Drug giant Merck accused of deaths cover-up

By Jim Giles, New Scientist Magazine:

It is perhaps the biggest drug scandal of recent years. Before Merck withdrew Vioxx in 2004, the popular painkiller was linked to heart attacks in tens of thousands of people. Now researchers have alleged that Merck knew of the dangers years earlier, but tweaked statistics and hid data so that regulators remained in the dark.

Vioxx was a blockbuster drug for Merck in the 5 years it was on the market, generating billions of dollars in revenue. After it was linked to heart attacks and strokes, the firm pulled its product, and earlier this year Merck agreed to provide almost US$5 billion in compensation to those claiming to have been harmed.

But an analysis of documents released during the litigation process that led to that settlement, carried out by Richard Kronmal, a statistician at the University of Washington, Seattle, who acted as an expert witness in the Merck lawsuits, suggests that company scientists were aware of the problems well before 2004.

Internal report

Kronmal’s study, co-authored with colleague Bruce Psaty, focuses on a 2001 internal company report. In it, Merck staff describe two recently completed trials involving around 1000 patients on Vioxx and a roughly equal number taking a placebo. Thirty-four people taking the drug died, compared with just 12 on the placebo.

But when Merck submitted the results to the US Food and Drug Administration (FDA) the same year, the company analysed the data in a different way. Deaths that occurred after patients completed their course of Vioxx appear to have been removed from the results, even though the drug can cause problems after patients stop taking it. Removing the deaths reduced the risk attributed to Vioxx.

The studies still prompted the FDA to ask whether the risk associated with the drug was enough to warrant stopping another ongoing trial, but Merck replied that it wasn’t. According to documents cited by Psaty and Kronmal, the company described the increase in mortality – which its own report revealed to be threefold – as “small numeric differences… most consistent with chance fluctuations”.

A Merck statement, released to coincide with the Psaty and Kronmal paper, does not address the allegations in detail, but says that the company has analysed the trials and “found that there was no pattern suggesting the deaths had any connection to Vioxx; some of the deaths were caused by car accidents, poisonings, infections and other causes that are not related to Vioxx”.

The full set of documents released during the trials also contains details of other possible tactics employed by Merck. When a study suggested that Vioxx was more dangerous than a rival drug, for example, the company is alleged to have decided not to publish the results or properly inform the FDA.

Expert witness

David Egilman, a public health researcher and advocate at Brown University in Attleboro, Massachusetts, acted as an expert for Vioxx plaintiffs and has also analysed the internal documents. He says the documents contain descriptions of an experiment, known as Protocol 906, that compared the response of around 450 arthritis patients to Vioxx and Pfizer’s drug, Celebrex. The two drugs performed equally well, but the rate of side effects among Vioxx users – around 10% – was roughly twice that of those on Celebrex.

Egilman says the documents also contain an email in which a Merck employee tells a co-worker that “this is a very serious result and you will hardly be surprised by the idea of keeping this VERY TIGHT for the moment”.

Egilman adds that the results of Protocol 906 were never published or made clear to the FDA. Merck did not respond to a request from New Scientist for comment on Egilman’s analysis.

Critics say problems with data manipulation are due to intense pressure on drug companies to chase the multi-billion revenues generated by blockbuster drugs.

“It completely clouds your ethical responsibility,” says Merrill Goozner, director of the Center for Science in the Public Interest in Washington, D.C.

Journal reference:Journal of the American Medical Association (vol 299, p 1813)

In Praise of Bill Ayers: Courage and Conviction

By Dave Lindorff, CounterPunch:

The pundits are having a heyday with Hillary Clinton’s sleazy McCarthyite attack on Barack Obama during the April 16 debate, trying to link him to the Weather Underground because of his having served on a charity organization board with one of the Weathermen, Bill Ayers, who is currently a distinguished professor of education at the University of Illinois, and who is married to Bernadine Dohrn, another Weather Underground veteran.

What has them in a lather is Ayer’s comment, made a few years ago, that he has no regrets for the organization’s having set off several bombs back in the early 1970s, and that in fact they “should have set o[f]f more.”

(Incidentally, as Robert Parry notes, those comments were made before 9-11, not, as Hillary Clinton charged duplicitously in the April 16 Philadelphia debate, right after 9-11.)

