The ICMJE state that editors must have full and final authority for approving advertisements and the COPE guidelines state that advertisements that mislead must be refused. Our publishers send every advertisement to our editorial office for approval before publication. I would be interested to know what criteria other editors use in assessing whether an advertisement misleads. There was a debate about this in connection with advertisements referring to studies but I have not been able to locate it again and would be grateful for any information anyone might have relating to it.

Elise Langdon-Neuner
Journal of Men's Health and Gender
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This is a really delicate area, given that in some cases, advertisers want to be positioned next to certain articles etc. Last year I refused an ad, as when I checked out the references listed on it (supposedly supporting their claims), they were actually tertiary refs and the link to the claims about the product tenuous. I also do not accept ads with 'data on file' wherever possible. However, I have to admit, I don't always get to see the ads before they are printed- which causes some tension!

Deborah
Editor, JWC
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See the work of Steve Woloshin et al. from Dartmouth.

You also have to remember that "misleading" is hard to define. Gemfibrizil was marketed with a relative risk reduction of 34%, although the absolute risk reduction was 1.4% and the number needed to treat was 71 men for 5 years to prevent a single heart attack. All the numbers are accurate and accepted outcome measures, but they lead the reader in different directions.