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Research Letter |

Clinical Trial Evidence and Use of Fish Oil Supplements

Andrew Grey, MD1; Mark Bolland, PhD, MBChB1
[+] Author Affiliations
1Department of Medicine, University of Auckland, Auckland, New Zealand
JAMA Intern Med. 2014;174(3):460-462. doi:10.1001/jamainternmed.2013.12765.
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Randomized clinical trials (RCTs) with “hard” end points and meta-analyses of these trials should influence clinical practice because they represent the highest level of evidence. Health care behaviors based on less robust evidence are often established before such RCTs are conducted. If the results of high-quality RCTs contradict established practice, numerous barriers exist to their acceptance and implementation.1 ω-3 Fatty acid (FA) supplements are commonly used for the management of cardiovascular, neurocognitive, ophthalmic, and inflammatory disorders. In 2002, their use in the secondary prevention of heart disease was endorsed by the American Heart Association.2 Recently, their health effects have been studied in several RCTs and meta-analyses, many of which were reported in high-impact journals. Here, we report the relationship between these publications in influential journals and the use of ω-3 FAs.

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Figure.
Sales of Fish Oils or ω-3 Fatty Acids (FAs) in the United States, 2007 Through 2012

Data are in millions of US dollars. Arrows indicate dates of publication of randomized clinical trials (solid arrows) or meta-analyses of randomized clinical trials (dashed arrows) of ω-3 FAs in high-impact medical journals between January 1, 2005, and December 31, 2012. Trials and meta-analyses with cardiovascular disease (CVD) end points are shown in the lower panel, and those with non-CVD end points are shown in the upper panel. a indicates the trials reporting a benefit of ω-3 FAs; NA, not available.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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