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Non-science and nonsense, without refutation

Posted by plosmedicine on 30 Mar 2009 at 23:42 GMT

Author: Ken Gillman
Position: Honorary Senior Lecturer
Institution: James Cook University
Submitted Date: June 01, 2005
Published Date: June 1, 2005
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

Altmans reminder published research should be open to comment and correction must be unequivocally supported [1]. This is such a fundamental requirement of the scientific paradigm that it is sometimes forgotten, as it appears to have been by the current editors of the BMJ. Wasnt Poppers book entitled conjecture and refutation? There is an unassailable argument that journals not willing and able to make space for all proper scientific criticism of previously published work have abrogated any right to be called scientific. The BMJ ploy of relegating criticism out of hard-copy and into less visible off database e-copy [2] is worthy of Sir Humphrey [3]. I agree with Smith [4] that they are producing the appearance of being purveyors of advertorials.

The field in which I publish, serotonin syndrome, suffers from a plethora of 'me-too' case reports which are usually of poor quality and rarely have a balanced review of the literature. As Altman states, making intelligent comment in severely restricted space is difficult, often to the point of over-simplification. There is a strong tendency for commentators (I include myself) to ignore it, or sacrifice academic rigor for a simple benign comment more likely to get published, that might at least alert some inquiring readers to other salient references. In doing so one is galled about what is, in essence, giving in to bullying, but one feels powerless to do much about it. That is because experience rapidly teaches that trying to engage editors in debate is the fast route to being ignored and therefore getting nothing published at all. Privately, eminent colleagues, whose views would add to the debate, indicate they have no time to bother; I observe a widespread sense of resignation about the tidal wave of poor quality publications in a myriad of minor, and now major league, journals. Perhaps a post-publication open peer review system, where views are computer-weighed according to the experience of people in that field, might be possible and useful?

It is time consuming to prepare these comments, so imperious inflexibility by journal editors (who do invariably refuse to discuss such responses prior to submission or enter into any correspondence whatsoever) discourages setting aside the valuable time required when it is likely to be wasted. Smith's insights make one suppose that the disinclination to make hard copy space for responses may be a deliberate policy dictated by anti-science imperatives. Indeed, it is now apparent that we should cease regarding even the BMJ as a bona fide scientific journal, but merely a vehicle to give their imprimatur to reprints of advertorials. It discredits science when an authority who gives expert evidence for medico-legal cases at an international level, is compelled to state in reports and evidence that major journals like the BMJ have published material [5] that is indisputably unbalanced and significantly incorrect [2, 6]. The medico-legal repercussions may even appear on the doorstep of journals in the form of a failure to warn liability if they are shown to have unreasonably refused to publish corrections that have major patient outcome implications [7]. This has already happened to drug companies.

I agree with the PLoS editors that 750 words is usually sufficient. When a longer response is necessary I suggest those who are good editors will become receptive and flexible if approached to consider such responses. It is not reasonable or sensible for the BMJ editors refuse to acknowledge or respond to correspondence about such a fundamentally important scientific issue. Such a stance makes it difficult for clinicians to justify paying for, or even reading free copies of, journals. So as Smith says, they become advertorials and their future readership and influence will be an inevitable downward spiral. The key insight and good news, at least for clinicians, is that it does not matter at all because there are far too many poor journals anyway.


1. Altman, D.G., Unjustified Restrictions on Letters to the Editor. PLoS Medicine, 2005. 2(5): p. e126.
2. Gillman, P.K., NMS and ST: chalk and cheese. BMJ, 2005: p.
3. Lynn, J. and A. Jay, Open Government, in The Complete Yes minister. 1981, BBC Books: London. p. 11.
4. Smith, R.L., Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies. PLoS Medicine, 2005. 2: p. e138.
5. Haddow, A.M., et al., Clomipramine induced neuroleptic malignant syndrome and pyrexia of unknown origin. Bmj, 2004. 329(7478): p. 1333-5.
6. Isbister, G.K. and N.A. Buckley, Clomipramine and neuroleptic malignant syndrome: literature on adverse reactions to psychotropic drugs continues to confuse. Bmj, 2005. 330(7494): p. 790-1; author reply 791.
7. Healy, D., A Failure to Warn. International Journal of Risk and Safety in Medicine, 1999. 12: p. 151-156.

No competing interests declared.