIAS |
Industry-funded research that favors the funders is not new. Bias has
been identified across several industries. In pharmaceuticals, for
example, positive results are four times more likely if the drug’s
manufacturer funds the study.
[22]
When companies pay for the economic analyses of their own cancer drugs,
the results are eight times more likely to be favorable.
[23]
Compared to drug research, the potential for industry manipulation in
GM crop studies is considerably higher. Unlike pharmaceutical testing,
GM research has no standardized procedures dictated by regulators. GM
studies are not usually published in peer-reviewed journals and are
typically kept secret by companies and governments. There is little
money available for rigorous independent research, so company evidence
usually goes unchallenged and unverified. Most importantly, whereas
drugs
can show serious side-effects and still be approved, GM food cannot. There is no tolerance for adverse reactions; feeding trials
must show no problems.
Thus,
when industry studies show problems (in spite of their efforts to avoid
them), serious adverse reactions and even deaths among GM-fed animals
are ignored or
dismissed as “not biologically significant
” or
due to “natural variation
s.”
Numerous reports including peer-reviewed articles and part 3 of the book
Genetic Roulette are
replete with examples of rigged research. But making these public does
not seem to curtail its practice. Consider the wormy corn of the
British Food Journal.
Not only has the editor refused to retract the paper, he has not even
agreed to reconsider its Award for Excellence. A blatant propaganda
exercise still stands validated as exemplary science.
In
the critical arena of food safety research, where the health of society
is caught in the balance, it is entirely unacceptable that the biotech
industry is without accountability, standards, or peer-review. At our
expense, they’ve got bad science down to a science.
|
THIS
ARTICLE IS BASED ON PART 3 OF THE BOOK, GENETIC ROULETTE: THE
DOCUMENTED HEALTH RISKS OF GENETICALLY ENGINEERED FOODS, BY JEFFREY M.
SMITH.
www.GeneticRoulette.com |
Jeffrey
M. Smith is the author of the new publication Genetic Roulette: The
Documented Health Risks of Genetically Engineered Foods, which presents
65 risks in easy-to-read two-page spreads. His first book, Seeds of
Deception, is the top rated and #1 selling book on GM foods in the
world. He is the Executive Director of the Institute for Responsible
Technology, which is spearheading the Campaign for Healthier Eating in
America. Go to
www.seedsofdeception.com to learn more about how to avoid GM foods.
[1]
Powell
D.A.; Blaine K.; Morris S.; Wilson J., Agronomic and consumer
considerations for Bt and conventional sweet-corn, British Food
Journal, Volume: 105, Issue: 10, Page: 700-713 (Nov 2003)
[2]
GM Nation? The findings of the public debate,
http://www.gmnation.org.uk/ut
_09/ut_9_6.htm#summary
[3]
To see the Toronto Star photo in Laidlaw’s book, go to
http://www.gmwatch.org/p1temp
.asp?pid=72&page=1
[4]
Corn Fakes, Private Eye, No. 1194, 28 September-11 October 2007
http://www.gmwatch.org/archive2
.asp?arcid=8314
[5]
Editorial and letters, British Food Journal 2006 Vol : 108 Issue: 8 (August 2006)
http://www.foodsafetynetwork
.ca/en/article-details.php?a=3
&c=9&sc=62&id=897
[6]
Tim Lambert, Would you eat wormy corn?, September 7 2007
http://scienceblogs.com
/deltoid/2007/09/would_you_eat
_wormy_sweet_corn.php
[7]
“Elements
of Precaution: Recommendations for the Regulation of Food Biotechnology
in Canada; An Expert Panel Report on the Future of Food Biotechnology
prepared by The Royal Society of Canada at the request of Health Canada
Canadian Food Inspection Agency and Environment Canada” The Royal
Society of Canada, January 2001.
[8]
FIFRA Scientific Advisory Panel (SAP), Open Meeting, July 17, 2001.
