Talk:Texas Medication Algorithm Project

Info on TMAP

TMAP was a way for several pharmaceutical companies, primarily Janssen (of Johnson & Johnson) to increase sales for expensive, on-patent drugs (atypical antipsychotics) by developing guidelines for prescribing. Google "TMAP Janssen Risperdal Texas" to find articles in a variety of publications, from Forbes to pharma-focused outlets.

Here are some in the popular press:

Making Drugs, Shaping the Rules in The New York Times article

State Settles Largest Ever Medicaid Fraud in the Texas Tribune article

Here is a court filing: pdf

Also, I would not say TMAP is a controversy, as one of my fellow editors did. Janssen was caught engaging in fraud, tried in court, and settled for -- I think -- $158 million. The sad part is that a lot of Medicaid children were given drugs that Janssen claimed were in their best interest, but were not.Sunandmoonandstars (talk) 17:11, 19 January 2021 (UTC)

Untitled

I'm just a user. I'm doing some research and wanted to know about the Texas Medication Algorithm Project. This entry does not inform the reader about what it is. I am to believe it is a screening for mental health disorders. A screening would have specific screening questions and screen for specific mental health disorders. This entry does not provide that basic information but talks more about controversy. I still don't know anything about the actual screening tool or what they are screening for. Thanks. User:mimlandry

Large POV chop

After going over this, the final two thirds of this article simply had to be discarded: it simply made too may charged allegations without any evidence (at the moment). If the original author can find some primary or secondary sources to cite regarding this controversy, we can add a "controversy" section later. – ClockworkSoul 22:13, 27 Feb 2005 (UTC)

The bias is now in the external links and see-alsos. How about removing all that inflammatory stuff from there? JFW | T@lk 1 July 2005 13:28 (UTC)

Agreed. I've posted an NPOV template for now. In a way, it's even more POV now that the article doesn't explicitly mention a controversy, yet piles on a load of See also and External links that point to a controversy. Surely there is a way to discuss the controversy from an NPOV standpoint. I did remove one of the links under "See also," as it was a link to a search on an external web site and didn't pertain directly to this particular topic, but rather to a laundry list of claims of pharmaceutical overstepping. Lawikitejana 06:48, 9 October 2006 (UTC)

Evidence for incomplete study design?

I have a natural and adverse reaction to corporate conspiracy types, but lots of evidence exists for sub-optimal planning by drug companies (witness Vioxx). The healing arts have a long way to go before they become the healing sciences, but I am interested if analyses exist that point to shortcomings in the TMAP initiative.

patients or screening, and age range

"The Texas Medication Algorithm Project (TMAP) is a controversial corporate-sponsored set of psychiatric management guidelines designed to enable doctors to systematically screen and treat patients for diagnosed mental disorders within Texas' publicly-funded mental health care system. TMAP was initiated in the fall of 1997 to provide more uniform early intervention screening and treatment for Texas children."

It isn't clear to me whether this is screening, in which case it is of children, or whether it is management of patients, who may be general or paediatric. Clarify please. Midgley 21:59, 18 March 2006 (UTC)

References

I'm fascinated. There is a report int eh BMJ referred to in the body text, but no reference, and then there are a bunch of rather softer references... why not refer to teh WP:RS BMJ? WHat view does it offer of screening (or treating - I'm still unclear) thus? Midgley 22:06, 18 March 2006 (UTC)

Children? - first page of main reference -

" an algorithm-driven treatment philosophy for major adult psychiatric disorders treated in the Texas public mental health sector. ".

The article very firmly says children. Where does that come from, please? Midgley 22:08, 18 March 2006 (UTC)

Article about some other project?

A high proportion of the article as it was simply did not appear in the references - the first one is actually about it and includes the algorithms. Which I read. These algorithms are much less exciting than some people would like them to be - they are suggestions by senior doctors on the order in whcih to use certain drugs in certain conditions. There is an explicit note that entry may be at any level - IE th etreating doctor has their usual clinical discretion. As for the drugs and the comapnies, I'd find that a more convincing indication of something wrong if someone had indicated an alternative drug for each one chosen and in each condition, and suggested that that was better - in the opinion of the doctors writing the guidelines.

As evidence based medicine the level of evidence used - expert opinion - is the lowest rank. Above that are trial-based conclusions. However when you first start writing guidelines, setting out what your local experts do is a very good first step. you can then consider whether there is a large range of opinion, and start to test opinions against objective evidence and move up the hierarchy. As written that was a hogepodge of conspiracy theory, allegations of financial malfeasance, lists of participants in inverted order (the commissioning public body that runs the public services surely goes first, having initiated the project, and those that contribute to its funding later). FWIW, they look like useful aides-memoire, and are not that different from the Maudsley guidelines which are widely used or at least known in the UK. Midgley 00:50, 19 March 2006 (UTC)

where is the reference giving this?

"The pharmaceutical companies who funded the development of TMAP include Janssen Pharmaceutica, Johnson & Johnson, Eli Lilly, AstraZeneca, Pfizer, Novartis, Janssen-Ortho-McNeil, GlaxoSmithKline, Abbott Laboratories, Bristol Myers Squibb, Wyeth-Ayerst and Forrest Laboratories. " Note the list of supporters provided in one of the references given, in article now. an we expect this article to be duplicated 49 times for the US states, then once for each country of the UK and so on, and if not, why not? Folding it into a single article on Medication Guidelines, or possibly algorithms, would be more sensible than reduplicating it, and apart from this being the first in the US, there is nothing that makes it out to be in any way unusual or different from others. Several of the references do not look like WP:RS, and overall there are more references than so simple an article really benefits from. Midgley 00:22, 20 March 2006 (UTC)

Satel link

What is the link? I can't see anything about it in the article which is linked to. Midgley 23:43, 22 March 2006 (UTC)

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