POLICIES, PRACTICES, AND ATTITUDES OF NORTH-AMERICAN MEDICAL JOURNAL EDITORS

OBJECTIVE: To describe U.S. and Canadian medical journals, their edito rs, and policies that affect the dissemination of medical information. DESIGN: Mailed survey. PARTICIPANTS: Senior editors of all 269 leadin g medical journals published at least quarterly in the United States a nd Canada, of whom 221 (82%) responded. MAIN MEASURES: The questionnai re asked about characteristics of journal editors and their journals a nd about journals' policies toward peer review, conflicts of interest, prepublication discussions with the press, and pharmaceutical adverti sements. RESULTS: The editors were overwhelmingly men (96%), middle-ag ed (mean age 61 years), and trained as physicians (82%), Although 98% claimed that their journals were ''peer-reviewed,'' the editors differ ed in how they defined a ''peer'' and in the number of peers they deem ed optimal for review, Sixty-three percent thought journals should che ck on reviewers' potential conflicts of interest, but only a minority supported masking authors' names and affiliations (46%), checking revi ewers' financial conflicts of interest (40%), or revealing reviewers' names to authors (8%), The respondents advocated discussion of scienti fic findings with the press (84%), but only in accord with the Ingelfi nger rule, i.e., after publication of the article (77%). Fifty-seven p ercent of the editors agreed that journals have a responsibility to en sure the truthfulness of pharmaceutical advertisements, and 40% favore d subjecting advertisements to the same rigorous peer review as scient ific articles. CONCLUSIONS: The responding editors were relatively hom ogeneous demographically and professionally, and they tended to suppor t the editorial status quo. There was little sentiment in favor of tam pering with the current peer-review system (however defined) or the In gelfinger rule, but a surprisingly large percentage of the respondents favored more stringent review of drug advertisements.