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Can Medical Journals Be Trusted?

Can the medical journals be trusted to provide accurate, unbiased information about medicine even as they are almost entirely funded by drug companies?

Medical journals have a specific kind of advertising content within their pages. All their ads are for hospitals or drugs; there's not a non-medical ad in sight.

Since medicine is the subject of the entire journal, medical ads seem par for the course. But what should an editor do if a product advertised on a particular page isn't 100 percent safe? It might not be cost-effective for a budget-strapped medical journal to remove the ad and publish an article discussing the product's drawbacks. They run the risk of angering the pharmaceutical company and losing revenue. Donald M. Epstein, author of Healing Myths, adds that even if the dangers of a drug or medical procedure were to be included in a respected medical journal, often the "religious" belief that doctors, and even patients, have in conventional medicine overrides their decision-making process.

People believe that if a drug is FDA-approved and on the market, it must be okay. If a drug proves fatal to 10 or even 10,000 patients, doctors will still staunchly defend it, claiming the benefits outweigh the risks. Epstein's feelings are that anyone with a little common sense should be enraged by the fact that the entire industry is operating with self-imposed blinders -- from the pharmaceutical companies that hawk unsafe drugs to the medical journals that publish doctored clinical studies and misleading ads.

Richard Smith, the ex-editor of the British Medical Journal (BMJ), publicly criticized his former publication, saying the BMJ was too dependent on advertising revenue to be considered impartial. Smith estimates that between two-thirds to three-quarters of the trials published in major journals -- Annals of Internal Medicine, Journal of the American Medical Association, Lancet and New England Journal of Medicine -- are funded by the industry, while about one-third of the trials published in the BMJ are thus funded. He further adds that trials are so valuable to drug companies that they will often spend upwards of $1 million in reprint costs (which are additional sources of major revenues for medical journals). Consumers trust medical journals to be the impartial and "true" source of information concerning a prescription drug, but few are privy to what is truly going on behind the scenes at both drug trials and medical journals.

Scientists who conduct drug trials may be hard-pressed to stay impartial when the manufacturers so often pay them for lectures and consultations, or when they are conducting research that has been funded by the company. In addition, as stated by doctors Mark Hyman and Mark Liponis in Ultraprevention, since drug companies are so reliant on the word of doctors, they often visit doctors' offices to hand out free samples, take the staff out to lunch, offer free gifts -- including toys for kids, seminars at expensive restaurants and junkets to the Caribbean islands -- and frequently sponsor continuing education for doctors.

The scandal in medical research is far more shocking than the corporate scandals that recently created headlines, according to John Abramson in Overdosed America. Abramson says that the withholding of negative results and the misrepresentation of research are accepted norms in the field of drug trials, or "commercially sponsored medical research."
He even goes as far as to say that there is a web of corporate influence in the form of "regulatory agencies, commercially sponsored medical education, brilliant advertising, expensive public relations campaigns, manipulation of free media coverage," as well as the aforementioned relationship between trusted medical voices and the medical industry. In Abramson's view, this all contributes to the silencing of the industry's corruption. He likens the situation to the recent corporate scandal in which securities analysts received payments in order to write reports that drove up stock prices.

According to Ann Blake Tracy, PhD, author of PROZAC: Panacea or Pandora, a "CBS HealthWatch" article even accused pharmaceutical companies of authoring drug studies themselves, then paying doctors to sign their names onto them. Furthermore, of the approximately 3,000 medical journals published monthly, only 10 percent are cross-indexed into a computer system, according to Charles T. McGee, in his book, Heart Frauds. This cross-indexed material is closely reviewed by "conservative editorial boards" in order to screen out controversial content. The 10 percent of material that's been approved is the only material available to a doctor when he asks a medical librarian to conduct a computer search or a search of a CD-ROM service such as Medline. On top of that is Kenny Ausubel's report, contained in his book, When Healing Becomes a Crime, that many drug companies just cut out the middle-man and publish their own medical journals.

Opponents of the perceived corruption in medical journals offer many solutions. Smith, as mentioned previously, would either like more privately-funded studies published or have none published at all. Abramson feels that researchers have to have access to all the results of their studies, perform their own analysis of data, write their own conclusions and submit the report to peer-reviewed medical journals. A change may be in the cards, and as Richard Gerber, MD, notes, the number of patients seeking alternative medical answers to their problems is becoming too large for mainstream medical media to ignore. Gerber says that some medical journals are even publishing articles that explore the nature of these "unorthodox" treatments and discuss why patients are seeking alternative health care.

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Reference Source 136
October 5, 2005

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