Peter C. Gøtzsche

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Peter C. Gøtzsche (born 26 November 1949) is a Danish physician, medical researcher, and former leader of the Nordic Cochrane Center at Rigshospitalet in Copenhagen, Denmark. He co-founded and has written numerous reviews within the Cochrane collaboration. His membership in the organization was terminated by the Cochrane Collaboration’s Governing Board of Trustees on September 25, 2018[1][2]

Biography[edit]

After completing the gymnasium Gøtzsche studied science graduating as Master of Science in biology and chemistry in 1974.[3] He worked briefly as a teacher. In 1975 he took a job in the pharmaceutical industry as a drug representative for the Astra AB; several months later he became a product manager.[4] In 1977 Gøtzsche took a position at Astra-Syntex and was responsible for clinical trials. While at Astra-Syntex he started to study medicine and graduated as a physician in 1984.[3] He worked at hospitals in Copenhagen 1984-95. He co-founded with Sir Iain Chalmers and about 80 other investigators The Cochrane Collaboration in 1993. The same year he established The Nordic Cochrane Centre. In 2010, Gøtzsche was named Professor of Clinical Research Design and Analysis at the University of Copenhagen.[3] In 2017, he was elected a member of the Governing Board of Cochrane.

Research and reviews[edit]

Among his research findings are that placebo has surprisingly little effect[5][6][7] and that many meta-analyses may have data extraction errors.[8] Gøtzsche and his coauthors have at times criticized the research methods and interpretations of other scientists, e.g. in meta-analysis of placebo.[9][10]

Gøtzsche has commented on meta-analysis,[11] and the editorial independence of medical journals.[12] He has written about issues surrounding medical ghostwriting with the position that it is scientific misconduct.[13] He has also criticized the widespread use of SSRI antidepressants.[14]

Critique of mammography screening[edit]

Gøtzsche has been critical of screening for breast cancer using mammography, arguing that it cannot be justified; his critique has caused controversy.[15] His critique stems from a meta-analysis he did on mammography screening studies and published as Is screening for breast cancer with mammography justifiable? in The Lancet in 2000.[16] In it he discarded 6 out of 8 studies arguing their randomization was inadequate.

In 2006 a paper by Gøtzsche on mammography screening was electronically published in the European Journal of Cancer ahead of print.[17] The journal later removed the paper completely from the journal website without any formal retraction.[18] The paper was later published in Danish Medical Bulletin with a short note from the editor,[19] and Gøtzsche and his coauthors commented on the unilateral retraction that the authors were not involved in.[20]

In 2012 his book Mammography Screening: Truth, Lies and Controversy was published.[21] In 2013 his book Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare was published.[22]

Critique of reviews of HPV vaccine[edit]

At the behest of the Danish Health and Medicines Authorities the European Medicines Agency (EMA) was charged to review data in women concerning use of HPV vaccines and the possible development of rare side effects, namely Complex Regional Pain Syndrome (CRPS) and Postural Orthostatic Tachycardia Syndrome (POTS). EMA's review was issued in November 2015 and found no causal relationship.[23][24] Louise Brinth, a Danish physician who had published observational studies on POTS, subsequently critiqued the EMA review in a detailed rebuttal.[25] Gøtzsche supported her and issued a formal complaint to the EMA criticizing their report in May 2018.[26]

Gøtzsche et al. also found faults with a 2018 Cochrane review of the HPV vaccine.[27] The review had judged the vaccine as effective and did not find an increased risk of serious adverse effects.[28]

Expulsion from Cochrane[edit]

Gøtzsche who had been elected to the Governing Board in 2017[29] was expelled from the Board and the organization after a 6 to 5 vote of the 13-member board at the annual meeting at Edinburgh, Scotland in September 2018.[30] The Board announced the step on September 26 expelling Gøtzsche because of an "ongoing, consistent pattern of disruptive and inappropriate behaviours ..., taking place over a number of years, which undermined this culture and were detrimental to the charity’s work, reputation and members."[2] The Board had also commissioned a legal review of his activities in the context of his relationship to Cochrane and found transgressions.