In fact, it’s important to remember that while three members of the Weather Underground died at their own hands because of a failed bomb they were constructing, no one else died at their hands. The group scrupulously worked to make sure that their attacks were on property, not people.

It’s also important to remember that they were targeting a government that was engaged in a criminal war against a peasant country half a world away, that had killed nearly two million Indochinese people, most of them civilians, and that was well on the way to pointlessly sending 58,000 American troops to their deaths.

The actions of the Weather Underground may have been misguided and quixotic, but they were not terrorists in the sense of trying to cause mass terror among the American public, in the way that Al Qaeda terrorists or other terror groups indiscriminately attack civilians. They were much more carefully targeting the levers of power, and in effect, trying to “bring the war home.”

While many in the anti-war movement condemned the actions of the Weather Underground, I would argue that they, like the militant Black Panthers, performed an invaluable role by sending a loud, clear message to the nation’s ruling elite that if they continued the war, things would get worse at home.

Their actions made the peaceful mass protests against the Indochina War far more potent, because they forced the ruling elite in the US to have to ponder what would happen if those masses turned to the same kind of violent measures against them.

Ayers has long since earned the nation’s respect, whatever one may think of his youthful radicalism, by devoting his life to the challenge of helping educate those who have a hard time breaking the cycle of poverty and ignorance, which makes it obscene to criticize Obama for sharing a boardroom with him (Obama was 8 when Ayers was in the Weathermen back in 1970).

But Ayers and his comrades should also be honored for having been willing to go the extra mile and put their lives on the line to end a criminal war.

We could use that kind of courage and militancy today in the anti-war movement–if not in the form of another underground bombing campaign, then at least in the form of a willingness put bodies on the line to blockade and undermine an American imperial war machine that has chewed up the lives of tens of thousands of young Americans and killed over a million innocent Iraqis.

Five years into a war with no end in Iraq, it’s clear that just going about our business, and making periodic marches along the boulevards of Washington, New York or San Francisco is not enough.

Dave Lindorff is the author of Killing Time: an Investigation into the Death Row Case of Mumia Abu-Jamal. His book of CounterPunch columns titled “This Can’t be Happening!” is published by Common Courage Press. Lindorff’s newest book is “The Case for Impeachment”, co-authored by Barbara Olshansky. He can be reached at: dlindorff@yahoo.com

Don’t hold your breath: Obama would ask his AG to “immediately review” potential of crimes in Bush White House

Obama sez: “I think that impeachment is something that should be reserved for exceptional circumstances.” Well, duh! Isn’t this ruinous illegal war pretty exceptional?! Those in the Bush Crime Syndicate deserve nothing less than long prison sentences in striped pajamas. But of course the chance of that happening is zilch.

By Will Bunch, Philly.com:

Tonight I had an opportunity to ask Barack Obama a question that is on the minds of many Americans, yet rarely rises to the surface in the great ruckus of the 2008 presidential race — and that is whether an Obama administration would seek to prosecute officials of a former Bush administration on the revelations that they greenlighted torture, or for other potential crimes that took place in the White House.

Obama said that as president he would indeed ask his new Attorney General and his deputies to “immediately review the information that’s already there” and determine if an inquiry is warranted — but he also tread carefully on the issue, in line with his reputation for seeking to bridge the partisan divide. He worried that such a probe could be spun as “a partisan witch hunt.” However, he said that equation changes if there was willful criminality, because “nobody is above the law.”

The question was inspired by a recent report by ABC News, confirmed by the Associated Press, that high-level officials including Vice President Dick Cheney and former Cabinet secretaries Colin Powell, John Ashcroft and Donald Rumsfeld, among others, met in the White House and discussed the use of waterboarding and other torture techniques on terrorism suspects.

I mentioned the report in my question, and said “I know you’ve talked about reconciliation and moving on, but there’s also the issue of justice, and a lot of people — certainly around the world and certainly within this country — feel that crimes were possibly committed” regarding torture, rendition, and illegal wiretapping. I wanted to know how whether his Justice Department “would aggressively go after and investigate whether crimes have been committed.”

Here’s his answer, in its entirety:

What I would want to do is to have my Justice Department and my Attorney General immediately review the information that’s already there and to find out are there inquiries that need to be pursued. I can’t prejudge that because we don’t have access to all the material right now. I think that you are right, if crimes have been committed, they should be investigated. You’re also right that I would not want my first term consumed by what was perceived on the part of Republicans as a partisan witch hunt because I think we’ve got too many problems we’ve got to solve.

