Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies
Published: May 17, 2005
Copyright: © 2005 Richard Smith. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Competing interests: RS was an editor for the BMJ for 25 years. For the last 13 of those years, he was the editor and chief executive of the BMJ Publishing Group, responsible for the profits of not only the BMJ but of the whole group, which published some 25 other journals. He stepped down in July 2004. He is now a member of the board of the Public Library of Science, a position for which he is not paid.
Richard Smith is Chief Executive of UnitedHealth Europe, London, United Kingdom. E-mail: email@example.com
The Problem: Less to Do with Advertising, More to Do with Sponsored Trials
Why Do Pharmaceutical Companies Get the Results They Want?
Peer Review Doesn't Solve the Problem
Journals Should Critique Trials, Not Publish Them
Examples of Methods for Pharmaceutical Companies to Get the Results They Want from Clinical Trials
Conduct a trial of your drug against a treatment known to be inferior.
Trial your drugs against too low a dose of a competitor drug.
Conduct a trial of your drug against too high a dose of a competitor drug (making your drug seem less toxic).
Conduct trials that are too small to show differences from competitor drugs.
Use multiple endpoints in the trial and select for publication those that give favourable results.
Do multicentre trials and select for publication results from centres that are favourable.
Conduct subgroup analyses and select for publication those that are favourable.
Present results that are most likely to impress—for example, reduction in relative rather than absolute risk.
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