Tag Archives: medical journals

Study considers role of impact factor, income in journal editors’ decisions

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

A newly published study looks at medical journals and whether the publication of industry-supported trials might cause a conflict of interest by improving the journals’ importance or income.

Researchers looked at “impact factor” – a measure of a journal’s importance based on how often its articles are cited – and they looked at income from the sale of reprints to drug companies.

While they found that the publication of industry-supported randomized controlled trials is associated with an increase in both the impact factor and income from reprints, they do not conclude that editors’ decisions are affected by those increases.

Importantly, these findings do not imply that the decisions of editors are affected by the possibility that the publication of an industry-supported trial might improve their journal’s impact factor or income.

Despite that conclusion, the researchers do suggest that journals routinely disclose information on the source and amount of income they receive.

In that spirit, PLoS Medicine discloses its sources of income for 2009 and the editors discuss the issue in an editorial.


More about conflicts of interest in publishing

How ghostwriters sold hormone replacement

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Writing in PLoS Medicine, Adriane J. Fugh-Berman, M.D., demonstrates the cynical art of “publication planning” and the use of academic journals as an avenue for unregulated drug promotion by showing, with the help of documents from a major drug manufacturer, how ghostwriting was used to sell hormone replacement therapy.

The documents in question come from the lawsuits against Wyeth over the development of breast cancer during treatment with the hormone replacer Prempro, and were brought to light, according to Fugh-Berman, “when PLoS Medicine and The New York Times intervened in the litigation. Both intervenors successfully argued that ghostwriting undermines public health and that documents proving the practice should be unsealed.”

Fugh-Berman was a paid expert witness in the trial, and thus was familiar with the documents before their release. Her conclusion?

… the pharmaceutical company Wyeth used ghostwritten articles to mitigate the perceived risks of breast cancer associated with HT (menopausal hormone therapy), to defend the unsupported cardiovascular “benefits” of HT, and to promote off-label, unproven uses of HT such as the prevention of dementia, Parkinson’s disease, vision problems, and wrinkles.

According to Fugh-Berman, the effects of this careful campaign seem to have outweighed the preponderance of evidence, at least in the minds of some doctors.

Today, despite definitive scientific data to the contrary, many gynecologists still believe that the benefits of HT outweigh the risks in asymptomatic women. This non-evidence–based perception may be the result of decades of carefully orchestrated corporate influence on medical literature.

Through the course of the article, Fugh-Berman lays out the entire ghostwriting/marketing process, complete with instructive details and damning examples. There’s a lot to take in, but you’ll emerge with a far better understanding of the mundane mechanics that make ghostwriting work.


Journal editor linked to spinal implant royalties

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

John Fauber of the Milwaukee Journal Sentinel continues his coverage of conflicts of interest in medical research and journals with a look at journal editors. First, Fauber lays out the case in question:

  • For seven years, a University of Wisconsin orthopedic surgeon (university bio | hospital bio) has been editor-in-chief of the Journal of Spinal Disorders & Techniques.
  • During that time, he’s received more than $20 million in patent royalties thanks to spinal implants sold by Medtronic.
  • Also during that time, an average of more than one Medtronic-related article appeared in each issue of the journal, most of them positive. Some were even co-authored by the editor/surgeon himself and related to the implant for which he gets royalties.
  • Despite these coincidences, the journal never disclosed the potential conflict of interest.

Fauber then goes on to explore why journal editors aren’t mentioned more often in conflict-of-interest scandals, and then to explain exactly why those editors hold the sort of power that makes these conflicts particularly distressing. As Fauber explains, editors of medical journals can accept or reject manuscripts of studies involving drugs or devices – something that can make or break the product.

They can send a study out to peer reviewers who may be sympathetic to a particular drug or device by virtue of their own financial relationships with the companies that make those products. They can give authors more leeway to say positive things about a drug. They can turn down studies that say bad things about the product of a company they get money from.

The author of “On The Take: How Medicine’s Complicity with Big Business Can Endanger Your Health,” Jerome Kassirer, says that “Once an editor makes a decision, there is no recourse; they are like a king.”

Earlier coverage:

Journal launches site for journalists covering studies

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In an editorial in the Journal of the National Cancer Institute, “Promoting Healthy Skepticism in the News: Helping Journalists Get It Right,” Steven Woloshin, Lisa M. Schwartz and Barnett S. Kramer analyze some recent media coverage of journal articles and research findings and conclude that “When it comes to exaggeration of health hazards and medical breakthroughs, there is plenty of blame to go around.”

It would be easy to pin all the blame for exaggeration on journalists. After all, they have to grab their reader’s (or listener’s) attention. Screaming headlines and breathless reporting come in handy. And many health journalists lack the medical or statistical training needed to appraise research critically. Curiously, many fail to approach medical research with the same skepticism they routinely apply to political reporting. Nonetheless, blaming journalists for all exaggeration would be unfair. Many health journalists (and their editors) do a great job.

The writers also acknowledge that researchers’ passion can play a part, as well as the desire to get good media attention. They also point to journals’ failure to include or highlight some important elements that would help journalists accurately report on study findings.

In a move to help improve coverage of research, the JNCI has launched “a Web site for science and health journalists to help them ‘get it right.'” The first offering is “Reporting on Cancer Research,” a set of tip sheets designed to help reporters better understand oncology research and its results. It was developed for the writers’ book, Know Your Chances: Understanding Health Statistics, and adapted for journalists attending the annual Medicine in the Media workshop. Each PDF highlights a different aspect of interpreting cancer research (risk numbers, statistics, findings and outcomes, and cautions), and all four are succinct and easy to use, even on deadline.

Grassley digs into journal ghostwriting practices

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Ben Comer of Medical Marketing & Media reports that Iowa Republican Senator Chuck Grassley sent a letter to eight prominent medical journals, asking them to share their editorial policies regarding the disclosure third parties involved in the creation of journal articles, as well as the penalties they have set for authors who don’t follow those policies. Grassley asked the journals to respond by July 22. Read the senator’s press release here.