Table 1 Potential commercial bias in medical journal articles, and ICMJE protection

Academic

discourse and commercial planning [1–3]

• Clinical trials: what studies to undertake, whom to recruit as partners, whether and how to publish.

• Publications: number, theme, placement, scheduling and authorship of articles.

• Limited options available to ICMJE.

• Clinical trial registration (III L).

• Duplicate/prior publications (III D).

Article content [1–13]

• Clinical trials: design, conduct, discontinuation, analysis and interpretation.

• Data misrepresentation, fabrication and falsification.

• Review criteria and literature search.

• Insertion of commercial “key messages.”

• Language and rhetoric.

• Limited options– heavily reliant on peer review.

• Contributor listings (IIA 1).

• Stringent author accountability (IIA2).

• Access to data (IIB, IIB 2).

• Authors’ right to publish.

• Reporting guidelines (IV A2).

• Commercial supplements and series – journal’s editorial control maintained (IIIG).

• Rules on correction or retraction of inaccurate or fraudulent data (IIIB).

Article attribution [1, 2, 13–15]

• Spinning the sum effect of authorship, contributorship, acknowledgements, text, labeling, etc.

• Depends on what readers perceive, not merely what is disclosed.

• Advocacy-based marketing foregrounds recruited academic authors while obscuring the proprietary role of commerce using small print, vague language and omission.

• Extensive options – but poorly developed.

• Ban on ghost authorship (II A2).

• Funding source, trial identifier listed visibly in Abstract (IV A3).

• Contributorship, interest declarations and “Sources of support” sections provide limited benefits but involve small print (IIA, IIB, IV A3).

• Declaration of product being marketed – but only for supplements (IIIG).