Correspondence

Conflict of interest in research

The report by Ho et al in American Journal of Emergency Medicine [1] contains some significant Methodological errors and makes some dubious claims about the safety of conducted electrical weapons (CEWs, or Tasers). In addition, the report involves a conflict of error that ought to be acknowledged within the text.

Ho et al estimate that of 10 608 incidents of Taser use, 2452 involved people with Mental illness and that 45% of this group (1111) “were in situations where lethal force by the law enforcement agency would have been justified, or where the subject represented an imminent life threat to himself [sic]” (p 780). The estimate of people with mental illness seems extraordinarily high until reading the authors’ criteria for “mental illness.” Criteria included use by Law enforcement officers of terms such as psychiatric, mental, agitated, crazy, suicide, and bizarre. Although corroborat- ing data were sought, there is no indication as to how many cases produced such data. The estimate of number of people with mental illness is therefore almost certainly inflated. The authors go on to claim that the data “translate to more than 1100 lives potentially saved.” This is clearly an exaggeration, at least in emphasis.

Later in the article, an even more astonishing claim is made. Reporting on 36 deaths within 72 hours of use of a Taser, the authors conclude that their database “does not seem to support a connection between CEW use in mentally ill persons and their subsequent deaths” (p 784). However, in 32 of the 36 cases, the weapon “had no effect, and this was primarily due to failure to deliver the CEW current (eg, a target miss or very thick clothing).” In 3 cases, the cause of death has not been made publicly available, leaving one case in which a Taser was used effectively. In this single case, the Taser was cleared as not being the primary cause of death (emphasis added). The authors’ conclusions on the basis of this data are plainly unsupportable.

Of the 5 authors of this article, 2 are affiliated to Taser International, but this conflict of interest was not declared in the text of the article. Given the exaggerated claims of the authors, there is strong suggestion that the evident conflict of interest has exerted a material effect on the research. It is

surely no coincidence that the article is currently showcased on the Taser International Web site.

Anthony J. O’Brien RN, BA, MPhil

University of Auckland School of Nursing Auckland, New Zealand

doi:10.1016/j.ajem.2008.01.006

Reference

[1] Ho J, Dawes D, Johnson M, Lundin E, Miner J. Impact of conducted electrical weapons in a mentally ill population: a brief report. American Journal of Emergency Medicine 2007;25(7):780-5.

Reply

To the Editor,

We read with great interest the letter from Mr Anthony O’Brien regarding our work, and thank you for the chance to respond to his criticisms. We recognize that the subject matter might be viewed as inflammatory by those who do not support this technology use in modern-day society. However, we are also happy to know that it has stimulated further discussion and debate.

We believe that Mr O’Brien has failed to understand what this article is about. He describes our data as “unsupportable” that appears to be his subjective opinion. The data represented in our study were reported from a fixed, voluntarily reported database in a retrospective review fashion. The description of this was very well articulated in the Methods section of the article. The limitations of our study, including the possibility of skewing error, were also articulated in the Limitations section. Because our article retrospectively reports certain events or subject descriptors from a fixed database, it is unclear to us how the results could have been unsupported. The data were captured as given, and those were what we reported.

0735-6757/$ – see front matter (C) 2008