Authority, Business Models, Controversial Topics, Economics, Ethics, Research, Social Role

Pulling the Wool Over Their Eyes — The PubMed National Advisory Committee and Conflicts of Interest

Suit by Kniže in Vienna's I. district

Suit by Kniže in Vienna’s I. district (Photo credit: Wikipedia)

Advisory committees can help an organization navigate difficult terrain, bringing their members’ unique expertise and perspectives to bear on particularly thorny problems — or they can be window dressing. Worse, if these invited advisors aren’t accorded the respect they deserve, members can suffer from “the mushroom effect.”

Ideally, advisors are well-informed about matters going on both inside and outside of the organization, are managed so that they avoid conflicts of interest, and rotate membership in a transparent and regular way.

However, if management handpicks members, exploits term limit loopholes, keeps important secrets from its advisory group, and abuses conflicts of interest instead of preventing them, an advisory committee or similar group can be considered to have been severely compromised.

The PubMed Central (PMC) National Advisory Committee (NAC) is described thusly:

The PubMed Central National Advisory Committee advises the Director, NIH, the Director, NLM, and the Director, NCBI, on the content and operation of the PubMed Central repository. It is responsible for monitoring the evolution of PubMed Central and ensuring that it remains responsive to the needs of researchers, publishers, librarians and the general public. The committee meets at least once a year at the National Library of Medicine. Committee members are appointed by the NIH Director from the biomedical and information communities and the general public.

Federal employees ultimately manage these advisory committees. As federal employees, they are required to abide by conflict of interest rules promulgated by the US Office of Government Ethics. When it comes to using their position and government resources, the government states:

The public may lose confidence in the integrity of Government if it perceives that an employee is using public office to serve a private interest, and it expects that Government information, property, and time (including the time of a subordinate) will be used to serve the public’s interests. Accordingly:

  • An employee is required to act impartially.
  • An employee may not make improper use of Government position, title, or authority.
  • An employee may not use Government property, nonpublic information, or time (including the time of a subordinate) for other than authorized purposes.

. . .

Executive branch employees may not use their Government positions to suggest that the agency or any part of the executive branch endorses an organization (including a nonprofit organization), product, service, or person.

Documents obtained from the Web and via a Freedom of Information Act (FOIA) request suggest that PMC NAC members are not currently being appointed by the NIH Director; that in at least one case a departing member was asked to handpick his successor without any review; that this successor was allowed to come from the same organization as the departing member; and that management at the National Library of Medicine (NLM) and the National Center for Biotechnology Information (NCBI) kept activities with this NAC member’s organization secret from the public — and the PMC NAC — despite these activities using US government resources in a questionable manner.

The role of the PMC NAC’s Wellcome Trust members is of particular interest in discussing conflicts of interest at PMC, given the extraordinary treatment eLife received last year and the degree to which employees of the US government coordinated activities with employees of Wellcome Trust, a UK-based charity, in planning various activities.

Wellcome Aboard
From 2005 until the end of last month (January 31, 2013), there was a member from Wellcome Trust on the PMC NAC. Wellcome had a longer tenure on the NAC than any other organization, and by allowing an outgoing Wellcome member to handpick his successor from his organization in 2008, Wellcome locked up two consecutive terms on the NAC.

Wellcome Trust first appears in the NAC minutes in 2003, where it is mentioned as providing support for back issue scanning projects. There are reports in 2004 minutes about similar involvement by Wellcome as a supporter of open access (OA) and PMC initiatives. Robert Kiley of Wellcome appears as a member of the NAC at the first meeting of 2005. He would become Chair of the NAC in 2007. As with all other PMC NAC minutes, there is nothing recording nominations of new members, aside from one mention in 2005, when six members left the NAC, and it was noted that “nominations for six new members have not been given clearance at this time but NCBI will be notified upon approval.”

In 2008, Kiley’s term on the PMC NAC was approaching its end. Instead of a call for new members, Kiley was allowed to handpick his replacement, as this email between Ed Sequeira of PMC and Chris Bird of Wellcome, from July 21, 2008, shows:

I believe you know that Robert’s term on the PMC advisory committee runs out at the end of this year. He mentioned recently that you’d be willing to join the committee in his stead. We’d be very happy if you would and I’m writing to confirm your interest. Though it’s possible to have two meetings a year, I think we’ll be continuing our recent trend of just one — around may or june.

If you’re game to take this on, could you send me a CV whenever it’s convenient? After that, our committee management person, Christine Ireland, will get in touch with you about the pile of forms you need to complete, and then you should be done.

