Do Pharma ads affect journal publication re: supps | Arthritis Information

This pilot study has several limitations. It included only a few of the many clinical medical journals available and used only the American library version of these journals, but it did focus on those with very high readership that are often quoted by professional organizations, the media and policymakers. Results from the smaller secondary analysis of the CAM journals would be enhanced by larger sample of more diverse CAM publications. The review did not specifically address the funding for different trials or evaluate the methodologic quality of the published trials. This study was not a survey of journal editors regarding the number of submissions of different types they receive or how they decide which articles to include. An alternative hypothesis that might explain these findings is that journals with a high number of pharmaceutical ads receive few submissions about dietary supplements; furthermore, it is possible that a large number of articles about dietary supplements are of poor quality and do not deserve publication. It is also possible that the observed associations are due to another underlying factor ; for example, one recent study reported that in high impact journals, European journals were approximately twice as likely as American journals to publish positive articles about complementary therapies [42]. In addition, this study used the number of issues per journal as the study denominator rather than the total number of articles per issue; future studies could use the number of articles per issue as the denominator to address the related question of whether journals with more advertising per issue also have fewer articles of all types and hence fewer articles about dietary supplements. Future studies on this topic to explore alternative hypotheses for our findings should include a larger number of journals and more diverse journals; additional studies might also survey journal editors to determine the number of articles submitted for consideration for publication and ask about the percentage of submissions related to dietary supplements.

Conclusion

These findings support the hypothesis that in major medical journals, more pharmaceutical advertising is associated with publishing fewer articles about DS and having more negative conclusions about DS safety. While awaiting future definitive studies to confirm these findings in a larger, more diverse sample of journals and to explore alternative explanations, these data support current efforts to reduce conflicts of interest in medical publishing and to make any such conflicts more transparent. The impact of advertising on publications appears to be non-trivial; the ultimate impact of this bias on professional guidelines, health care, and health policy is a matter of great public concern and underscores the need for additional health services research on this topic.