Positive clinical trials of herbal medicines? You wouldn’t read about it.

Is media coverage of herbal medicines and research biased?

It seems a popular line from some in the current FSM campaign about natural medicine being taught in university is to claim that research, when done, shows it “all” to be ineffective rubbish anyway. Almost invariably this is claimed devoid of supporting evidence.

A few years ago some researchers put the news media representation in English-speaking countries of herbal and pharmaceutical trials to the test.

After identifying 201 and 352 articles on pharmaceutical and herbal trials respectively via searches of English language (US, UK, Canada,  Aust, NZ) newspapers between 1995 and 2005 . They had students review, analyse and rate the newspaper articles using a standardised coding method used previously (positive, neutral, negative tone). Then compared this analysis to the quality and detail of the original journal articles of 48 pharmaceutical and 57 herbal medicine trials identified through the newspaper articles.

The studies used were from mostly high impact well recognised journals, that were undertaken in the US, UK or Europe. The overall rating for the journals in the studies used was higher than average across the board for herbal medicines, ie many herbal studies are not published in such high-ranking journals, but those included in this study were.

Aside from some more readily acknowledged problems of media reporting regarding details and accuracy of reporting scientific research, such as benefits vs risks, conflicts of interest and funding, dosages and practical clinical implications. Which applied to reports of both pharmaceutical and herbal medicines, more or less for different issues.

The main finding was that overall there was a significant bias in the newspaper articles in favour of the pharmaceutical studies compared to the herbal medicine studies. With absolutely none of the 201 newspaper articles on pharmaceutical trials rated as negative (68.2% positive, 31.8% neutral). Where only 21% of articles covering herbal medicine trials were rated positive and the majority (57.1%) were rated neutral. Even with the articles on the pharmaceutical studies also reporting a significantly higher risk of adverse events.

Yes, out of 201 newspaper articles over 10 years on pharmaceutical trials not a single article was rated as negative. I can only wonder if one of those trials included vioxx.

The researchers also suggest that overall the high impact factor scientific journals that they  sourced the studies from were more likely to publish negative result herbal medicine trials than negative pharmaceutical trials. Though the negative tone of newspaper articles was even greater than this accounted for.

All of this was despite the quality of the trials investigated in the study being considered of equal quality, although some elements of the studies such as patient numbers and length of study were significantly different.

The latter probably reflecting the historically marginal status of herbal medicine within institutional research bodies and in regard to funding in the English-speaking world, at least over much of the last century.

They conclude by suggesting that even though there are shortfalls generally in regard to newspaper reporting of scientific research. That there does appear to be a significant negative bias in regard to reporting herbal medicine trials and research, a failing in particular in light of the growing pool of evidence and scientific research around herbal medicines over the last two decades.

Also a failing in light of the growing public interest in and use of natural and traditional medicines such as herbal remedies, this study suggests a balanced and accurate portrayal of the research is generally not being provided by the news media in English-speaking countries.

Interestingly enough, this study suggesting that there is a negative bias in media reporting of what is apparently a growing element of public health has not been cited by any other articles (on PubMed Central at least) in the three years since it was first published.

Given the contention and sometime vociferous debate flying around about natural medicine, its place in university and the significant debates around the efficacy or research evidence of herbal medicines. It is all the more remarkable that such research concerning common public information sources appears to be completely ignored.

Other researchers analysing the content of 11 medicine journals also found a negative relationship between the pharmaceutical advertising content of journals and the likelihood of publishing any ‘dietary supplement’ studies or more negative research findings. So the more pharmaceutical advertising was in the journal, the less likely to be any reports regarding herbal, vitamin or mineral supplements, and even if present they were more likely to be negative.

It seems the chances of well conducted research that reflects some efficacy and safety of herbal remedies in the English-speaking world is required to overcome a range of economic and professional biases in both the peer-reviewed and general media. Entirely over and above any actual scientific findings determined in the process of the study.

Herbal remedy clinical trials in the media: a comparison with the coverage of conventional pharmaceuticals

Does pharmaceutical advertising affect journal publication about dietary supplements?

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