Medical journals used to be thought of as the last bastion of scientific honesty -- the repository of objective truths about the state of medical research. In recent years, however, that reputation has been repeatedly soiled by incidents of greed, dishonesty and carelessness.

Journals have admitted publishing research reports funded by and biased in favor of drug companies, not checking author's credentials, and allowing monetary considerations influence their publishing decisions.

A recent study shows that these journals, and the researchers published in them, are issuing press releases that deliberately try to deceive the public about the importance of their findings.

In addition, the press releases usually do not highlight limitations of the study that could call into question the validity of those findings, or include information on funding of the research, according to researchers in the June 5, 2002 Journal of the American Medical Association (JAMA).

Steven Woloshin, M.D., and Lisa M. Schwartz, M.D., of Dartmouth Medical School and the White River Junction Veterans Affairs Outcomes Group examined the medical press release process at several high-profile medical journals and reviewed recent releases to evaluate how study findings are presented and whether limitations and potential conflicts of interest are acknowledged.

While medical journals are supposed to take steps to ensure accuracy and acknowledgment of limitations in articles, press releases seldom reflect these efforts, say the authors. Medical journal press releases are perhaps the most direct way that journals communicate with the media. Although journalists rely on press releases -- and many newspapers run them almost verbatim -- there is little scrutiny of the release process or quality.

For this study, the authors conducted telephone interviews in January 2001 with press officers at nine prominent medical journals and analyzed 127 press releases about research articles, for the six issues of each journal preceding the interviews.

Seven of the nine study journals routinely issue press releases: Annals of Internal Medicine, British Medical Journal (BMJ), Circulation, JAMA, Journal of the National Cancer Institute (JNCI), The Lancet and Pediatrics. The Annals of Surgery and the New England Journal of Medicine do not routinely issue press releases.

The researchers found that of the journals that routinely issue releases, "in each case, the editor with the press office selects articles based on perceived newsworthiness and releases are written by press officers trained in communications.

"Journals have general guidelines (e.g., length) but no standards for acknowledging limitations or for data presentation. Editorial input varies from none to intense.

"Of the 127 releases analyzed, only 29 (23%) noted study limitations and 83 (65%) reported main effects using numbers; 58 reported differences between study groups and of these, 26 (55%) provided the corresponding base rate, the format least prone to exaggeration. Industry funding was noted in only 22% of 23 studies receiving such funding."

The researchers noted, "A number of authors have criticized the accuracy and balance of the news media in reporting on medical science. As a direct means of communication between medical journals and the media, press releases provide an opportunity for journals to influence how the research is translated into news."

To correct these deficiencies it was suggested, "Editors might develop presentation standards for releases analogous to the structured abstract format used by many journals, and might include a section putting results in context (e.g., are the results consistent with other studies, is there a corresponding editorial), a limitations section, and a statement about potential conflicts of interest."

"The public and many physicians often learn about new medical research through the news media, rather than medical journals. We think that journals can and should do more to enhance the quality of medical reporting," the researchers admonished.

The same issue of JAMA also included two related reports.

The first revealed that information from abstracts presented at scientific meetings are widely reported in major media outlets, even though the information may be preliminary and may have undergone limited scientific review. "The current press coverage of scientific meetings may be characterized as 'too much, too soon,'" the authors noted. "Results are frequently presented to the public as scientifically sound evidence rather than as preliminary findings with still uncertain validity."

The second related report warned that the views included in research papers often do not represent the opinions of all scientists who participated in the study. The author, Richard Horton, editor of The Lancet, reviewed a number of research reports published in his journal and contacted the original researchers.

"Important weaknesses were often admitted on direct questioning but were not included in the published article," he noted. "Contributors frequently disagreed about the importance of their findings, implications, and directions for future research ... I have found evidence of censored criticism; obscured views about the meaning of research findings; incomplete, confused, and sometimes biased assessment of the implications of a study; and frequent failure to indicate directions for future research. ... What was striking was the inconsistency in published evaluations, especially regarding weaknesses."

SOURCES: "Media Coverage of Scientific Meetings -- Too Much, Too Soon?" by Lisa M. Schwartz, M.D., et. al., Journal of the American Medical Association (JAMA), June 5, 2002.

"Press Releases: Translating Research Into News," by Steven Woloshin, M.D., et. al., (JAMA), June 5, 2002.

"The Hidden Research Paper," by Richard Horton, (JAMA), June 5, 2002.