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From the Townsend Letter
August/September 2006


Medline Bias
by Andrew W. Saul

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The US National Library of Medicine (NLM) describes itself as the "world's largest medical library” and claims to provide information in "all areas of biomedicine and health care." Yet that statement is demonstrably untrue. The NLM does not include the Journal of Nutritional and Environmental Medicine; Medical Veritas; Fluoride; the Journal of American Physicians and Surgeons; or the Journal of Orthomolecular Medicine (now in its 30th consecutive year of publication) in the electronic index known as Medline. Why not?

Medline is the preeminent online search engine for medical publications. With Medline, you can access abstracts of millions of scientific papers instantly from your computer. The public loves Medline; nearly two million people use it every day. This excellent, free service is made available by the US Department of Health and Human Services/National Institutes of Health – in other words, through tax dollars. Generally, the service is money well spent, until you go searching, say, for megavitamin therapy research papers. Then you will find that you can't find all of them. That is because of selective indexing.

What are the consequences of such exclusion? First, such selective indexing prevents the public from learning about all the scientific research and clinical reports that demonstrate the effectiveness of megavitamin (orthomolecular) therapy. It also greatly hampers professionals by preventing them from seeing pro-vitamin studies. Have you ever wondered why so many doctors simply do not know about vitamin therapy? Well, wonder no longer. You cannot study what you cannot find; you cannot find what is not indexed. There is little difference between freedom of speech and freedom of access. If people cannot find it, they cannot read it. These days, you don't have to burn literature; just make it hard to access.

Selection Bias
While the tax-supported NLM does not see fit to index the Journal of Orthomolecular Medicine, it does choose to index Time magazine. Believe it or not, there are no fewer than 1,260 indexed articles on Medline just from Time magazine. I found another 1,136 Medline listings for Newsweek. Time nor Newsweek are not medical journals. Neither are Consumer Reports or Reader's Digest, and, yes, they too are indexed by Medline.

How did this happen?
To this day, Medline's indexing decisions are made by a Literature Selection Technical Review Committee, whose members are appointed by NLM. This committee decides for you what you may or may not have access to. And the process of deciding what will or will not be indexed is done in secret. There are no public hearings.

What Does Medline Choose to Index?
At Medline, in the "Search PubMed for" box, type in "flatulence" and you will get 1,233 indexed citations. Here are some additional topics and titles that Medline also indexes:

  • Increasing the portion size of a packaged snack increases energy intake in men and women. (Appetite. 2004)
  • How dogs navigate to catch Frisbees. (Psychol. Sci. 2004)
  • Olfactory responses and field attraction of mosquitoes to volatiles from Limburger cheese and human foot odor. (J Vector Ecol. 1998)
  • Staring at one side of the face increases blood flow on that side of the face. (Psychophysiology. 2004)
  • Rhinotillexomania (nose-picking): psychiatric disorder or habit? (J Clin Psychiatry. 1995)
  • An objective evaluation of the waterproofing qualities, ease of insertion and comfort of commonly available earplugs. (Clin Otolaryngol. 2004)
  • Effect on tipping of barman drawing a sun on the bottom of customers' checks. (Psychol Rep. 2000)
  • Espresso kiosks can be profitable addition to hospital foodservice. (Health Foodserv Mag. 2000)

Yes, it's true: All the above are duly indexed by the NLM's Medline. They may instantly accessed, from anywhere in the world, with a few clicks of the mouse.

If Medline indexes what might quite fairly be called "unique" studies, it should at the very least also index two-time Nobel Prize winner Linus Pauling's eight nutritional papers published in the Journal of Orthomolecular Medicine, four of which appeared in a single year (1991). It is absurd that the NLM, which has indexed no fewer than 117 papers by Linus Pauling, excludes equally valuable work by Pauling simply due to where that work appeared. How can an author's work be significant if published in one journal, but not even worth mentioning if published in another?

Medline has steadfastly refused to index the Journal of Orthomolecular Medicine for three decades. Let it now be said: The emperor has no clothes. The National Library of Medicine/Medline is biased.

Andrew W. Saul is Assistant Editor of the Journal of Orthomolecular Medicine and is the author of the books Doctor Yourself: Natural Healing that Works and Fire Your Doctor! How to be Independently Healthy. His peer-reviewed natural healing website,, receives over 35,000 hits per day. You can read papers from the Journal of Orthomolecular Medicine free of charge at

Andrew W. Saul

Condensed and reprinted with permission from
Saul AW. Medline bias.
J Orthomolecular Med. 2005; 20 (1): 10-16.


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