So this is an area where I would want to exercise judgment — I would want to find out directly from my Attorney General — having pursued, having looked at what’s out there right now — are there possibilities of genuine crimes as opposed to really bad policies. And I think it’s important– one of the things we’ve got to figure out in our political culture generally is distinguishing betyween really dumb policies and policies that rise to the level of criminal activity. You know, I often get questions about impeachment at town hall meetings and I’ve said that is not something I think would be fruitful to pursue because I think that impeachment is something that should be reserved for exceptional circumstances. Now, if I found out that there were high officials who knowingly, consciously broke existing laws, engaged in coverups of those crimes with knowledge forefront, then I think a basic principle of our Constitution is nobody above the law — and I think that’s roughly how I would look at it.

The bottom line is that: Obama sent a clear signal that — unlike impeachment, which he’s ruled out and which now seems a practical impossibility — he is at the least open to the possibility of investigating potential high crimes in the Bush White House. To many, the information that waterboarding — which the United States has considered torture and a violation of law in the past — was openly planned out in the seat of American government is evidence enough to at least start asking some tough questions in January 2009.

Canada Likely to Label Plastic Ingredient, Bisphenol-A, ‘Toxic’

By Ian Austen, New York Times:

The Canadian government is said to be ready to declare as toxic a chemical widely used in plastics for baby bottles, beverage and food containers as well as linings in food cans.

A person with knowledge of the government’s chemical review program spoke on the condition he not be named because of a confidentiality agreement. He said the staff work to list the compound, called bisphenol-a, or B.P.A., as a toxic chemical was complete and was recently endorsed by a panel of outside scientists.

A public announcement by Health Canada may come as early as Wednesday but could be delayed until the end of May. Canada would be the first country to make a health finding against B.P.A., which has been shown to disrupt the hormonal systems of animals. The department’s decision was first reported in The Globe and Mail, a Toronto newspaper, on Tuesday.

Also on Tuesday, a draft report from the United States Department of Health and Human Services’ National Toxicology Program endorsed a scientific panel’s finding that there was “some concern” about neural and behavioral changes in humans who consume B.P.A.

B.P.A. is widely used to make polycarbonate plastics, which are rigid and transparent like glass but very unlikely to shatter. Polycarbonates have many uses that pose no risk, like the cases of some iPod models. Because animal tests have shown that even small amounts of the chemical may cause changes in the body, however, researchers have focused on food- and drink-related applications of B.P.A., like the popular Nalgene brand beverage bottles.

“If the government issues a finding of toxic, no parent in their right mind will be using products made with this chemical,” said Rick Smith, the executive director of Environmental Defence, a Canadian group that has been campaigning against B.P.A. “We will be arguing strongly for a ban on the use of this chemical in food and beverage containers.”

The public and industry will have 60 days to comment on the designation once it is released, setting into motion a two-year process that could lead to a partial or complete ban on food-related uses of plastics made using B.P.A.

Alastair Sinclair, a spokesman for Health Canada, said, “When the minister has an announcement to make, he will make it.” Mr. Sinclair declined to answer any questions.

A spokeswoman for the Canadian Plastics Industry Association referred a request for comment to the American Chemistry Council in Arlington, Va. The council did not respond to interview requests.

Some scientists question the significance to humans of studies indicating that even very small amounts of B.P.A. can induce changes in animals. There is also some dispute about how much of the chemical is released by plastics.

Jack Bend, a professor of pathology at the University of Western Ontario in London and one of the Canadian government’s outside scientific advisers, declined to comment on what action Health Canada would take. But he said he was concerned about the widespread use of B.P.A.

“The first thing is that it’s an endocrine disrupter, there’s no question about that,” Professor Bend said, referring to the chemical’s impact on the hormonal system. “Should people that are exposed to these low levels of this chemical be outrageously concerned? I’d err on the side of not creating panic. We simply don’t know. But we should find out.”

Professor Bend added that the impact of B.P.A. on the development of human fetuses was worrisome. It may prove to cause damage in much the same way as early exposure to mercury, he said.

But Warren G. Foster, director of the center for reproductive care and reproductive biology at McMaster University in Hamilton, Ontario, is more skeptical.

“In my experience working with bisphenol-a, it’s a relatively benign chemical,” said Professor Foster, who once headed the reproductive toxicology group at Health Canada. “There’s room here for a lot more research.”

