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Policies, practices, and attitudes of north american medical journal editors

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OBJECTIVE: To describe U.S. and Canadian medical journals, their editors, and policies that affect the dissemination of medical information.

DESIGN: Mailed survey.

PARTICIPANTS: Senior editors of all 269 leading medical journals published at least quarterly in the United States and Canada, of whom 221 (82%) responded.

MAIN MEASURES: The questionnaire asked about characteristics of journal editors and their journals and about journals’ policies toward peer review, conflicts of interest, pre-publication discussions with the press, and pharmaceutical advertisements.

RESULTS: The editors were overwhelmingly men (96%), middle-aged (mean age 61 years), and trained as physicians (82%). Although 98% claimed that their journals were “peer-reviewed,” the editors differed in how they defined a “peer” and in the number of peers they deemed optimal for review. Sixty-three percent thought journals should check on reviewers’ potential conflicts of interest, but only a minority supported masking authors’ names and affiliations (46%), checking reviewers’ financial conflicts of interest (40%), or revealing reviewers’ names to authors (8%). The respondents advocated discussion of scientific findings with the press (84%), but only in accord with the Ingelfinger rule, i.e.,after publication of the article (77%). Fifty-seven percent of the editors agreed that journals have a responsibility to ensure the truthfulness of pharmaceutical advertisements, and 40% favored subjecting advertisements to the same rigorous peer review as scientific articles.

CONCLUSIONS: The responding editors were relatively homogeneous demographically and professionally, and they tended to support the editorial status quo. There was little sentiment in favor of tampering with the current peer-review system (however defined) or the Ingelfinger rule, but a surprisingly large percentage of the respondents favored more stringent review of drug advertisements.

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Supported by the Robert Wood Johnson Foundation, Princeton, New Jersey.

The views herein do not necessarily reflect the policies of the authors’ institutions or the Robert Wood Johnson Foundation.

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Wilkes, M.S., Kravitz, R.L. Policies, practices, and attitudes of north american medical journal editors. J Gen Intern Med 10, 443–450 (1995).

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