BMJ  2003;326:1171-1173 (31 May), doi:10.1136/bmj.326.7400.1171

Paper

Evidence b(i)ased medicine—selective reporting from studies sponsored by pharmaceutical industry: review of studies in new drug applications

Hans Melander, senior biostatistician1, Jane Ahlqvist-Rastad, senior medical officer1, Gertie Meijer, documentalist1, Björn Beermann, professor1

1 Medical Products Agency, Box 23, S-751 03 Uppsala, Sweden

Correspondence to: H Melander hans.melander{at}mpa.se

Objectives To investigate the relative impact on publication bias caused by multiple publication, selective publication, and selective reporting in studies sponsored by pharmaceutical companies.

Design 42 placebo controlled studies of five selective serotonin reuptake inhibitors submitted to the Swedish drug regulatory authority as a basis for marketing approval for treating major depression were compared with the studies actually published (between 1983 and 1999).

Results Multiple publication: 21 studies contributed to at least two publications each, and three studies contributed to five publications. Selective publication: studies showing significant effects of drug were published as stand alone publications more often than studies with non-significant results. Selective reporting: many publications ignored the results of intention to treat analyses and reported the more favourable per protocol analyses only.

Conclusions The degree of multiple publication, selective publication, and selective reporting differed between products. Thus, any attempt to recommend a specific selective serotonin reuptake inhibitor from the publicly available data only is likely to be based on biased evidence.

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