Abstract
Commercial interests in health care have begun to affect the contents of some medical research reports in a way that could interfere with the essential function of medical journals. Recently I was asked to review a manuscript submitted for publication to Pediatrics , investigating the application of a proprietary clinical scoring system in a pediatric population. Basic information was withheld because of its proprietary nature, such as the identification of clinical variables, values of normal age-related ranges, as well as the equations relating patient characteristics to outcome. The missing information made a potentially useful contribution uninterpretable. The difficulties encountered in evaluating this incomplete report typify a problem that journals increasingly will face as they deal with articles having commercial importance. Many journal editors have not yet stated a position on the practice of withholding proprietary information from articles submitted for publication. The fact that commercial interests arise in an article on health services research indicates the economic importance of this growing field. Health services research deals with effectiveness, costs, and efficiency of health care. In order to interpret observations of health outcomes, objective methods are needed to characterize the patient population involved. For example, a clinical scoring system measuring severity of illness might assist in the interpretation of differences in clinical outcomes between two health care organizations. Using clinical scoring systems, the investigator may be able to attribute differing outcomes … Address correspondence to: Robert K. Kanter, MD, Department of Pediatrics, SUNY Health Science Center, 750 East Adams St, Syracuse, NY 13210.
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