Pharmaceutical industry sponsorship of journal supplements.

The November 2005 Supplement to CHEST, “Improving Outcomes in Respiratory Failure: Ventilation, Blood Use, and Anemia Management,” contained eight review articles1–8 concerning transfusion medicine. Publication was supported by an educational grant from Ortho Biotech, the manufacturer of recombinant human erythropoietin (epoetin). Not surprisingly, the articles are not supportive of transfusion: five articles1,4–6,8 discuss the risks of blood transfusion in respiratory failure, and three articles1,4,5 mention epoetin as an attractive alternative. One review article4 discusses at length the benefits of epoetin seen in a randomized trial in long-term acute care patients, even though the results of this trial have not undergone peer review.9 Although Ortho Biotech was disclosed as the sponsor, no information was given regarding their role in choice of topic, selection of authors, or potential influence over content. One half of the articles list authors who either received consultancy fees from Ortho Biotech or are members of their Speaker’s Bureau. These financial ties raise serious questions about their objectivity. This is particularly problematic in the case of review articles, which do not make primary data accessible to readers and are therefore more vulnerable to author bias. In addition, when a journal Supplement is supported by industry, the journal itself acquires a financial conflict of interest that casts doubt on its editorial independence. For this reason, many of the most reputable journals (for example, the New England Journal of Medicine, JAMA, and Lancet) do not produce sponsored Supplements. We regret that CHEST is not among these. Supplements such as these erode the confidence of the readers in the scientific objectivity of the editors and create a dangerous blurring of the line between the medical literature and pharmaceutical industry marketing.