PETER ROST: PHARMA MARKETING EXPERT WITNESS. AWP, MEDICAL DEVICE EXPERT.: JAMA editors spew venom over "nobody and a nothing" doctor. Senator Grassley, this story is for you.

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JAMA editors spew venom over "nobody and a nothing" doctor. Senator Grassley, this story is for you.

By David Armstrong, WSJ Health Blog

Editors of The Journal of the American Medical Association, better known as JAMA, can be a little thin-skinned when it comes to outsiders taking issue with studies published in the prestigious medical journal.

Jonathan Leo, a professor of neuro-anatomy at tiny Lincoln Memorial University in Harrogate, Tenn., posted a letter on the Web site of the British Medical Journal this month criticizing a study that appeared in JAMA last spring. The study concerned the use of the anti-depressant Lexapro in stroke patients. In addition to identifying what he said was an important omission in the paper — that behavioral therapy worked just as well as the drug when compared head to head in the study — Leo also pointed out that the lead author had a financial relationship with Forest Laboratories, the maker of Lexapro, that was not disclosed in the study.

Leo says he received an angry call from JAMA executive deputy editor Phil Fontanarosa last week, shortly after Leo’s article was published on the BMJ Web site. “He said, ‘Who do you think you are,’ ” says Leo. “He then said, ‘You are banned from JAMA for life. You will be sorry. Your school will be sorry. Your students will be sorry.” Fontanarosa referred a call for comment to a JAMA spokeswoman, who said Leo’s retelling of the conversation was “inaccurate.”

“He did talk to the guy, but he said he didn’t threaten him,” the spokeswoman said. “It was something along the lines of not setting a good example for students. He didn’t say he would be banned. He didn’t think Leo was taking a very good approach by taking this confidential process within JAMA out to media and another medical journal. It’s just not the way things are handled here.”

The call from Fontanarosa was followed up by ones from JAMA editor-in-chief Catherine DeAngelis to Leo’s superiors, Leo says. He said she asked his superiors to get him to retract his article in the BMJ. Leo says he decided to call DeAngelis directly to find out what, in particular, she might be objecting to. He said she was “very upset” but didn’t make specific complaints about the article.

In a conversation with us, DeAngelis was none too happy to be questioned about the dust-up with Leo.

“This guy is a nobody and a nothing” she said of Leo. “He is trying to make a name for himself. Please call me about something important.” She added that Leo “should be spending time with his students instead of doing this.”

When asked if she called his superiors and what she said to them, DeAngelis said “it is none of your business.” She added that she did not threaten Leo or anyone at the school.

Leo says he notified JAMA five months ago about the problem of the lead author not disclosing his financial relationship with Forest Labs. In this week’s edition of JAMA, a letter from the author, Robert Robinson, was published in which he acknowledged his financial relationship with Forest and apologized for the lack of disclosure.

“Although Forest Laboratories provided honoraria and expenses through their speakers’ bureau for Robinson, neither the design, analysis, or any of the expenses (including the cost of medications) of our study were supported by monies, materials, or any intellectual input from Forest Laboratories,” wrote Robinson, the head of the psychiatry department at the University of Iowa, and a co-author. “We sincerely regret this lack of transparency in our initial disclosures that resulted from these errors of memory.”

Robinson did not return a telephone message left at his office. Forest Labs said Robinson was a member of the company’s speaker’s bureau from 2004-2005. It would not say how much it paid him. In addition, Forest would not say if it has any research or other financial relationships with Robinson’s medical school.


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