Gøtzsche, critical of big pharma and its influence on medicine, expressed concern about "growing top-down authoritarian culture and an increasingly commercial business model” at Cochrane that "threaten the scientific, moral and social objectives of the organization”"[29] After the expulsion, four members of the Board resigned and two had to leave to restore a balance between appointed and elected members throwing the organization into turmoil.[30]

Gerd Antes of Cochrane Deutschland interpreted the situation as a "governance crisis" and called for "the strict orientation on the objectives and fundamental principles of Cochrane" naming "(s)cientific rigour, knowledge with minimal bias, maximum trust and consistent safeguarding against interest-driven influence on the evidence" as primary .[31]

Books[edit]

  • Peter C. Gøtzsche; Henrik R. Wulff (2007). Rational Diagnosis and Treatment: Evidence-based Clinical Decision-making (4th ed.). John Wiley & Sons. ISBN 9780470723685.
  • Peter C. Gøtzsche (2012). Mammography Screening: Truth, Lies and Controversy. Radcliffe Publishing. ISBN 9781846195853.
  • Peter C. Gøtzsche; Richard Smith; Drummond Rennie (2013). Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare. Radcliffe Publishing. ISBN 9781846198847.
  • Peter C. Gøtzsche (2015). Deadly Psychiatry and Organised Denial. People's Press. ISBN 978-87-7159-623-6.

Reports[edit]

References[edit]

