Intended for healthcare professionals

Analysis And Comment Commercial bias in medical journals

Commercial influence and the content of medical journals

BMJ 2006; 332 doi: (Published 15 June 2006) Cite this as: BMJ 2006;332:1444
  1. Joel Lexchin, associate professor (,
  2. Donald W Light, professor2
  1. 1 School of Health Policy and Management, York University, Toronto, ON, Canada
  2. 2 University of Medicine and Dentistry of New Jersey, Stratford, NJ, USA
  1. Correspondence to: J Lexchin, 121 Walmer Road, Toronto, ON, Canada M5R 2X8
  • Accepted 28 April 2006

How confident should we be in the objectivity of medical journals? Do commercial biases play a part in determining what appears in print?

Authors of articles in medical journals may be affected by commercial bias. Whether this same concern applies to the editors and owners of journals has rarely been critically examined.1 2 Our article explores the reasons for concern. We use information in the literature on three important questions. Do financial conflicts of interest affect decisions made by journal editors? Do journals have policies on authors' conflicts of interest, and how well do editors enforce those policies? Do financial considerations affect the content of medical journals? We end with a proposal for future research that would help to advance this debate.

Sources of bias

Government organisations and societies of health professionals can also influence journal content. A former editor of JAMA was fired by the American Medical Association because of political sensitivity over an article on oral sex that he published at the time of President Clinton's impeachment.3 An article in CMAJ on the information requested by pharmacists before dispensing postcoital contraception was changed after complaints by the Canadian Pharmacists Association about whether the research was ethical.4 However, we think that the greatest potential for bias comes from commercial influences, hence the direction of our article.

Conflicts of interest

Because journal editors have a great deal of control over original scientific articles, commentaries, and editorials, any commercial bias due to their own conflict of interest would affect the content of their journals.5 Only one systematic study has examined editors' policies on conflict of interest (financial and non-financial). Nine of 30 peer reviewed general and internal medical journals, including the top four by impact factor (a measure of frequency of citation), had an explicit policy for dealing with editors' financial conflicts of …

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