The 100,000 reprint rule
In August 2001, a Seattle pharmacist called a radio show on which Jeffrey Drazen, the top editor of the New England Journal of Medicine, was appearing. On the air, the pharmacist, Jennifer Hrachovec, begged Dr. Drazen to update an article in the journal that touted the benefits of the painkiller Vioxx while playing down its heart risks.Dr. Hrachovec had been reviewing data on a Food and Drug Administration Web site indicating that patients in a Vioxx clinical trial had suffered more heart attacks than the journal article about the trial reported. "It bothers me there is more data from the trial than has ever been published and the New England Journal still hasn't published an editorial or any kind of update," she said. "My concern is that doctors are still using this and exposing their patients to higher risks of heart problems and they just don't even know that that's the case."Dr. Drazen was dismissive. "We can't be in the business of policing every bit of data we put out," he told Dr. Hrachovec.
It is a good point that they can't police every bit of data that they put out. But this was no ordinary paper:
... the journal sold 929,400 reprints of the article -- more than one for every doctor in the country. Merck says it bought most of them.
How about this for a rule of thumb: if more than 100,000 reprints are ordered for an article, the article should get a higher level of scrutiny, which means more space devoted to responses and greater involvement of the journal in follow-up on the article.