It is no secret that reprints of studies published in medical journals are widely used as promotional tools by the pharmaceutical industry. And these reprints are also a welcome source of revenue for publishers. Of course, this has raised perennial questions about conflicts of interest, since the value of a large reprint order has the potential to influence whether a paper is accepted for publication.
To explore such concerns, a group of researchers sought to determine whether industry funding is associated with high reprint orders. And a new analysis suggests an association does, indeed, exist. In seven journals that were studied, industry-sponsored articles were significantly over-represented among those most frequently requested as reprints, according to the analysis in BMJ (read here). Although, articles with high reprint orders were no more likely to be randomized controlled trials than other study designs.
To sort this out, a group of researchers e-mailed the editors-in-chief of several leading medical publishers: the Journal of the American Medical Association, Lancet, The New England Journal of Medicine, Annals of Internal Medicine and BMJ for details of top articles by size of reprint orders. This was called the high reprint group. But some would not participate: JAMA called the data proprietary, the NEJM would not share and Annals said this was too much work.
So they settled on seven journals published by the Lancet and BMJ groups: Lancet, Lancet Neurology, Lancet Oncology, BMJ, Gut, Heart, and Journal of Neurology, Neurosurgery & Psychiatry. From there, they selected control articles from each journal that ran immediately before the high reprint article from the same section of the same issue. When this was not possible, they chose the first article in the same section of the previous issue. The control article, they note, was always of the same type as the high reprint article and could not be in the high reprint group.
The upshot? "Papers with high reprint orders were significantly more likely to be funded by industry in all journals except Gut, where the trend was for high reprint papers to be funded by industry," the researchers wrote. "The effect of industry funding on being a high reprint paper was similar across all studies." There was only one journal, Gut, where randomized controlled trials were significantly more likely to generate high reprint orders.
What else? General medical journals had more reprint orders than speciality journals and some of the reprint orders were "substantial, equating to a large amount of income generated," they wrote. As a result, reprint orders "could potentially be a source of publication bias, although our study was not designed with this in mind. An overall association of study design with reprint orders was not apparent, although this might differ by journal."
Of course, there were some limitations. For one thing, a few of the most widely read journals, as noted, declined to provide data, so the sample studied may - or may not - be particularly representative. And data for only the most highly ordered papers was analyzed, suggesting the need to compare income from studies that are not requested as often with the highly requested papers.
"We have identified a potential source of publication bias among several medical journals," they conclude. "This will need confirmation from data generated by other publication groups and further research. We emphasise that there is currently no evidence that the potential for future reprint orders influences decisions to publish particular articles... However, because reprints provide considerable sources of revenue, we would suggest that data on reprint orders should be made more available generally and that specific data for reprint orders should be included with individual articles."
Their closing remark throws down the gauntlet to medical publishers - effectively, they are saying the books should be opened. This is, of course, a provocative notion, especially to private companies. Nonetheless, the suggestion is that greater transparency would inspire confidence that reprint orders does not influence publication decisions. What do you think?
Should Medical Journals Disclose Reprint Figures?
- Yes (66%, 76 Votes)
- No (34%, 37 Votes)
Total Voters: 115