May 20th, 2011

Medical Journal Ads And Unsubstantiated Claims


Fewer than half of the claims in advertisements that appear in leading medical journals aimed at ear, nose and throat specialists are actually supported by data referenced by the advertisers, according to a new study in Archives of Otolaryngology. And the finding suggests that doctors may be misled by the content of the ads.

The researchers chose a sample of 50 claims from 23 ads that ran in four leading journals and sent them to five specialists, who were asked to compare the claims to references listed in the ads. The upshot? Only 28 percent of the claims were strongly supported by the referenced data, but 12 percent of the time, the data actually contradicted the claims (here is the abstract).

The issue is troublesome, the lead researcher says, if busy docs may rely on one-line glossy ads rather than pouring through lengthy articles. “The fact is that the scientific literature is copious and much of it is somewhat obscure,” Jeffrey Spiegel, a head and neck surgeon at Boston University, tells Reuters. “It doesn’t have to lead to actual harm, but it can still be wasted time and effort.”

The results underscore an ongoing debate over the value of ads in medical journals. As Reuters notes, drugmakers are believed to generate from $2 to $5 in sales for each dollar spent on advertising in medical journals. And ads are lucrative to journals as well, although some have begun banning them from their pages. Earlier this year, for instance, Emergency Medicine Australasia took this step (read here).

However, Richard Rosenfeld, editor of Otolaryngology - Head and Neck Surgery, one of the journals that was reviewed, believes ads alert docs to meds that may not otherwise know about. And he says the results are not clear cut. “The fact that (the five reviewers) can’t agree reflects the nature of what an ad is,” he tells Reuters. “The problem is that we’re attempting to provide a level of precision to something that was never intended to be precise. Ads are intended to attract interest.”

Although the FDA reviews promotional materials from drug and device makers, Reuters writes that Spiegel suggests the system might be overwhelmed, since there is no requirement for claims to be vetted before they’re published. “Perhaps it would be appropriate for the medical journals to go the extra distance and help its readers by rating the ads,” he offers.

Paul Levine, editor of Archives of Otolaryngology - Head & Neck Surgery, which contributed ads for the review, says he is uncertain about the best approach. “We need to figure out a methodology to better evaluate the veracity of these ads,” he tells Reuters. “What is implied in the study is that it’s everybody’s responsibility to ensure that claims of any type are in fact true.”

Rosenfeld, whose journal is the official publication of the American Academy of Otolaryngology - Head and Neck Surgery Foundation, does review ads. “When I sign off what I’m saying is I feel that the advertisers are providing a reasonable and fair representation of their product,” he tells Reuters, adding that he also rejects some. “They are obviously looking to spin their product in the best light possible. I think the bottom line from this study is caveat lector, let the reader beware.

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