Thanks and best wishes

Ed

Bird replies a few days later, on July 24, 2008:

Hi Ed

I would be pleased to serve on this committee. Do you mean a full CV or more of a short bio?

Thanks

Chris

Beyond this, nothing much more was done to identify new members for the NAC. In this email from November 18, 2008, Christine Ireland expresses concern about a lack of activity to Sequeira:

Greetings–

As you know, the PubMed membership rotates on January 31, 2009. I still haven’t received the nominations for this slate — which are now extremely overdue. Please let me know when the nomination forms and current CV’s will be sent to me. If you have names now that you’d like me to check, I’d be glad to do so this week. I’ll be on vacation next week.

THANKS,

Christine

(For those who believe that there isn’t widespread confusion between PubMed, PMC, and MEDLINE, here is a nice example of PMC being described as “PubMed” by an NLM employee.)

Sequeira sends an inquiry to Lipman about 30 minutes later:

David

Sorry to bug you, but you were going to come up with some names.

I’ve attached our most recent correspondence on the subject. The current membership list is at http://www.pubmedcentral.nih.gov/about/nac.html.

Thanks

Ed

Apparently without a response from Lipman, Sequeira responds to Ireland the next morning:

Christine

Yes, I’m aware that these are way overdue and I’ve been working with David Lipman on coming up with names. The only definite one we have currently is Chris Bird from Wellcome Trust in the UK.

The Director of the NIH isn’t involved, and they’re at the eleventh hour, with Lipman being asked to create a slate. The only nominee at this point is one handpicked by an outgoing member, who recommended a person from the same organization — an organization that will create definite conflicts of interest for the NAC in a few years.

Current and former NAC members asked via email said they had never been involved in recommending or selecting new members. Federal rules around advisory committees note that “[a]gency officials, members of Congress, the general public, or professional societies or current and former committee members may nominate potential candidates for membership on a committee.” In the case of the PMC NAC, the only indication we have of a member being asked for a nomination is the first Wellcome member, who nominated his co-worker.

Coincidentally, Kiley is now chair of Europe PubMed Central, formerly UK PMC. Wellcome’s involvement in PMC activities continues.

But what occurred while there were Wellcome Trust employees on the PMC NAC is the issue here.

Compounding Conflicts of Interest
As soon as Wellcome announced eLife, the US government employees managing the PMC NAC should have been acutely aware that there was a potential conflict of interest brewing. There were plenty of warnings. For instance, eLife Sciences Publications LTD filed as a non-profit in Delaware in October of 2011, yet the email address used to request special treatment for eLife in March 2012 came from a Wellcome email address. The ties between eLife and Wellcome were obvious.

Despite these and many other clear warnings of looming problems with conflicts of interest, I’ve seen no evidence that it was ever discussed. Instead, the conflict was acted upon — eLife was given unprecedented access to PMC infrastructure while its inclusion in PMC and PubMed were expedited. All this was done for eLife in approximately seven business days, without having published any content, demonstrated the ability to accept submissions, or presented any content to the NLM for evaluation.

Of course, the world did not yet know this, nor did the PMC NAC. With Lipman as Executive Secretary of the PMC NAC, and the conflicts above secretly brewing in the background, his role in what happened next is illustrative.

The June 2012 PMC NAC agenda included, for the first time in its history, a speaker from a specific new publishing initiative. In this case, the recipient of that unprecedented invitation was Mark Patterson — the very same person who in February 2012 requested that eLife be published via PMC, who worked with NLM staff to craft eLife promotional wording, who asked NLM for help to communicate with PeerJ about the special treatment eLife had received, and who was employed at Wellcome as he advocated for eLife in early 2012.

Patterson was asked to speak via videoconference. At this time, it was known that eLife was an initiative supported by Wellcome Trust. However, nowhere in the minutes is it noted that Patterson mentioned that PMC had already agreed to publish eLife content early, or that eLife had been expedited into PMC and PubMed. When it comes to publishing platforms, Patterson only mentions eLife’s contracts with eJournal Press and HighWire Press.

Lipman was also present at the meeting, and himself made no mention of what he knew was going on.

In the minutes, Lipman speaks about early discussions with eLife, perhaps tipping his hand a little, and provides eLife with his opinion of how they should run their business.

So who invited this exceptional talk to the PMC NAC?

