Follow the money

Caveat on this rating: Two pairings are mandatory. On the evidence: educational meetings do change practice at moderate certainty (Cochrane CD003030.pub3, 2021, 215 studies), and physician-industry interaction is associated with prescribing (Brax, PLoS One 2017, pooled OR 2.52, 95% CI 1.82-3.50, moderate quality) - but only TWO studies in that review examined industry-funded CME specifically, one at high risk of bias, published 1988 and 1992, neither measuring clinical outcomes; the most-cited (Orlowski, Chest 1992) measured prescribing after physicians were flown on "all-expenses-paid trips to popular sunbelt vacation sites", conduct Standard 4.1.c now prohibits. On the accreditor: the review most often quoted for "no evidence of bias" (Cervero and Gaines 2014) was commissioned and funded by the ACCME, as its own cover states, and its finding is symmetrical - no data-based article supports OR refutes the assertion. The register is disclosure, never accusation: you should know who pays.

Caveat on this rating: The domain label is load-bearing, per the verified record: the primary-sourced pressure case here (the Annals advertising pullback) is a MEDICAL-JOURNAL case, not a consumer-news case, and the body says so in those words. No news-side adjudicated case exists; no "pharma funds X% of TV news" figure has any federal or peer-reviewed basis (the viral personalization is fact-checked False, PolitiFact 2023); and the pharma advertising-revenue-to-coverage causal literature is absent. The absences print as content - presenting the journal case as a news-media case would be the overreach this row exists to avoid.

Caveat on this rating: What is measured versus what is asserted, per the framing rule in the verified record: these three studies measure coverage QUALITY - benefits inflated, harms omitted, conflicts undisclosed - and none of them measures why. No robust empirical literature links pharmaceutical advertising revenue at an outlet to that outlet's drug-safety coverage decisions (the classic ad-revenue studies are about tobacco, a different industry, and are not presented as pharma evidence). This row presents the measured record and asserts no cause; "media buries drug harms because pharma pays them" publishes beyond the evidence and is on the do-not-publish list.

Caveat on this rating: The built-in rebuttal is structural, per the verified record: BOTH directions print together, always. A brand-name request quintupled prescribing where antidepressants are not clearly indicated (55% vs 10%) AND requests cut undertreatment of real depression (minimally acceptable care 56% without a request, 90-98% with one) - the authors' conclusion is that DTC advertising "may have competing effects on quality, potentially both averting underuse and promoting overuse". The chain also stays explicit: Kravitz tests requests, not ads; the ads-to-requests link is the review tier (Mintzes 2012). "Ads make doctors prescribe" is on the do-not-publish list.

Caveat on this rating: The mandatory rebuttal, printed beside the guidance annotation per the verified record: Rosenthal et al., NEJM 2002 (doi:10.1056/NEJMsa012075) - "the initial surge in direct-to-consumer advertising preceded the 1997 FDA guidelines... and thus the 1997 guidelines may not have been the most important reason" for the increase. The 1997 draft and 1999 final guidance are rendered as annotations ("the rules changed here"), never as the asserted cause of the spend curve - and DTC advertising was never illegal, so "legalized" appears nowhere in this row.

Caveat on this rating: The DSM panel counts are from 2006 and 2012 - historical, not current. The American Psychiatric Association's rebuttal is shown beside the Cosgrove counts because the two figures count different groups in different years, and both are correct as stated.

Caveat on this rating: The overtreatment figure is an aggregate estimate with a wide band, not a finding about anyone's individual care. Population-level effects of payment systems say nothing about any individual clinician's reasoning, and the research does not claim otherwise - nothing here says your doctor is motivated by money.