He added that substances could be declared toxic under Canada’s chemical management system if they had the potential for adverse effects in animals but not humans.

“If I was a fish and there was bisphenol-a in the water, I’d be concerned,” he said. “If I was a fetus and my mother was using a plastic water bottle, I wouldn’t be bothered.”

While the Canadian plastics association referred a reporter to Professor Foster, he said that he had no ties to it or the chemical industry.

The draft report released in the United States is effectively a call for further research on the chemical.

Michael D. Shelby, the director of the toxicology program’s center for the evaluation of risks to human reproduction, said he wanted to see further confirmation that the test results could be repeated and more data about the long-term consequences of exposure to the chemical.

But he said that research strongly suggested that polycarbonate food and beverage containers and food cans were the main source of human exposure to B.P.A. When asked if people should stop using them, Dr. Shelby replied: “That becomes kind of a personal choice. These are certainly two things people can get around.”

In a statement, the American Chemistry Council said the draft report “affirms that there are no serious or high-level concerns for adverse effects of bisphenol-a on human reproduction and development.”

CALIFORNIA COURT ORDERS SILENCING OF HOMEOWNER VOICE

By Peter Amherst, AHRC:

Freedom of Speech and the Housing Financial Crisis

Washington, California –

In what some observers claim is a shocking violation of the First Amendment, a California court has ordered the domain name of the most prominent voice for homeowners to be turned over to the biggest homeowner association law firm, Peters and Freedman. (Technically, the domain name is to be turned over to a homeowner association, but observers claim that the real party in interest is the law firm.)

For more than 10 years, the American Homeowners Resource Center has operated a website, www.ahrc.com, which has enabled homeowners who live in homeowner associations, both to learn about homeowner associations and to share their views and experiences. The thousands of articles on the website range from analyses of legislation to reports of abuse by homeowner association boards and their lawyers. In the process, it has earned the ire of some in the homeowner association industry.

Prominent among these is the law firm of Peters and Freedman, who claim to represent more than 700 homeowner associations in Southern California. Articles on the website have reported about their involvement in foreclosures. In one case, a condo owner, Melissa Colburn, filed a RICO action against them when she found that her condo had been sold from under her without any notice.

Despite admitting in her ruling that “plaintiff’s motives in seeking the domain name are likely mixed; i.e., that plaintiff is likely motivated in part by a desire to close down the web site”, Jane D. Myers , a lawyer employed as Commissioner by the Orange County Superior Court, ordered the web site to be turned over to them.

As the website gets over 100,000 hits a day (almost 3 million a month)and is recognized by search engines such as Google as being the number one wesbite devoted to homeowner associations, the commissioner’s ruling silences this independent voice.

At a time when the entire country is roiled by a financial crisis of incalculable proportions, some obvservers claim that the necessity of having independent voices which are beholden to none, is even more pressing. They point out that the so-called mainstream media missed the looming financial crisis in the same way as they missed the lack of evidence for the Iraq war.

As Congress grapples with ways to address the crisis which has shaken the very foundations of the American financial system, many argue that Congress needs to affirm – with legislation if necessary – the importance of the First Amendment. They say that vital, robust journalism is essential to America. If that vital, robust journalism is stifled in any way – such as the taking of the AHRC.com domain name by powerful corporate interests – crimes and abuses will go unreported.

Homeowner associations now represent a massive part of the U.S. economy. With over $35 trillion in housing stock, and more than 1 in 5 living in a homeowner association, they are integral to the economic health of the country. If they sneeze, the rest of the ecomony may get a cold.

Already, initial reports indicate that the foreclosure rate is highest in homeowner association housing. As the majority of new housing is now in homeowner associations – in fact, many cities now mandate that all new housing tracts have homeowner associations – a significant number of sub-prime mortgages were for this type of housing.

But, as AHRC has reported, another financial crisis is looming on the horizon. As the housing stock in homeowner associations ages, the need for repairs increases. However, in many areas, homeowner associations are woefully underfunded to meet these repair bills.

Some boards of homeowner associations have gone out and obtained loans from banks – for which they do not need homeowner approval – to fund these repairs. The homeowner association then issues a special assessment on each homeowner to pay for that loan. With many homeowners living on razor thin budgets, such increases are beyond their means. When this is coupled with dramatic declines in home values, especially when a homeowner owes more on their home than the home is worth, many homeowners will opt simply to walk away from the home.

