Short Take on Understanding Bias

A recent commentary (Rosenbaum L. NEJM 2015; 372: 1959-63) adds a couple of new terms to my lexicon regarding bias.

The author notes that there have been multiple concerns regarding industry-sponsored studies.  For example:

  • Industry-sponsored studies are more likely than government-sponsored ones to have positive results
  • Physicians who attend symposia funded by the pharmaceutical companies subsequently prescribe the featured drugs at a higher rate

While the Physician Payment Sunshine Act requires drug and device companies to disclose payments over $10, she notes that the long-term effects of this transparency are unclear.  With increased transparency, there could be a “phenomenon called ‘moral licensing’: once disclosure gets off your chest, you feel liberated and may feel licensed to behave immorally.  A corollary concern” for the audience, is that this disclosure may be interpreted as a sign of honesty or a sign of expertise rather than as a warning of potential bias.

Two new terms for me:

  • “‘Self-serving bias’: when we stand to gain from reaching a certain conclusion, we unwittingly assimilate evidence in a way that favors the conclusion.”
  • Bias blind spot“: “Studies suggest that we’re far more likely to think that drug promotions influence our colleagues than that they affect our own behavior.”

The author cautions that anti-industry bias could be detrimental as well.  If having ties to industry lessens the opportunity for individuals to voice their support (or opposition) for new drugs or devices, it could bolster individuals who may “overstate the risks and understate the benefits of these new treatments.”

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