Friday, July 31, 2009

Academic Journals, or Advertising Journals?

Academic Journals, or Advertising Journals?
And how can we tell the difference?

The good news is that Elsevier, one of the handful of leading publishers of academic research journals, has the guts to go public with this issue.

The bad news is that there supposedly legit academic journals, publishing supposedly legit studies, supposedly authored by researchers of integrity, supposedly judged and reviewed by impartial academic reviewers, and these journals are nothing more than marketing publications paid for by pharmaceutical companies.

Here is the controversy: There is a publishing company called Elsevier, one of the most prominent academic publishers, with Lancet as their lead journal. In this past year or so, someone figured out that Elsevier was coming out with a slew of journals called "Australasian Journal of [Fill in the Blank], and that these journals were basically funded by a specific pharmaceutical company to promote one of their specific patented drugs.

The lead example has been the Australasian Journal of Bone and Joint Medicine. Rather than sharing the latest evidence and outcomes, it emerged in court proceedings that the journal was bankrolled by Merck to promote rofecoxib, Merck's big-dollar pain medication marketed as Vioxx until lawsuits exposed the heart health risks from Vioxx.

So, while bone and joint docs in Australasia, and the rest of the world, believed that they were reading decent, selected, reviewed, vetted studies regarding rofecoxib/Vioxx and other treatments, they were actually reading a disguised advertising brochure.

Furthermore, Merck's pharmaceutical representatives were visiting docs across the world, and updating the docs on the latest "empirical" research. The drug rep could hand the doc a seemingly impartial, scientific article supposedly providing an impartial assessment of various medications for various pain conditions.

Investigation revealed that the publishing company, Elsevier, had several of these fake journals.
This issue progressed. To save their actual, legit, premier reputation and position, Elsevier jumped into action to squelch this practice.

First, they explained away these fake journals as being part of a rogue division operating all over Australasia with little supervision from the parent company.
Next, they declared that they would get rid of all of these journals.

To the credit of Elsevier, this August brings the publication of a commentary letter in Elsevier's premier journal, Lancet.

Australian researchers Jureidini and Clothier sublitted a letter, titled "Elsevier should divest itself of either its medical publishing or pharmaceutical services division.
what the letter strikes at is the issue that Elsevier develops twto types of publications: impartial scientific journals, and pseudojournals that are thinly veiled marketing pieces. The authors note, regarding Elsevier's pharma-promoting pubs masquerading as education, that "education is a euphamism for marketing."

Lancet published this bold, accusatory letter. This deserves a lot of admiration. However, Lancet/Elsevier follows up with a response that falls flat. They stand by their pharma-funded, pharma-promoted efforts to provide publications that appear as though they are impartial science, but are designed to "help pharmaceutical companies publish and market their research."
The advanced level of transparency, and acknowledgement of the issue, is progress in the issue of conflict of interest. Hopefully this trend will continue, and will snowball. We, and our physicians, need to be able to tell when we are reading an impartial, peer-reviewed journals, and we, and our physicians, need to be able to know when we are being presented with a piece of paper that is nothing more than advertising copy.

That only makes sense. The efforts now underway with Elsevier will correct these specific issues. But it takes a lot more to rebuild trust between consumers of research and publishers. It is very likely that as people recognize the gravity of this problem, trust for peer-reviewed medical journals in general will be damaged.

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