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Therapeutic Gains of Prolonged Bronchial Dilatation in Chronic Obstructive Pulmonary Disease

Gerard M. Turino, MD
[+] Article, Author, and Disclosure Information

From St. Luke's-Roosevelt Hospital, Columbia University College of Physicians & Surgeons, New York, NY.

Potential Financial Conflicts of Interest: Grants received (Boehringer Ingelheim); Grants pending (Boehringer Ingelheim).

Requests for Single Reprints: Gerard M. Turino, MD, St. Luke's-Roosevelt Hospital, 1000 10th Avenue, New York, NY 10019.

Ann Intern Med. 2005;143(5):386-387. doi:10.7326/0003-4819-143-5-200509060-00014
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Chronic obstructive pulmonary disease (COPD) is a major global medical problem. In the United States, COPD causes more than 500 000 hospitalizations and 100 000 deaths per year (12). As many as 25 million individuals are estimated to have various stages of COPD in the United States (3). The definition of COPD, which resulted from a National Heart, Lung, and Blood Institute and World Health Organization conference, is “a disease state characterized by airflow obstruction that is not fully reversible. The airflow obstruction is usually both progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases” (4).

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Conflict of Interest
Posted on September 21, 2005
Gil Porat
Penrose Hospital
Conflict of Interest: None Declared

It's amazing to me that Annals thinks the best person to write an editorial regarding Tiotropium is Gerard Turino, MD. He aknowledges that he has recieved grants and plans to recieve future grants from Boehringer Ingelheim. After printing a drug company sponsored study with barely marginal results, Dr. Turino declares Tiotropium a "first-line medication in therapy for COPD." In such studies of a very expensive, heavily promoted drug, you'd think Annals could do better in getting an unbiased opinion.

Gil Porat, MD

Conflict of Interest:

None declared

In Response
Posted on September 21, 2005
Harold Sox
Editor, ANnals of Internal Medicine
Conflict of Interest: None Declared

Dear Dr. Porat,

As a matter of policy, we avoid asking people to write an editorial if they have a financial relationship that readers might perceive to be a conflict of interest. When I contact someone to write an editorial commentary on an article about a commercial product, I inquire about financial relationships with the manufacturer or a competitor. If the person has a conflict, I withdraw the invitation, which I did several times in trying to find an editorialist for the randomized trial of tiotropium. Unfortunately, when communicating with Dr. Turino, all potential conflicts, including a relationship with the manufacturer of tiotropium, were not made clear.

I sincerely regret this occurrence, and I want to reassure you and other readers that we try very hard to avoid the situation that prompted your letter.

Harold C. Sox, M.D., MACP


Conflict of Interest:

None declared

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