Canadian Medical Association Journal Home

Free eCMAJ TOC

Back issues
Supplements
Selected series

eLetters
About this journal
Info for authors

PubMed

eLetters: Misdirected aspersions
In response to: A call for the regulation of prescription data mining

See response from D. Ford

Stuart MacLeod
Email: macleods@mcmaster.ca
Affiliation: Director FSORC
Posted on: November 27, 2000


Canada and most other developed countries are in the midst of a debate concerning data privacy which is particularly important because of its potential for impact on medical and health research. At stake is our ability to study a variety of health outcomes and to assemble data which will aid us in assessing new technologies or in attempting to attain optimal use of approved interventions. We urgently need agreed standards and codes of conduct which will be accepted in most countries so data can "travel" across international boundaries.

The recent CMAJ article by Zoutman et al. is unlikely to prove helpful in this debate or in generation of workable public policy. Beginning with a title which centres on the pejorative term prescription data mining, the authors have encouraged paranoia about pharmacoepidemiology practice in general and the activities of IMS Health in particular. Much of the analysis provided appears to be inaccurate with respect to the extraordinary efforts made in the past four years by IMS to protect physician privacy while making aggregate available for scientific, regulatory, and commercial purposes. To my knowledge disclosure of patient specific data by IMS has never been suggested although this risk is implied by Dr. Zoutman and his co-authors.

In calling for "enforceable regulations" to control prescription data mining, the authors seem to undervalue the contribution of such data to hypothesis generation. They offer faint praise that sounds more like scorn regarding the contribution of IMS data to research publications and projects, yet 31 papers and 125 projects over 4 years represents a sizeable pro-bono input to science. As a McMaster researcher, the Director of the Father Sean O'Sullivan Research Centre, and a member of the Centre for Evaluation of Medicines at St. Joseph's Hospital, Hamilton, I can readily attest to the value of IMS data freely given in support of academic pharmacoepidemiology research, risk analyses conducted for the coroner and other government departments and for teaching requirements.

I cannot share the author's enthusiasm for "enforceable regulations" which, from past experience, will raise jurisdictional disputes internationally and between the national and provincial governments within Canada and will plague us with logistical issues to the detriment of science. A code of conduct as already initiated by CMA deserves expansion and refinement and is much more likely to serve our future needs. In my opinion, it is also time to recognize IMS Health as an ally rather than an antagonist to our efforts to improve the quality and efficiency of Canadian health care. At this time, Dr. Zoutman's aspersions are misdirected.

S. M. MacLeod
Director
Father Sean O'Sullivan Research Centre
Professor, Clinical Epidemiology & Biostatistics
Medicine & Pediatrics
Faculty of Health Sciences, McMaster University

 

Copyright 2000 Canadian Medical Association or its licensors