Re-Check is very excited to contribute to the Preventing Overdiagnosis Conference 2018 in Copenhagen (#PODC2018) with a Poster in Conversation (#PODC2018Poster11) on Mapping Ghost Management in Medical Research and Public Health. We tested in threee case studies — breast cancer screening, HPV vaccines and oral contraceptives — a powerful hypothesis presented by Prof. Marc-André Gagnon at PODC2017. To know more about it, meet us on Tuesday 21th and Wednesday 22nd August 2018, at 8 AM, at the Preventing Overdiagnosing Conference in Copenhagen for a conversation on science, conflicts of interest, lobbying, ghost management and marketing. Coffee, danish pastries and Swiss chocolate provided!


Our abstract:

Mapping Ghost Management in Medical Research and Public Health

By Catherine Riva, Serena Tinari, Re-Check

Category: Other – Developing tools to investigate and identify the stakes that may lead to overdiagnosis and too much medicine

Objectives: At the Preventing Overdiagnosis Conference 2017, Marc-André Gagnon (Carlton University, Ottawa) built on the concept of ghost management in science (Sergio Sismondo) to develop a reflection on corporate capture and institutional corruption in the biopharmaceutical sector. He postulates that because of the current business model, the activity of pharmaceutical firms is more oriented towards producing influence on medical knowledge and social determinants of value, than towards producing innovative treatments. We wanted to verify the validity of this hypothesis by mapping the strategies and issues highlighted in three long-form Re-Check investigations on 3rd and 4th generation oral contraceptives, systematic breast cancer screening and HPV vaccines.

Method: Search for documents as well as for scientific and mainstream publications, FoIA requests, journalistic investigative methods, Re-Check evaluation grids and mapping tools.

Results: The mapping of our investigations confirms the hypothesis put forward by Gagnon. Our maps show ghost management at work in the case of these three health measures targeting healthy girls and women. Ghost management is practiced by the pharmaceutical industry, but also by other players in the health system (health authorities, regulatory authorities, research centers, NGOs) as soon as the stakes reach a critical size. Our maps illustrate how this “new model of science (…) drawing its authority from traditional academic science” (Sismondo) is an effective strategy for capturing the different levels identified by Gagnon: science, regulation, market, health professions, media, technology and civil society.

Conclusions: Re-Check mapping highlighting ghost management currently at work in medical research and public health confirms Gagnon’s hypothesis (Sismondo’s concept). Such methods deserve to be developed, enriched, validated and applied by academic research. They should also become part of an evaluation grid used by journalists investigating pharmaceutical companies and health system’s players: organizations devoted “to influence ideas and social structures in a way that maximizes commercial value” (Gagnon) and strengthens their position. The more investigations and academic research document the phenomenon, the better it may enable to develop solutions and transform institutional structures and medical practices to stem this endemic corruption.

DOI: 10.1136/bmjebm-2018-111070.105