There are documented cases of NAV (the welfare authorities) paying for LP courses. Both NAV and the directorate of health have paid ~100k NOK (£7.4k) a piece for HCPs to be trained in LP. NAV have also demanded that patients tried LP in order to qualify for disability benefits.
I don't know if it's a requirement or not, but I found one paper where an author did disclose previously being an LP practitioner:
I think Landmark has a COI because her income depends on the outcome of the trial showing the treatment works, so that introduces a potential for bias in her study design and choice of outcome measures, and interpretation of the results.
Technically they do (the entire psych field does), because if they reported and interpreted the results of their trials honestly and without bias, they would be out of a job. But it’s so far removed that it probably doesn’t qualify for a COI statement.
I don't think that's true for White and Sharpe. If they are tenured professors of psychiatry, their jobs don't rely one one particular treatment trial outcome. If one fails they just move on to another bit of research and go on treating patients and teaching students.
Yes, but every clinician earns their salary by providing interventions they favor and, in some cases, investigate in research. That's what they get paid to do. How is what she is doing different than a CBT therapist receiving money for providing CBT? I don't really see the distinction that would require disclosures by her and not by them. In PACE, the investigators were getting paid or at least were advising outside, unmentioned parties--insurance companies--outside of their sphere of providing treatment.
I don't really agree with the reasoning here. What you describe is appropriate care. If Landmark provides LP to everyone, whether it makes any sense or not, that might be unethical. But does it mean she has to report her practice as a COI? Why? So if someone is a psychotherapist with a CBT specialty, and they get paid by patients, and they research CBT, would they have to declare that they practice CBT as a conflict? How would that be different from what she's doing? She's paid to provide LP intervention, and if she's not getting other payments from elsewhere or there's not something beyond that, I don't see why she should be under a greater burden than any therapist providing care. If a surgeon provides cateract surgery, and they research cateract surgical techniques, do they need to declare their cataract surgery practice as a conflict?
LP is a commercial product that she has direct financial ties to. Abrahamsen has the same ties (actually stronger because it’s her own invention) to ICIT.
Indeed. Definitely another case where the declaration of conflicts should be at least as long as the paper itself. In her case it's more direct because there is a clearly for-profit commercial venture involved, but almost everyone involved has some degree of conflict or a degree of bias so extreme that it would be comical if it wasn't for how serious this is. This is about on par with Theranos promoting the technology they tested themselves, in their private labs, after having developed it. But in a case where the government paid for it and its board includes government cronies and so on.
This is actually where it gets interesting about direct vs indirect conflicts of interest. They might have paid her, because they have a financial stake in the outcome and it would be worth it to them. But also she is clearly personally and ideologically invested in it to the point where she would no doubt do this for free simply because it's worth it to her, payment in kind. Which is itself clearly a conflict of interests that disqualifies her as an expert witness, but it's all under the same kind of nuance that David is talking about, with the examples of clinicians researching a technique they themselves use at their clinic.
Why is the Lightning Process more of a commercial product than someone offering CBT and getting paid for it? The ICJME form says that "related" to the manuscript means that a third party is somehow profiting. Is there a 3rd party profiting from Landmark offering LP therapy? The assumption here seems to be that all providers are employed by someone, so if they're taking money from patients, that's a conflict. But in the U.S. we have a lot of private practitioners who are not on a salary and get paid directly by patients, whether through their insurance or out-of-pocket. That's especially true when it comes to psychotherapeutic interventions.
I really struggle to understand how it’s only a COI if a third party benefits, but not if you benefit yourself. That would be like defining corruption based on if your family or friends benefit, and ignoring any personal benefits.
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