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Healthy Skepticism Library item: 6915

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Redelmeier DA.
Drug dependence in a journal club.
ACP J Club 1999 Nov-Dec; 131:(3):A13-4


Abstract:

Redelmeier expressed concern that, by running a journal club for hospital house-staff, he has unwittingly given a large amount of promotion to the pharmaceutical industry. The problem is that reliance on staff preferences resulted in disproportionate attention to therapeutic studies, the desire for rigor created an affinity for RCTs, and drug trials dominated because of their desirable methodological characteristics such as large sample sizes and double-blinding. These three factors favoured studies funded by drug companies. The problem will not go away soon. Regulatory and commercial interests conspire to perpetuate it. Redelmeier encouraged clinician-teachers who run journal clubs to guard against this trend and sometimes choose less popular articles, including studies other than drug trials. More generally, he expressed concern that the appeal of rigorous evidence may tempt people to only ask questions that are easily answered.

Keywords:
*editorial/Canada/United States/ Drug Therapy* Education, Medical, Continuing*

 

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Cases of wilful misrepresentation are a rarity in medical advertising. For every advertisement in which nonexistent doctors are called on to testify or deliberately irrelevant references are bunched up in [fine print], you will find a hundred or more whose greatest offenses are unquestioning enthusiasm and the skill to communicate it.

The best defence the physician can muster against this kind of advertising is a healthy skepticism and a willingness, not always apparent in the past, to do his homework. He must cultivate a flair for spotting the logical loophole, the invalid clinical trial, the unreliable or meaningless testimonial, the unneeded improvement and the unlikely claim. Above all, he must develop greater resistance to the lure of the fashionable and the new.
- Pierre R. Garai (advertising executive) 1963