[9]
Doug Gurian-Sherman, “Holes in the Biotech Safety Net, FDA Policy Does
Not Assure the Safety of Genetically Engineered Foods,” Center for
Science in the Public Interest,
http://www.cspinet.org/new/pdf
/fda_report__final.pdf
[10]
M. Cretenet, J. Goven, J. A. Heinemann, B. Moore, and C.
Rodriguez-Beltran, “Submission on the DAR for application A549 Food
Derived from High-Lysine Corn LY038: to permit the use in food of
high-lysine corn, 2006,
www.inbi.canterbury.ac.nz
[11]
Judy
Carman, “Is GM Food Safe to Eat?” in R. Hindmarsh, G. Lawrence, eds.,
Recoding Nature Critical Perspectives on Genetic Engineering (Sydney:
UNSW Press, 2004): 82–93.
[12]
FLRAG, “Comments to ANZFA about Applications A346, A362 and A363,” http://www.iher.org.au/
[13]
Marc Lappé and Britt Bailey, “ASA Response,” June 25, 1999,
http://cetos.org/articles
/asaresponse.html
[14]
S.
R. Padgette, N. B.Taylor, D. L. Nida, M. R. Bailey, J. MacDonald, L. R.
Holden, R. L. Fuchs, “The composition of glyphosate-tolerant soybean
seeds is equivalent to that of conventional soybeans,”
J. Nutr. 126 (1996):702–716.
[15]
B.
G. Hammond, J. L. Vicini, G. F. Hartnell, M. W. Naylor, C. D. Knight,
E. H. Robinson, R. L. Fuchs, and S. R. Padgette, “The feeding value of
soybeans fed to rats, chickens, catfish, and dairy cattle is not
altered by genetic incorporation of glyphosate tolerance,”
J. Nutr. 126 (1996): 717–727.
[16]
A. Pusztai and S. Bardocz, “GMO in animal nutrition: potential benefits and risks,” Chapter 17,
Biology of Nutrition in Growing Animals (Elsevier, October 2005). earlier
[17]
Ian
F. Pryme and Rolf Lembcke, “In Vivo Studies on Possible Health
Consequences of Genetically Modified Food and Feed—with Particular
Regard to Ingredients Consisting of Genetically Modified Plan
Materials,”
Nutrition and Health 17(2003): 1–8.
[18]
Andreas Rang, et al, “Detection of RNA variants transcribed from the transgene in Roundup Ready soybean,”
Eur Food
Res Technol 220 (2005): 438–443.
[19]
Ian
F. Pryme and Rolf Lembcke, “In Vivo Studies on Possible Health
Consequences of Genetically Modified Food and Feed—with Particular
Regard to Ingredients Consisting of Genetically Modified Plan
Materials,”
Nutrition and Health 17(2003): 1–8.
[20]
Arpad Pusztai, “Can science give us the tools for recognizing possible
health risks of GM food,” Nutrition and Health, 2002, Vol 16 Pp 73-84;
Stanley W. B. Ewen and Arpad Pusztai, “Effect of diets containing
genetically modified potatoes expressing Galanthus nivalis lectin on
rat small intestine,” Lancet, 1999 Oct 16; 354 (9187): 1353-4; Arpad
Pusztai, “Genetically Modified Foods: Are They a Risk to Human/Animal
Health?” June 2001 Action Bioscience
http://www.actionbioscience
.org/biotech/pusztai.html
; and A. Pusztai and S. Bardocz, “GMO in animal nutrition: potential benefits and risks,” Chapter 17,
Biology of Nutrition in Growing Animals, R. Mosenthin, J. Zentek and T. Zebrowska (Eds.) Elsevier, October 2005
[21]
V. E. Prescott, et al, “Transgenic Expression of Bean r-Amylase Inhibitor in Peas Results in Altered Structure and Immunogenicity,” Journal of Agricultural Food Chemistry (2005): 53.
[22]
J.
Lexchin, L. A. Bero, B. Djulbegovic, and O. Clark, “Pharmaceutical
industry sponsorship and research outcome and quality: systematic
review,”
BMJ 326 (2003):1167–1176.
[23]
Mark Friedberg, et al, “Evaluation of Conflict of Interest in Economic Analyses of New Drugs Used in Oncology,”
JAMA 282 (1999):1453–1457.
Spilling the Beans is a monthly column available at
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.
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