Updated 3/30/99
The following is from a lecture, "The Ideal Tocolytic Agent," by the American College of Obstetrics and Gynecology Chairman Dr. Karlis Adamsons MD, PhD, director of Obstetrics and Gynecology, University of Puerto Rico School of Medicine:
"From the theoretical point of view, beta mimetic drugs seem to be the least suitable tocolytic agents. Paradoxically, they have become the most widely used, partially because of the aggressive promotion by the manufacturers. Indeed, a beta mimetic drug (ritodrine) is the only tocolytic agent for which the manufacturer has sought and obtained endorsement by a federal regulatory agency (The Food and Drug Administration)."
A separate message from Dr. Karlis Adamsons on biomedical journals provides another clue:
"The so called "gold standard" for valuable scientific information is considered to be the peer reviewed journal, or the most recent edition of a major text book. The information contained in this two sources must be pretty much in agreement, because they form the bases upon which the entire academic and professional community of the nation is basing the construction of the examinations not only for the medical students but also for residents in training, and for those seeking specialty certification. This creates a difficult situation for information to be disseminated which is in conflict with accepted hypotheses or theories. We have to recognize also that the reviewer of a manuscript might have the necessity to protect her/his views, particularly if the given views are undergoing verification by and ongoing research project sponsored by an extramural source. Examples would include the rejection of manuscripts describing the adverse effects of betamimetic drugs on fetal oxygenation during the period when a drug manufacturer was seeking approval of the FDA for Ritodrine as a tocolytic agent, and the disinterest of our major journals to publish information on thyroxine a accelerator of fetal maturation until the termination of the futile studies with TRH. It is fortunate for the scientific community that in such situations there are European journals which might seek new ideas and challenges to existing concepts."
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Article on physicians' profit motive in prescribing home uterine monitoring/tocolytics
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