Letters

Twists in the tale of impossible means

BMJ 2000; 320 doi: http://dx.doi.org/10.1136/bmj.320.7245.1343 (Published 13 May 2000) Cite this as: BMJ 2000;320:1343

In which a copy of the original manuscript is found safe in Norway …

  1. Jon Håvard Loge, postdoctoral research fellow (j.h.loge{at}medisin.uio.no)
  1. Department of Behavioural Sciences in Medicine, POB 1111 Blindern, 0317 Oslo, Norway
  2. Academic Department of Psychological Medicine, Guy's, King's and St Thomas's School of Medicine and Institute of Psychiatry, London SE5 8AF
  3. Hairmyres Hospital, East Kilbride G75 8RG
  4. BMJ

    EDITOR—Recently, Bland correctly identified impossible means for fatigue and scores with the general health questionnaire in a paper published by Pawlikowska et al in 1994.1 2 The authors admitted the mistake and reported the correct values, but they could not explain how the values came to be incorrect in their paper.3 Missing proofs, the theft of a computer, and the passage of time might seem like poor excuses and indicate unreliable researchers.

    I can, however, confirm that the values reported by Chalder and Wessely in their authors' reply correspond with the values in the original manuscript. I received a copy in 1993, when the manuscript was being reviewed by the BMJ. On the front page one of the authors has written by hand: “submitted to the BMJ, not for citation.” Since then my copy of the manuscript has been stored on a bookshelf at the University of Oslo. I checked it with some excitement after reading Bland's criticism to find that the values in the authors' reply were the same as those in my copy of the original manuscript (available on request).

    Perhaps the authors were correct when they said that the manuscript had been attacked by gremlins. The gremlins seem to have attacked somewhere in the production line because the referees at the BMJ reviewed a manuscript with correct means.

    References

    1. 1.
    2. 2.
    3. 3.

    … the researchers rejoice that the gremlins were at the BMJ after all …

    1. Simon Wessely, professor of epidemiological and liaison psychiatry (s.wessely{at}iop.kcl.ac.uk)
    1. Department of Behavioural Sciences in Medicine, POB 1111 Blindern, 0317 Oslo, Norway
    2. Academic Department of Psychological Medicine, Guy's, King's and St Thomas's School of Medicine and Institute of Psychiatry, London SE5 8AF
    3. Hairmyres Hospital, East Kilbride G75 8RG
    4. BMJ

      EDITOR—Initially this correspondence was both painful and embarrassing to us,1 2 but it has now become less so. It clearly shows, however, that there is no doubt that the analyses and conclusions of our paper written all those years ago remain valid and are certainly not faulty.

      In March I received from Dr Loge a copy of the original manuscript that we sent him as a professional courtesy after we had submitted the manuscript to the BMJ. As he states in his letter above, the means are indeed correct. Hence our somewhat ungallant suggestion that the BMJ was attacked by gremlins though not gallant is accurate.

      What have we learnt?

      Firstly, we congratulate Bland for rereading an old paper and spotting what no one else had seen.

      Secondly, we thank God for Norwegian colleagues who keep copies of old manuscripts.

      Thirdly, we will not dispose of proof copies when the reprints finally arrive.

      Fourthly, we feel sure that our sleepless nights over this one will be cured by receipt of a bottle of wine from the BMJ.

      References

      1. 1.
      2. 2.

      … the reviewer shows that the gremlins might have attacked on several fronts …

      1. Anthony Pelosi, consultant psychiatrist
      1. Department of Behavioural Sciences in Medicine, POB 1111 Blindern, 0317 Oslo, Norway
      2. Academic Department of Psychological Medicine, Guy's, King's and St Thomas's School of Medicine and Institute of Psychiatry, London SE5 8AF
      3. Hairmyres Hospital, East Kilbride G75 8RG
      4. BMJ

        EDITOR—Bland found that the analysis was flawed in a paper on fatigue and psychological distress that had been published by the BMJ in 1994.1 2 He quite properly asks why nobody noticed this at the refereeing stage. The authors are unable to account for their errors and have tried, as they say, “totally ungallantly” to transfer the blame to the BMJ.3 They also wonder how the referee could have failed to detect the mistakes.

        I refereed the manuscript for that paper. I think I can explain the most serious discrepancy identified by Bland. The authors originally coded the four possible responses in each item of their main questionnaires as 1 to 4. Therefore total scores for the general health questionnaire ranged from 12 to 48 and those for the fatigue questionnaire from 11 to 44. I told them they had to code the responses as 0 to 3. It looks as if they gave the correct scores when describing the total sample but did not recode the responses when examining males and females separately. I made various other suggestions, but I was not going to rewrite the results section of the paper and I certainly draw the line at proof reading.

        I remember this manuscript well for several reasons. At first I could make neither head nor tail of some of the analyses. I ended up being angry with myself for spending too much time—on a sunny Sunday afternoon—trying to understand the results instead of just recommending rejection. My irritation melted away when I got a note back thanking me for an “excellent” referee's report. At Christmas I received my first ever invitation to the BMJ's friends of the journal party, and I have always believed it was because of the high standard of that report.

        May I take this opportunity gently to point out to the editors at the BMJ that they have never again invited me to their Christmas party. Am I doing anything wrong?

        References

        1. 1.
        2. 2.
        3. 3.

        … and the editor invites everyone to dinner

        1. Richard Smith, editor
        1. Department of Behavioural Sciences in Medicine, POB 1111 Blindern, 0317 Oslo, Norway
        2. Academic Department of Psychological Medicine, Guy's, King's and St Thomas's School of Medicine and Institute of Psychiatry, London SE5 8AF
        3. Hairmyres Hospital, East Kilbride G75 8RG
        4. BMJ

          This fascinating—but ultimately unimportant—correspondence illustrates the difficulties that historians face. Here we have a small episode that happened only six years ago, with all of the main protagonists (authors, reviewers, and editors) contributing to the debate, and still we cannot be sure what happened. You can thus see the difficulty of trying to work out why the first world war started or why dinosaurs died out.

          One problem is that we do not have a copy of the edited paper from 1994. The error was clearly not in the manuscript that was first submitted. It might have been introduced by the reviewer asking for a change and the authors not making it correctly. Or it might have been introduced by us in the editing process. Either way, it is an example of publication subtracting rather than adding value, and we apologise to readers and authors for any part we might have played in it.

          How can we make amends? Certainly we will ask Dr Pelosi to our Christmas party, but I think too that we should follow the British dictum that when in doubt brew up, start a public inquiry or a royal commission, or hold a dinner. A dinner seems most appropriate. We will call it the dinner of impossible means, and we will invite the authors, the reviewer, the critic, and the Norwegian colleague—and I'll be there to pay the bill.