BMJ  2005;330 (5 February), doi:10.1136/bmj.330.7486.0-h

Editor's choice

Questions and answers

Question: Is the role of a medical journal to question or provide answers?

Answer: Both—although asking questions is feasible, finding answers with certainty is hazardous. Questions and answers are the lifeblood of any journal, and here are some examples from this week's issue.

Q: Does passive smoking cause lung cancer?

A: Two more studies add to the evidence that already implicates passive smoking to such a degree that reduction of secondhand smoke must be a public health priority worldwide. Evidence for the causal link is clear, the argument is over the magnitude of risk (pp 265, 277, 287).

Q: Does a doctor's personality and learning style predict stress, burnout, and career satisfaction?

A: Extraversion, openness to experiences, and agreeableness confer advantages at work. Neuroticism predicts a disordered approach to work, perceived high workload, and stress (p 269). But tomorrow's workforce might value all the different personality types in a team (http://careerfocus.bmjjournals.com).

Q: What has driven whole body CT scanner clinics out of business?

A: The limits of direct to consumer advertising, the power of dissuasion by professional societies, costs, and tests that found innocuous lumps but missed common cancers. Of a hundred people who undergo a scan, 30-80 will be told they need a workup—which will turn out to be nothing (p 272).

Q: Does dumping 20 tonnes of aluminium sulphate directly into the water supply cause long term effects on health?

A: Yes, said a BMJ paper in 1999: it will damage cerebral function in those exposed. No, says a government scientific advisory committee, there is no conclusive link between the Camelford incident and the chronic symptoms and diseases reported (p 275).

Q: Are helmets protective in skiers and snowboarders?

A: Helmets protect against head injuries but the estimates for neck injury are more imprecise and may be compatible with an increased risk (p 281). Do you value your head more than your neck?

Q: Is simultaneous submission to multiple journals a method of reducing time to publication (p 305)?

A: Probably, but it will waste reviewers' time, editors' time, and—thanks to inefficient communication between journals—will inevitably lead to duplicate publication and further distort the scientific record.

Q: Can a man increase the size of his penis?

A: "It is possible to surgically increase the size of an erect (and flaccid, for that matter) penis, but it should not be undertaken lightly, as it is by no means guaranteed to produce the result one might be hoping for" (280).

Q: Has this given you a buzz for questioning or answering?

A: Take a look at our Question and Answer service on bmj.com, examples of which—like the last one—you will find sprinkled about this week's issue (pp 280, 288, 292, 304, 307).

Kamran Abbasi, acting editor

(kabbasi{at}bmj.com)


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Relevant Articles

More evidence on the risks of passive smoking
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BMJ 2005 330: 265-266. [Extract] [Full Text] [PDF]

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