On May 14, 2012, Lipman emailed Kiley at Wellcome:

Hi Robert –

We were hoping to get a presentation on elife from someone at HHMI for the upcoming PMC Advisory Committee meeting in June. Who would you suggest I contact about this there?

Reading between the lines of this and other related emails, I’m speculating that Lipman wanted someone from the Howard Hughes Medical Institute (HHMI) to give the presentation primarily for logistical reasons — it was mid-May for a June meeting, time was short, and HHMI is in the US. You can see in the emails that the PMC team was scrambling to put together an NAC agenda and get speakers. Based on what transpired, the reason to get a speaker from HHMI apparently wasn’t to help with any perceptions around conflicts of interest. I have found no emails to HHMI about an eLife presentation, for instance, and no email produced so far shows any concern on Lipman’s part about real or perceived conflicts of interest.

On May 16, 2012, at 9:27 a.m., Lipman emails Kent Smith at the NCBI, with a cc to Sequeira:

Mark can do this.

10AM EDT would work.

What kind of video conf set up?

Did Kiley facilitate getting Patterson to speak? There is no evidence, but there is no evidence of any other path being pursued. Unbeknownst to its members, the PMC NAC ended up receiving a presentation from the same eLife representative who first asked NLM for special treatment, sending the request from a Wellcome email account. In setting this presentation up, Lipman knew full well the NLM had bent or broken rules to expedite the inclusion of eLife in PMC and PubMed, and would soon be publishing eLife on PMC, giving this new journal a major market edge. Lipman also knew the PMC NAC had a member from Wellcome aboard who was selected by his Wellcome predecessor. Finally, Lipman knew that the PMC NAC had no idea all this is going on, and Patterson seems complicit in keeping the secret.

At the presentation in question, as has been noted elsewhere, Lipman gave Patterson advice about potential business models, as well.

A Promise of Continuation
As noted above, Kiley rotated off the PMC NAC after 2008, with Bird taking his place as the Wellcome representative. There are term limits on the PMC NAC, as there should be. The goal of term limits is to ensure diversity, and also to help avoid the perception (and reality) of cronyism or favoritism. By filling Kiley’s spot with another Wellcome employee, Lipman and Sequiera were not honoring the spirit of term limits, in my opinion. They were ensuring that there was a Wellcome employee on the PMC NAC for double the usual term.

Continuity with Wellcome representatives comes up again in routine communications. Letters from Lipman to departing NAC members dated February 27, 2009, reveal an interesting contrast in their final paragraphs.

In two of the three letters, the final paragraph reads:

I’ve enjoyed having you on the committee and am pleased to forward the enclosed certificate to you as a memento of your contribution.

However, in the letter to Kiley, the final paragraph is a bit different:

It has been a pleasure having you on the committee and I know I will continue to enjoy working with you. In the meantime, I’m pleased to forward the enclosed certificate to you as a memento of your contribution.

While perhaps an innocuous acknowledgement of how Wellcome works in the OA space and the long association between Kiley and Lipman, the phrase “I know I will continue to enjoy working with you” takes on a slightly different meaning when the entire story of eLife is included — how it was expedited into PMC by Lipman, how Kiley possibly helped get Patterson on the agenda for the June 2012 meeting, how Kiley selected his successor on the PMC NAC as part of keeping a Wellcome representative on the PMC NAC, and how eLife was able to use PMC as its primary publisher for months at no charge.

It Takes Two to Tango
Yesterday, at the Professional and Scholarly Publishers (PSP) meeting in Washington, DC, Randy Schekman, editor-in-chief of eLife, was asked about the posts of the past couple of days. According to multiple sources, he said that eLife had done nothing wrong in requesting early publication on PMC, and that they just followed Lipman’s lead.

I think Schekman is incorrect, based on the evidence accumulated thus far (recall that Patterson was managing executive editor of eLife even when he was sending emails from a Wellcome account):

  • Patterson approached the NLM for preferential treatment, before eLife had even obtained a functional domain.
  • Patterson’s request went beyond “please help us get indexed immediately” – which would have been improper but less inflammatory. It was a request for pre-publication support, specifically to give eLife a competitive advantage.
  • Patterson requested promotional support from an NIH employee.
  • Patterson worked with an NLM employee on the introductory editorial for eLife, and accepted changes that obfuscated the deal they’d worked out.
  • Patterson coordinated with this same NLM employee to craft responses to questions from PeerJ about fairness.
  • Patterson concealed the sweetheart deal PMC gave eLife from the PMC NAC, despite giving an extensive presentation that touched on hosting solutions.