This creates an even bigger inventory of unsold homes, which reduces the value of homes even more, and inevitably deepens the financial crisis. In other words, the crisis now begins to feed on itself, leading to the possibility that it will go into a tailspin. A recession then becomes a depression – and that spells disaster for the country.

Hence, the ramifications of a decision in a court case in California could be immense. AHRC has had the courage to publish without fear or favor the unblemished truth about lawyers, politicians, judges and others who have been involved in homeowner associations. To kill that voice sends an unmistakeable message to all similar voices that powerful corporate interests will be allowed to prevail – at the expense of the country.

Individuals and groups are urging Congress to take action to preserve fundamental First Amendment rights in the case of AHRC.com. They say that the founding fathers may not have got everything right in drafting the Constitution – but they got at least one thing right – the First Amendment.

USDA Accused Of Bullying Inspectors Who Reported Safety Violations

By Meg Marco, Consumerist.com:

First the FAA makes their own inspectors cry in front of Congress and now the Associated Press says that the head of the federal inspectors’ union is alleging that the USDA told him to “drop the matter” when he reported food safety violations at slaughterhouses. When he refused, he was placed on “disciplinary investigative status.”

The head of the union that represents 6,000 federal food inspectors told a congressional committee Thursday that the Agriculture Department tried to intimidate him and other employees who reported violations of regulations, an allegation denied by the agency.Union chief Stan Painter said that following a mad cow disease scare in 2003, he told superiors that new food safety regulations for slaughtered cattle were not being uniformly enforced. Painter said he was told to drop the matter, and when he didn’t, was grilled by department officials and then placed on disciplinary investigative status.

Painter said he was eventually exonerated, but the incident “has caused a chilling effect on others within my bargaining unit to come forward and stand up when agency management is wrong.” He said that supervisors tell workers to “let the system work” rather than cite slaughterhouses for violations.

Maybe we’re not getting enough rest at night, but isn’t having “inspectors” that “inspect” the slaughterhouses…

Well, um, isn’t that part of the system? The enforcement part? No?

The USDA’s spokesperson says they looked into Painter’s allegations and found no evidence to substantiate them.

The spokesperson also said that the recent (notorious) failure to uncover animal abuse was “not because of a lack of inspectors, adding that he believes the agency has enough to do the job effectively.” We’re not sure, however, whether that statement to the AP was accompanied by a Nancy Nord-style wink.

Union head claims USDA tried to intimidate employees [AP]

The Very Annoying Washington Post

By Robert Parry, Consortium News:

One of the many annoyances about living in George W. Bush’s Washington is to read the commentaries about the Iraq War on the editorial pages of the Washington Post. Possibly never in modern times has a major newspaper been more wrong, more consistently with more arrogance than has the Post on this vital issue.

Beyond getting almost nothing right – from the Post’s certitude over Iraq’s WMD to its reverence for Colin Powell’s U.N. testimony to its excitement over the purple-ink elections to its enthusiasm over whatever latest corner has been turned – the Post also has this obnoxious tendency to mock Americans who don’t share the paper’s wisdom.

One might have thought that editorial-page editor Fred Hiatt and the Graham family would have learned a few lessons in humility from their wretched record as cheerleader for what even many Republicans now acknowledge has been a disastrous war.

As Greg Mitchell, editor of Editor & Publisher, wrote in a column dated March 11, 2007:

“By now, nearly four years into the Iraq War and related controversies, one is tempted to simply disregard the Washington Post editorial page, and some of its regular columnists, on those matters: They have been so wrong on nearly everything for so long.” [See Mitchell’s new book, So Wrong for So Long.]

But self-criticism is not the Post’s way. Instead the editorial page is back again, mocking those who haven’t submitted to the new conventional wisdom about Bush’s courageous “surge” decision and its brilliant implementation by Gen. David Petraeus.

So, after Petraeus’s Senate testimony on April 8, Hiatt and his team were chortling about politicians – particularly Democratic presidential contenders Barack Obama and Hillary Clinton – who had doubted that the surge would turn the war around.

In its April 9 lead editorial, the Post noted that when Petraeus last testified in September 2007, “the military results of the U.S. troop surge in Iraq, though significant, were still so preliminary that much of the debate centered on whether they were real.”

