Take Out the Trade Names If you think your conference attendees aren't as concerned as you are about commercial influence creeping into meeting content, think again. Dr. Eduardo Bruera, chairman, department of symptom control and palliative care, University of Texas M.D. Anderson Cancer Center in Houston, and two colleagues, noticed that trade names seemed to be popping up with increasing regularity.

To see if their perceptions were accurate, they analyzed the use of trade names at the World Congress on Pain, which is held every three years, organized by the International Association for the Study of Pain. They found that the proportion of abstracts containing a trade name increased from 19 percent in 1993 to 36 percent in 1999 - an 89 percent increase. Bruera and his colleagues, Carla Ripamonti, MD, National Cancer Institute, Milan, Italy; and Leaha Beattie-Palmer, also at M.D. Anderson, wrote a letter explaining their findings, which was published in the September 14, 2000, issue of The New England Journal of Medicine.

We asked Bruera to explain the possible impact of this trend on industry meetings.

Q: Why do you think the use of trade names in scientific sessions is increasing so dramatically?

A: The use of trade names seemed to be associated with two factors: the presence of a patented drug and part authorship by pharmaceutical companies.

Q: Why is the escalating use of trade names a concern?

A: The role of industry at scientific meetings has been reasonably well-defined. Traditionally, advertising did not take place in the scientific paper area - and it looks to us like this has changed in recent years.

It is in the best interest of the scientific organizations that run the congresses, as well as those who pay the registration fees, to avoid this slippery slope. We can eliminate the pressure on investigators and industries to try to make their trade name appear by clearly establishing that the use of trade names should not be allowed in poster and slide presentations. That would make the participants of the meeting more comfortable with the [meeting's] credibility. The other thing would be to make disclosure of industry support and participation mandatory.

Q: Under the Accreditation Council for CME's Standards for Commercial Support, such disclosure is required. The Standards also say that if trade names are used in presentations, those of several companies should be used.

A: I don't remember a single case where there was [more than one] trade name used. I have received several phone calls from meeting organizers and physicians who have observed similar things. We have regulated the educational components [of medical meetings], but we have not regulated enough the scientific paper presentation component.

Q: One of your findings that struck me is that trade names were used in 58 percent of abstracts describing more-expensive drugs, as compared to 10 percent of the time when describing less-expensive drugs.

A: One of the challenges that all our scientific organizing committees should address, because of the potential impact it may have on patient care, is the [potential for] tremendous over-representation of those more-expensive products.

We need to require our abstract and paper reviewers to use different criteria. Right now, we're slanted much more toward excellent methodology at the cost of content. Industry-sponsored research can be scientifically much better than [other] research because industry has more resources. Independent research which is of great quality, but which may not have same level of support, may not make it to the main presentation. If 90 percent of the meeting is clogged with methodologically excellent studies on one single agent, the ability of the meeting to impact patient care is decreased dramatically because other clinical problems end up not being covered. The scientific committee should be able to say, "We already have enough papers with this content. Let's be sure that other content is represented."

Q: Should meeting organizers worry about losing commercial support if they follow your suggestions?

A: I doubt it. A meeting that people feel is of great educational value and well-organized will always be attractive to industry.