In short, between Kiley and Patterson, Wellcome and eLife employees worked to orchestrate unfair advantages, leverage their insider status with PMC to get help others could not, operationalize conflicts of interest, use their insider advantages for months on end, keep secrets from the PMC NAC and others, and conspire with NLM employees to deflect questions when they came.

Schekman would be better off acknowledging that his people were not innocent bystanders. They were instigators, participants, and accomplices.

It takes two to tango.

Conflicts of Interest Are Perceived Conflicts
To manage conflicts of interest, an organization has to manage the appearance of conflicts, which can exist once the potential for acting on that conflict exists. The definition of a conflict of interest utilized by the Institute of Medicine’s Committee on Conflict of Interest in Medical Research, Education, and Practice, and published on an NIH Web site (hosted at NCBI), underscores this:

A conflict of interest is a set of circumstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by a secondary interest.

Lipman seems to have a particular blind spot when it comes to conflict of interest. In addition to what we’ve seen so far, there’s the fact that Lipman is the editor-in-chief of a BioMed Central journal (Biology Direct). Another NCBI employee is his equal on the same journal. Vitek Tracz, founder of BioMed Central, was on the PMC NAC at the beginning. Tracz also founded Faculty of 1000, whose F1000 Research was recently accepted into PMC, despite not being a journal and having some questionable practices around acceptance and peer-review.

It’s not clear if Lipman is receiving compensation from BMC for his editorial work there, but the perception of a conflict is real and multi-faceted — BMC (Tracz) to PMC (NAC) to BMC (Lipman) to PMC (F1000 Research). There seems to be a lot of back scratching going on.

Abuse of Position
All of these behaviors seem to add up to a series of abuses of position and government resources — secret deals with non-US charities to help them launch a new publication business; using the PubMed indexing that comes with inclusion in PMC to tacitly endorse eLife while violating published procedures to do so; and failing to act impartially, but rather repeatedly acting in a manner that sought to provide advantages to select initiatives. And there are other conflicts in plain sight.

Conclusion
PMC and the NCBI are competing with publishers, competing with technology companies, advising emerging publishers on business matters, selectively helping some publishers while making life difficult for others, mismanaging their conflicts of interest, refusing to answer legitimate questions, keeping their advisory group in the dark, and violating their own stated role by becoming a publisher when the right person asks.

Perhaps the most memorable example of how far things went came in the email published Wednesday between Sequeira (of NCBI) and Patterson (of Wellcome and eLife), which I’ve reproduced below:

Thanks for letting me have a look at this. . . . My reaction to the editorial: Now that we know for sure that you love us, we’d like you to pretend that we’re complete strangers in public.

Seriously, we’d like to play down the idea that there’s anything special about what you’re doing in PMC. Chris Kelly, who manages PMC production, is constantly fending off publishers — generally new, small journals — who push to get into PMC as early as possible because it raises their credibility and, often, their chances of survival. . . . And it’s not just the little guys. We’d had people like Peter Ashman at BMJ complain about inequitable treatment in a slightly different context.

I’m comfortable justifying what we’re doing with eLife, but anything you publish that presents this as a special deal could complicate our life greatly.

In this email, Sequeira is acknowledging favoritism, bias, and shame. In short, he knows there is a conflict of interest, and is hoping to sneak through it by downplaying it. And he’s working with Wellcome and eLife to do so.

We’ve placed a lot of trust in the NLM, NIH, and PMC over the years. However, it’s time to reassess. Their actions have become competitive, anti-competitive, and unreliable. There is a significant management problem somewhere in those organizations, both in people and processes. The PMC NAC is not serving a valuable role because it has been mismanaged. Conflicts of interest have been exploited. Favors seem to beget favors. In my estimation, PMC has been badly damaged, and its leadership requires a close examination.

How bad is it? People actually believe that these posts will result in retaliation around publications I’m currently asking MEDLINE to review for indexing — that’s how little trust and faith people in the scientific publishing community now have in the NLM as a source of unbiased and non-vindictive evaluation and indexing. I personally have not lost that faith and trust yet. But recent events and the records I’ve unearthed thus far are not reassuring, to say the least.

We need a strong, unbiased, open, fair, accountable, and reliable NLM. We don’t need a conflicted, secretive, activist, or biased NLM that has employees who slip easily into inappropriate behaviors and shirk their fundamental professional and ethical obligations.