When Petraeus and U.S. Ambassador Ryan Crocker returned this time, “the reduction of violence had been so great as to be undeniable. Sen. Barack Obama, who predicted that the surge would not slow the bloodshed, was among the Democrats who acknowledged yesterday that it had.”

The Post also was awed by the progress on Iraq’s political front.

“Gen. Petraeus and Mr. Crocker have gotten more confident about calling the surge a success, and rightly so,” the Post exclaimed.

Surge in Violence

It was almost as if the editorial had been written before the latest upsurge in violence and the outbreak of new political disorder in Iraq, with Shiite factions now battling among themselves as well as against Sunnis – with rockets raining down on the heavily fortified Green Zone and with casualties, including American dead, spiking.

The greatest “success” of the surge seemingly was to buy time for President Bush to run out the clock so he could end his presidency with roughly the same number of troops in Iraq as were there when the voters overturned the Republican congressional majorities in 2006.

It’s also clear that other developments – such as Sunni tribes accepting U.S. money not to shoot at American soldiers, Moqtada al-Sadr declaring a unilateral cease-fire for his Shiite militia, and de facto ethnic cleansing – also contributed to the drop in the horrendous levels of violence in 2006. But little of lasting substance actually had occurred.

Still, what was perhaps most galling about the Post’s editorial was its smug attitude that only Iraq War supporters respect the facts while the war’s critics are lost in their destructive partisan fantasies.

This up-is-down hubris has been a hallmark of Washington neoconservatives for years, especially as they constructed the make-believe world that has left 4,000 U.S. soldiers and hundreds of thousands of Iraqis dead. [For more on the neocons, see Robert Parry’s Secrecy & Privilege or Neck Deep.]

Yet, as the Post presents it, the neocons recognize the reality of success in Iraq, while the war’s critics insist on seeking cheap political gain.

The Post continued: “What hasn’t changed is the partisan debate over Iraq, which as Sen. Joseph I. Lieberman (I-Conn.) lamented, remains resistant even to established facts. … Democrats, including presidential candidates Sen. Hillary Rodham Clinton and Mr. Obama, remain locked within the ‘this war is lost’ prism the party adopted a year ago.”

But what also hasn’t changed is the Post’s disrespect for Americans who have been right much more often than the Post.

The newspaper never acknowledges how thoroughly wrong its editorial writers have been for so many years, never admits that war critics have been much closer to the mark than the Post’s “best and brightest” columnists, never shows the proper respect for dissent, and always suggests that to object to Bush’s open-ended war in Iraq is somehow unpatriotic or deranged.

At the end of the latest editorial, the Post favorably cites Ambassador Crocker’s opinion – that “an early or unconditional withdrawal would … invite disaster ‘with devastating consequences for the region and the world.’”

One might respond that the Post’s mindless enthusiasm for an aggressive, brutal war against a country that was not threatening the United States has, if nothing else, achieved exactly that – “devastating consequences for the region and the world,” not to mention the United States of America.

Robert Parry broke many of the Iran-Contra stories in the 1980s for the Associated Press and Newsweek. His latest book, Neck Deep: The Disastrous Presidency of George W. Bush, was written with two of his sons, Sam and Nat, and can be ordered at neckdeepbook.com. His two previous books, Secrecy & Privilege: The Rise of the Bush Dynasty from Watergate to Iraq and Lost History: Contras, Cocaine, the Press & ‘Project Truth’ are also available there. Or go to Amazon.com.

Merck Wrote Drug Studies for Doctors

Big pHARMa strikes again. Parents, think twice before injecting your children with Merck vaccines. Are they as “safe” as Vioxx?

By STEPHANIE SAUL, New York Times:

The drug maker Merck drafted dozens of research studies for a best-selling drug, then lined up prestigious doctors to put their names on the reports before publication, according to an article to be published Wednesday in a leading medical journal.

The article, based on documents unearthed in lawsuits over the pain drug Vioxx, provides a rare, detailed look in the industry practice of ghostwriting medical research studies that are then published in academic journals.

The article cited one draft of a Vioxx research study that was still in want of a big-name researcher, identifying the lead writer only as “External author?”

Vioxx was a best-selling drug before Merck took it off the market in 2004 over evidence linking it to heart attacks. Last fall, the company agreed to a $4.85 billion settlement to resolve tens of thousands of lawsuits filed by former Vioxx patients or their families.

