I was recently asked by the Therapeutics Initiative to review the final draft of Therapeutics Letter number 39 (January/February, 2001) prior to publication.

I submitted several criticisms, particularly in reference to the authors’ decision to exclude placebo data from the major table comparing risks of various anti-inflammatory drugs. I am not surprised that my comments were not incorporated into the publication, or that I did not receive any explanation for this. My concern is whether they were considered in good faith by the authors.

The publication states that “this Therapeutics Letter was submitted for review to 120 experts and primary care physicians in order to correct any inaccuracies and to ensure that the information is concise and relevant to clinicians.” The published version looks unaltered from the draft I reviewed. I wonder how many other of the reviewers submitted criticisms that were ignored. One might speculate whether the authors use editorial licence in selecting only data that support their goal, without documented accountability beyond lip service to the 120 reviewers.

Although the Therapeutics Letter is not factually wrong, the data are selective, and omission of placebo data gives a misleading message to the reader.

I am left to assume that the Therapeutics Letter is a politically driven publication with predetermined conclusions.

—Martin J. Fishman, MD 
Richmond