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Hospital’s suspension of evidence-based medicine expert sparks new controversy

The researcher at the center of a controversy roiling Cochrane, an international network of doctors and researchers, headquartered in London, that promotes evidence-based medicine, has been suspended as head of the Nordic Cochrane Centre in Copenhagen. Peter Gøtzsche, who was a founding member of Cochrane in 1993, has attracted attention for his outspoken critiques of pharmaceutical companies—and sometimes of Cochrane itself. In September, Cochrane’s governing board voted to remove him for “a consistent pattern of disruptive and inappropriate behaviours.” That decision led four other board members to resign in protest. Two weeks later, Gøtzsche said he would withdraw the Nordic Cochrane Centre from the international organization.

That was unacceptable to the board, however. In an interview with Science last month, Cochrane co-chair Marguerite Koster, a senior manager at Kaiser Permanente, said Cochrane CEO Mark Wilson would try to convince the Rigshospitalet in Copenhagen and the Danish government, which funds the Nordic Cochrane Center, to keep the center within the collaboration. Because he’s been ousted as a member, “Peter Gøtzsche no longer is the director of the Nordic Cochrane Center,” she argued. The board also took control of the website for the center and removed Gøtzsche’s statements about the case from it; he has since posted updates about the fight on his own website.

It’s unclear whether Cochrane’s lobbying has had any effect, but yesterday, the Rigshospitalet, which hosts the Nordic Cochrane Centre, announced it had suspended Gøtzsche. “We're striving to ensure that the Nordic Cochrane Centre continues as part of the international Cochrane Collaboration,” Deputy Chief Executive Per Jørgensen said in a statement. A spokesperson told Science the hospital would not give any further reasons for the suspension. Assistant Director Karsten Juhl Jørgensen has been appointed as acting head of the center, and the hospital has asked the University of Copenhagen to take over supervision of its graduate students.

In response, more than 3500 health care professionals, scientists, and public health advocates signed a letter protesting the hospital’s move to the Danish minister of health, who oversees the hospital as part of the national health system. Spanish politician David Hammerstein Mintz, one of the Cochrane board members who resigned in September, coordinated the petition, which gathered signatures for 3 days. Fiona Godlee, editor-in-chief of The BMJ, and Iain Chalmers, another founder of Cochrane, were among the signers. The letter states that Gøtzsche’s work has “played a pivotal role in favor of the transparency of clinical data, the priority of public health needs and the defense of rigorous medical research carried out independently of conflicts of interest.” The signers urge the minister “to reconsider this possible dismissal.”

Gerd Antes, an evidence-based medicine expert at the Center for Advanced Studies at Ludwig Maximilians University in Munich, Germany, and former head of the Cochrane Germany in Freiburg says he is “amazed” at the number of signatures. “How do you get 3000 people signing something in 3 days? This shows how wrong the board is,” he says. He says although Gøtzsche “has made mistakes … the actions of the board were devastatingly incompetent.”

Gøtzsche says he was informed last week that he was being suspended. “The only reason that they gave was that they no longer had confidence in my leadership,” he told Science. He says he is working with a lawyer to challenge the move.

Cochrane, meanwhile, is calling for applications for board members to replace the four who resigned. Applications close next week, and voting is scheduled to begin later this month.