The lead author of Wednesday’s article, Dr. Joseph S. Ross of the Mount Sinai School of Medicine in New York, said a close look at the Merck documents raised broad questions about the validity of much of the drug industry’s published research, because the ghostwriting practice appears to be widespread.

“It almost calls into question all legitimate research that’s been conducted by the pharmaceutical industry with the academic physician,” said Dr. Ross, whose article, written with colleagues, was published Wednesday in JAMA, The Journal of the American Medical Association. and posted Tuesday on the journal’s Web site.

Merck acknowledged on Tuesday that it sometimes hired outside medical writers to draft research reports before handing them over to the doctors whose names eventually appear on the publication. But the company disputed the article’s conclusion that the authors do little of the actual research or analysis.

The final work is the product of the doctor and “accurately reflects his or her opinion,” said a Merck lawyer, James C. Fitzpatrick.

And at least one of the doctors whose published research was questioned in Wednesday’s article, Dr. Steven H. Ferris, a New York University psychiatry professor, said the notion that the article bearing his name was ghostwritten was “simply false.” He said it was “egregious” that Dr. Ross and his colleagues had done no research besides mining the Merck documents and reading the published journal articles.

In an editorial, JAMA said the analysis showed that Merck had apparently manipulated dozens of publications to promote Vioxx.

“It is clear that at least some of the authors played little direct roles in the study or review, yet still allowed themselves to be named as authors,” the editorial said.

The editorial called upon medical journal editors to require each author to report his or her specific contributions to articles. “Journal editors also bear some of the responsibility for enabling companies to manipulate publications,” the editorial said.

JAMA itself published one of the Vioxx studies that was cited in Dr. Ross’s article.

In that case, in 2002, a Merck scientist was listed as the lead author. But Dr. Catherine D. DeAngelis, JAMA’s editor, said in a telephone interview on Tuesday that, even so, it was dishonest because the authors did not fully disclose the role of a ghostwriter.

“I consider that being scammed,” Dr. DeAngelis said. “But is that as serious as allowing someone to have a review article written by a for-profit company and solicited and paid for by a for-profit company and asking you to put your name on it after it was all done?”

Although the role of pharmaceutical companies in influencing medical journal articles has been questioned before, the Merck documents provided the most comprehensive look at the practice yet, according to one of the study’s four authors, Dr. David S. Egilman, a clinical associate medical professor at Brown University.

In the Vioxx lawsuits, millions of Merck documents were supplied to plaintiffs. Those documents were available to Dr. Egilman and Dr. Ross because they had served as consultants to plaintiffs’ lawyers in some of those suits.

Combing through the documents, Dr. Ross and his colleagues unearthed internal Merck e-mail messages and documents about 96 journal publications, which included review articles and reports of clinical studies. While the Ross team said it was not necessarily raising questions about all 96 articles, it said that in many cases there was scant evidence that the recruited authors made substantive contributions.

One paper involved a study of Vioxx as a possible deterrent to Alzheimer’s progression.

The draft of the paper, dated August 2003, identified the lead writer as “External author?” But when it was published in 2005 in the journal Neuropsychopharmacology, the lead author was listed as Dr. Leon J. Thal, a well-known Alzheimer’s researcher at the University of California, San Diego. Dr. Thal was killed in an airplane crash last year.

The second author listed on the published Alzheimer’s paper, whose name had not been on the draft, was Dr. Ferris, the New York University professor. Dr. Ferris, reached by telephone Tuesday, said he had played an active role in the research and he was substantially involved in helping shape the final draft.

“It’s simply false that we didn’t contribute to the final publication,” Dr. Ferris said.

A third author, also not named on the initial draft, was Dr. Louis Kirby, currently the medical director for the company Provista Life Sciences. In an e-mail message on Tuesday, Dr. Kirby said that as a clinical investigator for the study he had enrolled more patients, 109, than any of the other researchers. He also said he made revisions to the final document.

“The fact that the draft was written by a Merck employee for later discussion by all the authors does not in and of itself constitute ghostwriting,” Dr. Kirby’s e-mail message said.

The current editor of the journal Neuropsychopharmacology, Dr. James H. Meador-Woodruff, the chairman of psychiatry at the University of Alabama, Birmingham, said he was not the editor in 2005 but planned to investigate the accusations. “Currently, we have in place prohibitions against this,” Dr. Meador-Woodruff said.