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Healthy Skepticism Library item: 6865

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

Lexchin J.
How patient outcomes are reported in drug advertisements.
Can Fam Physician 1999 May; 45:1213-6:


Abstract:

OBJECTIVE: To examine how changes in outcomes are reported in drug advertisements in medical journals. QUALITY OF EVIDENCE: Advertisements from a convenience sample of 38 issues of Canadian Family Physician, Canadian Journal of Anaesthesia, Canadian Journal of Psychiatry, Canadian Medical Association Journal, and the New England Journal of Medicine. MAIN MESSAGE: Method of reporting changes in clinical outcomes (relative risk reduction [RRR], absolute risk reduction [ARR], number needed to treat [NNT]), name of product, and company marketing product were sought. In the 22 advertisements included in the analysis, 11 reported results as RRRs; two reported results as RRRs, but readers could calculate ARRs or NNTs from figures given in the advertisement; and nine gave no measure of results, but readers could calculate RRRs, ARRs, or NNTs from figures given. CONCLUSIONS: Most companies report changes in outcomes as RRRs, and this bias could influence the way physicians prescribe. Changes to the rules governing journal advertising and increased emphasis on critical appraisal skills would help mitigate this bias.

Keywords:
*analytic survey/Canada/journal advertisements/reporting of results/regulation of promotion/relative risk reduction/absolute risk reduction/number needed to treat/EVALUATION OF PROMOTION: JOURNAL ADVERTISEMENTS/INFLUENCE OF PROMOTION: PRESCRIBING, DRUG USE/REGULATION, CODES, GUIDELINES: AUTONOMOUS BODIES Advertising* Bias (Epidemiology) Canada Comparative Study Data Interpretation, Statistical Humans Periodicals* Pharmaceutical Preparations* Risk Treatment Outcome*

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909