Ouch.

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Government Studies and NFL Money Shouldn't Mix

Kavitha A. Davidson is a former Bloomberg View columnist.
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An ESPN report accusing the NFL of pulling funding from a brain study has led to immediate pushback by the league and the National Institutes of Health. The whole controversy highlights the myriad problems of the NFL funding such research in the first place.

On Tuesday, ESPN's Outside the Lines cited anonymous sources saying that the NFL -- which gave the NIH's nonprofit affiliate, the Foundation for the National Institutes of Health, $30 million in 2012 -- insisted that its gift not be used to fund a seven-year, $16 million study headed by a Boston University researcher. The scientist, Robert Stern, has been openly critical of the league's handling of brain trauma and of the concussion settlement it reached with players. He's also a highly respected researcher and went through several levels of NIH vetting. The NFL insisted its funding was still readily available, and later that day, the NIH's foundation released a statement that it had decided to fund the BU study itself while using NFL dollars for other research.

That the NIH foundation felt the need to address the public fallout against the NFL, in part doing the league's public relations for it, is an issue in itself. But it all points back to the inherent conflicts that arise when a league with a history of suppressing criticism and funding junk science provides the financial support for studies conducted by the government's primary research agency. 

Facing public criticism of how it handles brain injuries, the NFL gave the $30 million gift in 2012 to NIH foundation, which was set up by Congress to create public-private partnerships for government research. But from the tobacco industry funding studies claiming second-hand smoke doesn't cause cancer, to Coca-Cola's former top scientist organizing research that downplayed the soda's role in the obesity crisis, we've long had reason to be skeptical of such partnerships in science.

It's unrealistic to expect that public-private arrangements will end, both because of government underfunding of scientific research and the seemingly bottomless coffers of corporations like the NFL. The solution, though imperfect, is total transparency. VICE Sports' Patrick Hruby, who has covered the NFL's concussion crisis for years, is one of many pushing for the NIH to make public all its agreements and contracts with private entities. If the NIH claims the NFL has no "veto power" attached to its supposedly unrestricted gift, we should be able fact-check that claim.

Aaron Gordon of VICE tried to do just that. In November, he filed a Freedom of Information Act request with the NIH for all agreements pertaining to the NFL and concussions. On Wednesday, he looked at the memorandum of understanding between the foundation and the NIH's sports and health program. Gordon found that "the NFL is correct when it asserts that the NIH makes the funding decisions." But a section in the agreement stating that the NIH foundation "will use reasonable efforts to facilitate resolution of any Donor related issues that arise" sparks questions about whether that includes raising objections to a specific researcher. (It's also important to note that, unlike the NIH, the foundation is not a government agency, and isn't subject to FOIA requests.)

The new study at the center of all this aims to find a way to diagnose chronic traumatic encephalopathy in living patients. CTE, the brain disease that's the primary focus of most NFL brain-damage coverage and of the upcoming movie, "Concussion," is currently only diagnosable posthumously. Living NFL players are increasingly deciding to donate their brains to research after they die, but in addition to the obvious time concerns, that also opens the research up to NFL claims of sample bias, as most of the cooperating players presumably suspect that they suffer from brain trauma. 

Stern, the scientist directing the study, submitted a pointed statement last October arguing that many ex-players would not be compensated under the NFL's legal settlement because they didn't exhibit the symptoms or diseases covered, such as Alzheimer's and dementia, meaning the settlement's terms were too high and arbitrary. Absurdly, CTE is not one of the diseases covered for future awards under the deal, because the ruling judge felt the inclusion of some symptoms associated with neurological impairment sufficed. But Stern asserts that CTE's symptoms in the living manifest in both impaired cognitive functioning and behavioral issues including drug addiction and domestic violence.

The entire controversy also highlights overarching flaws in the NFL's campaign to convince the public that it's shifted its stance on concussions and is doing all it can to make football safe. All the talk and coverage about the NFL's brain-trauma crisis centers around concussions -- a myopic focus of which I've been guilty -- partly because the idea of a concussion is relatively easy for the public to understand, if nearly impossible to immediately diagnose. 

Yet according to Bennet Omalu, the forensic pathologist who discovered CTE and main character in "Concussion," we're putting too much emphasis on concussions.  Omalu recently told the Huffington Post's Maxwell Strachan that neuroscientists, including Stern, are increasingly shifting focus to subconcussive hits -- the smaller, much more frequent blows to the head that are inherent in the game and all but impossible to eliminate.

This broader scrutiny presents a much more existential crisis to the NFL: a four-year study of high school football athletes found that the average player sustains more than 650 subconcussive hits in a 14-week season. These don't individually result in diagnosable symptoms, but the cumulative effect is potentially devastating. 

The NFL's public strategy to combat brain trauma remains centered around concussions, in large part because the huge blows to the head seem like something we can work toward preventing, or at least minimizing. It's a completely different story when the hits causing brain damage occur on nearly every play.

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

To contact the author of this story:
Kavitha A. Davidson at kdavidson19@bloomberg.net

To contact the editor responsible for this story:
Tobin Harshaw at tharshaw@bloomberg.net