  1. ^ Vesper, Inga (17 September 2018). "Mass resignation guts board of prestigious Cochrane Collaboration". Nature. doi:10.1038/d41586-018-06727-0. open access publication – free to read
  2. ^ a b Cochrane's Governing Board (September 26, 2018). "Statement from Cochrane's Governing Board – Wednesday 26th September 2018". Cochrane Nordic. Retrieved November 5, 2018.
  3. ^ a b c Archived biography of Nordic Cochrane
  4. ^ Peter Gøtzsche (2013). Deadly Medicines and Organized Crime. CRC Press. p. 14ff. ISBN 978 1846198847.
  5. ^ Asbjørn Hróbjartsson & Peter C. Gøtzsche (January 2002). "Hvad er effekten af placebobehandling? En systematisk oversigt over randomiserede kliniske forsøg med placebobehandlede og ubehandlede patienter [What is the effect of placebo interventions? A systematic review of randomised trials with placebo treated and untreated patients]". Ugeskrift for Læger. 164 (3): 329&ndash, 333. PMID 11816328.
  6. ^ Hróbjartsson, Asbjørn; Gøtzsche, Peter C. (2010-01-20). "Placebo interventions for all clinical conditions". The Cochrane Database of Systematic Reviews (1): CD003974. doi:10.1002/14651858.CD003974.pub3. ISSN 1469-493X. PMID 20091554.
  7. ^ A. Hróbjartsson & P. C. Gøtzsche (August 2004). "Is the placebo powerless? Update of a systematic review with 52 new randomized trials comparing placebo with no treatment". Journal of Internal Medicine. 256 (2): 91–100. doi:10.1111/j.1365-2796.2004.01355.x. PMID 15257721.
  8. ^ Peter C. Gøtzsche; Asbjørn Hróbjartsson; Katja Maric; Britta Tendal (July 2007). "Data Extraction Errors in Meta-analyses That Use Standardized Mean Differences". JAMA. 298 (4): 430&ndash, 437. doi:10.1001/jama.298.4.430. PMID 17652297. There is an error in the article. Comments:
  9. ^ Asbjørn Hróbjartssona & Peter C. Gøtzsche (April 2006). "Unsubstantiated claims of large effects of placebo on pain: serious errors in meta-analysis of placebo analgesia mechanism studies". Journal of Clinical Epidemiology. 59 (4): 336–338. doi:10.1016/j.jclinepi.2005.05.011. PMID 16549252.
  10. ^ Asbjørn Hróbjartsson, Peter C. Gøtzsche (2007). "Powerful spin in the conclusion of wampold et al.'s re-analysis of placebo versus no-treatment trials despite similar results as in original review". Journal of Clinical Psychology. 63 (4): 373&ndash, 377. doi:10.1002/jclp.20357. PMID 17279532.
  11. ^ Peter C. Gøtzsche (September 2000). "Why we need a broad perspective on meta-analysis". BMJ. 321 (7261): 585&ndash, 586. doi:10.1136/bmj.321.7261.585.
  12. ^ Peter C. Gøtzsche (2008). "Ytringsfrihed og redaktionel uafhængighed: Fire fyringer og en kafkask proces" (PDF). Ugeskrift for Læger. 170 (18): 1537. Archived from the original (PDF) on 2011-08-07.
  13. ^ Peter C. Gøtzsche; Jerome P. Kassirer; Karen L. Woolley; Elizabeth Wager; Adam Jacobs; Art Gertel; Cindy Hamilton (2009). "What Should Be Done To Tackle Ghostwriting in the Medical Literature?". PLoS Medicine. 6 (2): e1000023. doi:10.1371/journal.pmed.1000023. PMC 2634793. PMID 19192943.
  14. ^ Gotzsche, Peter (30 April 2014). "Psychiatric drugs are doing us more harm than good". The Guardian. Retrieved 25 November 2014.
  15. ^ Donald G. McNeil, Jr. (2002-04-09). "CONFRONTING CANCER: SCIENTIST AT WORK -- PETER GOTZSCHE; A Career That Bristles With Against-the-Grain Conclusions". New York Times.
  16. ^ Peter C. Gøtzsche; Ole Olsen (January 2000). "Is screening for breast cancer with mammography justifiable?". The Lancet. 355: 129+. doi:10.1016/S0140-6736(99)06065-1.
  17. ^ Zahl, PH; Gøtzsche, PC; Andersen, JM; Mæhlen, J (March 2006). "WITHDRAWN: Results of the Two-County trial of mammography screening are not compatible with contemporaneous official Swedish breast cancer statistics". European Journal of Cancer. doi:10.1016/j.ejca.2005.12.016. PMID 16530407.
  18. ^ Kerry Grens (December 2006). "Mammography article withdrawal sparks dispute". The Scientist.[permanent dead link]
  19. ^ Per-Henrik Zahl; Peter C. Gøtzsche; Jannike Mørch Andersen; Jan Mæhlen (November 2006). "Results of the Two-County trial of mammography screening are not compatible with contemporaneous official Swedish breast cancer statistics". Danish Medical Bulletin. 53: 438&ndash, 440. doi:10.1016/j.ejca.2005.12.016. PMID 16530407. Archived from the original on June 21, 2007.
  20. ^ Peter C Gøtzsche; Jan Mæhlen; Per-Henrik Zahl (November–December 2006). "What is a publication?". The Lancet. 368 (9550): 1854&ndash, 1856. doi:10.1016/S0140-6736(06)69756-0.
  21. ^ Gøtzsche, Peter C (2012). Mammography Screening: Truth, Lies and Controversy. Milton Keynes: Radcliffe Publishing Ltd. p. 400. ISBN 978-1-84619-585-3. Archived from the original on 2012-05-27.
  22. ^ Gotzsche, Peter (2013). Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare. Radcliffe. ISBN 9781846198847.
  23. ^ HPV vaccines: EMA confirms evidence does not support that they cause CRPS or POTS, 5. November 2015
  24. ^ HPV vaccines: EMA confirms evidence does not support that they cause CRPS or POTS. (PDF; 94 kB) 20. November 2015
  25. ^ Louise Brinth: Responsum to Assessment Report on HPV-vaccines released by EMA November 26th 2015., online (PDF; 1,3 MB)
  26. ^ Nordic Cochrane Center: Complaint to the European Medicines Agency (EMA) over maladministration at the EMA (PDF) , vom 26. Mai 2016.
  27. ^ Jørgensen L, Gøtzsche PC, Jefferson T.: The Cochrane HPV vaccine review was incomplete and ignored important evidence of bias. BMJ Evidence-Based Medicine 2018; 23, S. 165-168, DOI:10.1136/bmjebm-2018-111012
  28. ^ Arbyn M, Xu L, Simoens C, Martin-Hirsch PPL: Prophylactic vaccination against human papillomaviruses to prevent cervical cancer and its precursors. Cochrane Database of Systematic Reviews 2018, Issue 5. Art. No.: CD009069. DOI:10.1002/14651858.CD009069.pub3.
  29. ^ a b Peter Gøtzsche (September 17, 2018). "A letter from Peter C Gøtzsche (this is an open letter initially published by Nordic Cochrane)". Nexusnewsfeed. Retrieved November 11, 2018.
  30. ^ a b Martin Enserink (September 16, 2018). "Evidence-based medicine group in turmoil after expulsion of co-founder". Science. doi:10.1126/science.aav4490. Retrieved November 5, 2018.
  31. ^ Gerd Antes (September 25, 2018). "Cochrane in the media: Explanation of contradictions and conflicts". Cochrane Deutschland. Retrieved November 11, 2018.

External links[edit]