The Canadian Medical Association Journal (CMAJ) recently published a paper which looks at the association between a journal's source of revenue and the drug recommendations made in the articles it publishes. It examines the influence of pharmaceutical advertising on the drug recommendations made in articles published in 11 German journals that focus on continuing medical education. The study was carried out by German researchers Annette Becker, Fatma Dörter, Kirsten Eckhardt, Annika Viniol, Erika Baum, Michael M. Kochen, Joel Lexchin, Karl Wegscheider and Norbert Donner-Banzhoff.
They conducted a cross-sectional study of all of the issues of 11 journals published in 2007. Only journals frequently read by general practitioners were chosen. Issues were screened for pharmaceutical advertisements and recommendations made in the editorial content for a specified selection of drugs. Each journal was rated on a five-point scale according to the strength with which it either recommended or discouraged the use of these drugs.
It was found that free journals were more likely to recommend the specified drugs than journals with sources of revenue that were mixed or based solely on subscriptions. The researchers identified 313 issues containing at least one advertisement for the selected drugs and 412 articles in which drug recommendations were made. The simultaneous appearance of advertisements and recommendations for the same drug in the same issue of a journal showed an inconsistent association.
Free journals almost exclusively recommended the use of the specified drugs, whereas journals financed entirely with subscription fees tended to recommend against the use of the same drugs, the researchers noted. They further state that doctors should be aware of this bias in their use of material published in medical journals that focus on continuing medical education.
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