Letters

BMJ should declare its own conflict of interest

On 26 November 1994 there was a large, glossy, two page spread for co-amoxiclav in the same edition as a review article on the diagnosis and management of sinusitis in which amoxycillin (with or without clavulanic acid) is recommended; on 7 January 1995 there was a two page advertisement for filgrastim only a few pages from a review article on bone marrow transplantation in which the authors indicate that such agents are useful to reduce neutropenia; on 8 April 1995 tinzaparin was advertised a few pages away from an article on recent advances in orthopaedic and trauma surgery, a serious complication of which is the development of deep venous thrombosis. These examples are from editions of the BMJ taken at random from the shelf of a hospital library, but similar examples may be found in virtually every edition.

I do not wish to imply that the authors of these articles were in any way biased towards any particular product, but I fear that the BMJ may be unduly influencing readers by coincidentally publishing such advertisements. Advertising is obviously a major source of income for the journal (£4368 a week for a two page display advertisement) and presumably is a cost effective way for pharmaceutical companies to influence the prescribing habits of doctors. I am concerned that the journal may be, unwittingly perhaps, aiding the industry in applying that influence.

The BMJ has a notable tradition, particularly in recent years, for being a little smug and rather holier-than-thou. Perhaps, before preaching at potential authors, it should take a look at its own standards, get its own house in order, and declare its own interest when carrying advertisements.

Consultant paediatrician West Suffolk Hospital, Bury St Edmunds, Suffolk IP33 2QZ

D C Mabin