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Is A Moratorium on Disease Management Company White Papers Warranted? If Not, Here Are 7 Guideline Rules

Posted Mar 12 2009 4:00pm
What’s up with disease management organizations and their ‘white papers?’ Typically paired with some inflated press release or a laudatory web site, these downloads (also labeled as ‘research,’) are typically engineered to convince the reader a novel and important advance is at hand. Capitalizing on the company’s supposed scientific ‘player’ status, we’re expected to believe that a ‘patented approach,’ or a ‘validated methodology’ or a ‘proprietary system’ backed by ‘industry leaders’ increases quality, saves money, attains physician buy-in and restores karma across the healthcare landscape. Alas, while there may be some exceptions, most of the time, those assertions are not supported by the data..

With the increasing visibility of the Disease Management Care Blog, it is fast becoming the target of company sponsored white papers, analyses, reviews and postings. It has generally avoided commenting on them because it has found many of the papers have astonishingly shallow research designs, truncated bibliographies and self-serving conclusions. Recall how disease management organizations published all that junk years ago? While the reviewers and editors finally caught up with them, like whack-a-moles, this pseudoscience still has a lingering safe zone on the web-pages of and spam-like email attachments from even some of the more reputable disease management companies.

Ah, you say, this is just the plain ol’ marketing, what’s the big deal and everyone does it? The big deal is that the disease management industry has a unique reputation for lousy analyses that have repeatedly violated multiple fundamental statistical and analytic rules. The audience of clinical leaders, policy makers, politicians’ aides, physicians and insurance executives has been sensitized to this and are likely to see these white papers for what they are: the same old garbage. As a result, these glossy faux articles paradoxically cause the industry to lose credibility. And since it’s not hard to find the old white papers out there, the arrival of even more makes the DMCB think there must be a manuscript zombies about, spreading their pestilence thanks to naïve marketing departments, poorly trained scientific writers and high level executives who are impatient with science and the pace of peer review.

The DMCB thinks the blow-back toxicity of the white papers run amok is enough to warrant a moratorium. The DMCB is humbly resigned, however, to the likelihood that the industry will not follow its recommendations. So, it offers up the DMCB Seven - If You Must - Rules to White Paper Management:

1. Think: is the scientific news that your company wants to share really so critically important that you can’t accommodate the peer review process? If it’s that important, many Journals will 'fast track' your findings. If it’s not that important, then it’s probably marketing, not a white paper. Treat it as such and don’t insult the intelligence of your customers by pretending otherwise.

2. There are some outstanding Journals that have an outstanding turn-around time with volunteer expert peer reviewers that can help sharpen the conclusions, spot inappropriate assertions and help you with a high acceptance rate. Your company won’t have to wait long to see its findings in print with all the advantages of a white paper with fewer gaffes.

3. If you must issue a white paper, strive to make it good enough to pass peer review anyway. In fact, it’s possible to submit it to a journal, skip the publication (though that’s very rude if they offer to take it) and use the reviewers’ comments to make the manuscript better.

4. The DMCB calls your bluff is you go with a white paper. Try using your readership as peer reviewers by open sourcing your (HIPAA compliant) data so that others can confirm your findings.

5. While you may believe your company is aided by claims of proprietary expertise, transparency is a stronger suit long term.

6. Minimize the involvement of sales and marketing until after the scientific writing is completed.

7. Think about getting involved with the PHI Institute. These guys have a process that helps companies assure that their in-house analyses follow the basic rules when it comes to correctly attributing causality between your program on one end that the observed outcomes at the other end.
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