3 problems and a solution

Today's Wall Street Journal devotes a front page article to the omission of unflattering information about drug trials in prestigious medical journals. A key reason is that study authors are usually paid by the drug company sponsors. (Worrisome Ailment in Medicine: Misleading Journal Articles)

A study published in the Journal of the American Medical Association last year reviewed 122 medical-journal articles and found that 65% of findings on harmful effects weren't completely reported. It also found gaps in half the findings on how well treatments worked... The problem calls into question whether journals can play the role of gatekeeper in an era when articles are increasingly used as marketing tools.

There are two other significant problems that the article doesn't mention:First, drug company advertising is a major source of medical journals' revenue. The result is that explicit drug company advertising is woven in with drug company sponsored articles, and the overall editorial independence of the journals is called into question.Second, scientific and medical publishers often charge institutions subscription rates that range well into the thousands of dollars per year, straining the budgets of university libraries. It adds up to monopoly profits for the journal publishers, who after all don't pay for the research (it's funded by drug companies, the NIH and foundations) and don't pay the peer reviewers either. It also restricts the flow of information.There is an emerging open-access movement led by the Public Library of Science (PLoS), which is "committed to making the world's scientific and medical literature a freely available public resource." PLoS publishes its own peer-reviewed journals: PLoS Biology and PLoS Medicine, and is launching PLoS Computational Biology, PLoS Genetics, and PLoS Pathogens.I'll write more about the PLoS business model and its effect on the publishing industry and research community in a future post.-------Welcome Grand Rounds readers! While you're here, feel free to check out the rest of the Health business blog.