Enhanced by Zemanta

About Kent Anderson

I am the CEO/Publisher of the STRIATUS/JBJS, Inc., the home of the Journal of Bone & Joint Surgery, JBJS Case Connector, JBJS Reviews, JBJS Essential Surgical Techniques, the JBJS Recertification Course, PRE-score, and SocialCite. Prior to this, I was an executive at the New England Journal of Medicine. I also was Director of Medical Journals at the American Academy of Pediatrics.

Discussion

11 thoughts on “Pulling the Wool Over Their Eyes — The PubMed National Advisory Committee and Conflicts of Interest

  1. The PMC National Advisory Committee members (http://www.ncbi.nlm.nih.gov/pmc/about/nac/) are far from a group of patsies. I’d be interested in hearing from their side.

    Posted by Phil Davis | Feb 8, 2013, 9:21 am
  2. Holy cow. That last email alone says it all.

    Posted by Adam Etkin (@adametkin) | Feb 8, 2013, 11:14 am
  3. How bad is it? People actually believe that these posts will result in retaliation around publications I’m currently asking MEDLINE to review for indexing — that’s how little trust and faith people in the scientific publishing community now have in the NLM as a source of unbiased and non-vindictive evaluation and indexing. I personally have not lost that faith and trust yet. But recent events and the records I’ve unearthed thus far are not reassuring, to say the least.

    This seems pretty inflammatory. We don’t do our arguments many favors when we proceed directly from questioning persons’ actions (good use of FOIA, btw) to questioning their motivations…

    Also, it is one thing to harp on the potential confusion between MEDLINE/PubMed/PMC, but quite another to say that the perceived misdeeds from one part must then, by definition, tarnish the whole.

    Posted by Ed Sperr | Feb 8, 2013, 12:05 pm
    • I’m simply sharing what people have told me since October — that I might experience retaliation through the publications my organization is in the process of getting into MEDLINE through the legitimate process. I’m not saying it will happen, and I sincerely don’t expect it will. However, the NLM brand has become so tarnished over the years — and not just by these posts, but within the community before the eLife situation brought things to a head — that it bears mentioning.

      The brand of NLM is suffering for many reasons. The confusion between PMC/PubMed/MEDLINE is not helping. The confusion (and real conflation at the PMC/PubMed level) allows cross-contamination.

      Posted by Kent Anderson | Feb 8, 2013, 12:09 pm
  4. Thanks for uncovering all this story over the last couple of months.

    Posted by D. Rordorf | Feb 8, 2013, 3:01 pm
  5. Is anything being done to make this information available to the US Office of Government Ethics? The behavior reported here is really appalling, and it should not go unpunished.

    Posted by Sandy Thatcher | Feb 18, 2013, 1:45 pm
    • The silence all around has been noteworthy. Aside from the US government, Wellcome and other funders have codes of conduct for their employees, and Patterson was a Wellcome employee during much of this (he may still be, for all I know). From a PR standpoint, they are making the classic mistake — hoping it will just go away.

      Posted by Kent Anderson | Feb 18, 2013, 2:15 pm

Trackbacks/Pingbacks

  1. Pingback: Very Inspiring Blogger Award « write lies - Feb 11, 2013

  2. Pingback: Don’t Shoot the Messenger — Keeping Our Eye on the Real Meaning of the eLife-PubMed Central Scandal « The Scholarly Kitchen - Feb 12, 2013

  3. Pingback: Extension and Conflation — How the NLM’s Confusing Brands Have Us All Mixed Up « The Scholarly Kitchen - Feb 14, 2013

  4. Pingback: The eLife Story Continues — Evasions Seem the Best We Can Expect | The Scholarly Kitchen - Feb 28, 2013

Side Dishes by Stewart Wills

Find Posts by Category

Find Posts by Date

February 2013
S M T W T F S
« Jan   Mar »
 12
3456789
10111213141516
17181920212223
2425262728  

The Scholarly Kitchen on Twitter

SSP_LOGO
The mission of the Society for Scholarly Publishing (SSP) is "[t]o advance scholarly publishing and communication, and the professional development of its members through education, collaboration, and networking." SSP established The Scholarly Kitchen blog in February 2008 to keep SSP members and interested parties aware of new developments in publishing.
......................................
The Scholarly Kitchen is a moderated and independent blog. Opinions on The Scholarly Kitchen are those of the authors. They are not necessarily those held by the Society for Scholarly Publishing nor by their respective employers.
Follow

Get every new post delivered to your Inbox.

Join 11,873 other followers

%d bloggers like this: