Bravo, brave BMJ, for the rapid response section

BMJ 2002; 325 doi: (Published 27 July 2002)
Cite this as: BMJ 2002;325:223

Recent rapid responses

Rapid responses are electronic letters to the editor. They enable our users to debate issues raised in articles published on Although a selection of rapid responses will be included as edited readers' letters in the weekly print issue of the BMJ, their first appearance online means that they are published articles. If you need the url (web address) of an individual response, perhaps for citation purposes, simply click on the response headline and copy the url from the browser window.

Displaying 1-10 out of 15 published

15 September 2002


Reading the response, counter-response, counter-counter response, (get the general drift ?), well lets just leave it at that. I am a firm believer in freedom of speech. Among other things, your portal provides an oppurtunity to all those brimming with ideas but sitting on the fence to hop in and get involved.

I suggest Mr.Wong to conduct a study on the adverse influence portals like this are having on the minds of lesser mortals !

I hope he excludes me from his study sample !

Competing interests: None declared

Wasiq Thiryayi, Clinical Observer in General Surgery

Royal albert Edward Infirmary, WN1 2NN

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It has been suggested by Wong[1], and supported by Bellucci[2], that the casual web surfer may mistake information contained in the BMJ Online Rapid Responses as being peer-reviewed.

I suppose it is possible to mistake a Rapid Response in BMJ Online for a peer-reviewed publication. For example, one look at the level of excellence being achieved in my piece “Surfer’s Lament”[3], and one immediately senses that some great cognitive event is unfolding. I probably sold myself short letting you have the piece for nothing - it would have been wiser to submit the piece to Nature, as being new information about sunspots. My lament could never be taken by readers of the Rapid Responses, as me poking a bit of fun at overly protective people[1,2] who are perhaps trying in vain to control the Internet.

Similarly, Wong’s piece[1], if put in the wrong hands, such as the hands of an undergraduate in English, could place such neologisms as “respondee” into the poor kid’s vocabulary - I see the evil seed has already sprouted in Bellucci’s lexicon, as per her latest Rapid Response[4], and I imagine it won’t be long before a global infestation of Wong’s term takes hold of a generation. So far, I’ve not been infected with Bellucci’s[4] “realise”. One can’t be too careful - there’s an 'axis of evil' out there.

Nevertheless, published is published, and a publication can be defined as follows:-

“Copies of a work or document distributed to the public by sale, rental, lease, or lending.”[5].

In other words, as the term “published” suggests, it’s the making available to the public that counts, when defining the term "publication".

In light of Bellucci’s recently stated interest in citation errors and the distinction to be made between research papers and other forms of publication[4], it should be made known to readers(for their protection), that it is well established that peer reviewed papers in such journals as BMJ, do abound with citation errors, and such errors have now become a fertile field for study. One paper on the subject[6] has been cited 34 times[7]. Further, the Institute for Scientific Information (ISI)[7] via their Science Citation Index, does include an author’s letters to the editor of journals(which letters are not research papers), in a given author’s list of publications, complete with a citation score.

Phillip J. Colquitt, New Farm, Australia.

PS: This letter was produced using Microsoft Word 2000[R], spelling checker turned on to the UK English option, cross referenced with the OED online, then cut and pasted into the BMJ Rapid Response screen. Please feel free to comment on any errors.


[1] Wong P. General Custer Was Brave too - BMJ Responses need definition. BMJ Rapid Responses 11 August 2002.

[2] Bellucci M. What is a response? BMJ Rapid Responses. 30 August 2002.

[3] Colquitt P. Surfer’s Lament. BMJ Rapid Responses. 2nd September 2002.

[4] Monica Bellucci More on Rapid Responses... BMJ Rapid Responses(12 September 2002)

[5] From ALA Glossary of Library and Information Science, 1983, p181. in PubMed, available at; accessed on September 13, 2002.

[6] McLellan MF, Case LD, Barnett MC. Trust, but verify. The accuracy of references in four anesthesia journals. Anesthesiology. 1992 Jul;77(1):185-8.

[7] ISI Web of Knowledge. Science Citation Index. Available at accessed on September 13, 2002.

Competing interests: None declared

Phillip J. Colquitt, Independent Technical Advisor

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12 September 2002

Dear BMJ,

My first ever response and I got a reply from an editor(1) and a mention by another respondee(2)!!! I am flattered by the former and bemused that the latter has mis-cited me in my first ever work!

I did not realise that I could choose to search just articles as Richard Smith has pointed out. As a 'newbie' to the web I will confess ignorance to that charge. I would be less concerned if the desire to search responses was the option rather than the standard result, then hacks such as myself aren't as likely to wonder why they have ended up reading such extraordinary opinions as above.

As for the 'Surfer's Lament', I have read my first reply over and over, but I can't seem to work out why I have been cited as also warning about 'Wong's Infidel'. I did no such thing.

I think Dr Wong's point was that when people list 'publications' in major medical journals they do so to attest to their credibility in research. If people are listing responses as publications they deserve to be shown up.



(1) Smith R. On you can search either the sacred text or everything. BMJ Rapid Responses. 01st September 2002.

(2) Colquitt P. Surfer’s Lament. BMJ Rapid Responses. 02nd September 2002.

Competing interests: None declared

Monica Bellucci, Registered Nurse

Sydney, Australia

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2 September 2002


Misguided fool that I am, I dared to copy and paste the address provided by Wong [1], and did then, of my own free will, and without further counsel, go to the website of Wong’s infidel [2].

Just as Wong had warned, and Bellucci too [3], I did find there at the infidel’s website, that most dreadful of things – “Rabid Responses”. These responses had been published in BMJ online, and were being listed by the infidel as being among his publications! Then, as if possessed, I read the infidel’s words in the “Rabid Responses”.

Having tasted the forbidden fruit of communication without method, and forgetting entirely that I live in Australia because I am bad, I was overcome by a lust for more, and did then go to a website called “PubMed”[4] - a very dark place indeed, and reputed to be a previously sacred medical site which became defiled by failed democratic American presidential candidate Gore, who did take it upon himself to aid the process of making the previously sacred Medline available to the disorderly masses [4].

With trepidation, I did type in the infidel’s name into the PubMed search screen, and, my heart in my mouth, did press “enter”. Indescribable my fear at finding that other sacred medical sites had been penetrated by the infidel – this time with peer review status and full indexing! – JAMA!, Thorax!!, and American Family Physician!!! All is lost.

Phillip J. Colquitt, September 2, 2002.

PS: I have no idea what the word “trepidation” means.


[1] Wong P. General Custer Was Brave too - BMJ Responses need definition. BMJ Rapid Responses 11 August 2002.


[3] Bellucci M. What is a response? BMJ Rapid Responses. 30 August 2002.


[5] Modlin M. Gore launches free MEDLINE from NLM.

Natl Netw. 1997 Aug;22(1):20. No abstract available.

Competing interests: None declared

Phillip J. Colquitt, Independent Technical Advisor

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Monica Bellucci is concerned that when she searches she may be given "false" information because the search includes rapid responses as well as information that has undergone greater editorial vetting. She might, for example, be given the idea that HIV is not the cause of AIDS.

She needn't worry. If you examine our search engine you will see that you can either do a search that is just "articles" or one that includes everything on, including rapid responses.

We hope eventually to include a means to rank rapid responses by value. Those looking at rapid responses could then view them either chronologically (as now) or by value.

Richard Smith, Editor, BMJ

Competing interests: None declared

Richard Smith, Editor


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30 August 2002

Dear BMJ,

I am new to the BMJ and this is my first response! I read some of the points above with interest as I just performed a search for information on the history of AIDS. Before long I am reading that AIDS is NOT transmissible and that HIV has nothing to do with AIDS.That will certainly upset a few researchers I know! :)

Having some training in medicine I won't say that I was converted, however there was no clear indication that I had crossed some invisible line into an 'open forum'. I came here searching for facts - I agree with Dr Wong's response.



Competing interests: None declared

Monica Bellucci, Registered Nurse

Sydney Australia

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Dear Joseph or is it Joe,

I am not surprised by your response, as my iconoclastic 'réponse rapide' strikes terror into the very heart of the true believer in medical monotheism, its reverence for divine scientific truth, and its reductionist view of Homo sapiens as a genetic string ball just waiting to be unravelled by the learned apeman. I am not so much outside the believer's square, but one who does not believe there is a square at all.

I have just thrown out or given away about 100 old textbooks (dogma defunct) and have a mountain of medical journals to which I hardly ever refer once they are opened and scanned ( by my cerebral cortex,not my scanner).I subscribe both to anglophone and francophone medical journals to keep me from anglophonic bias (dare I say this word) and do so, not only to 'keep up' but to reassure myself that most of it is 'bull' and will soon be buried in the local tip or be recycled as cardboard egg cartons.

Yes, opinions are opinions and should be labelled as thus, on the packet as non-organic and not approved by our scientific idiosavants,even though free thought and opinions, not just science are the true engines of societal change. The Reformation, the Enlightenment, the French Revolution and even the white settlement of this human garbage dump then called, New South Wales or New Holland, are all the progeny of opionions and not P values; those man-made, often misleading tools we have made to control the chaos of the cosmos and to find a pattern that reassures us fragile humans we can gain control of it.

I notice you are a student and gained Honours in your degree. I also have First Class Honours in Medicine, am a University Medalist and have a Doctor of Philosophy in Medicine from the University of Melbourne (on sarcoidosis) and speak as one who has done the hard yards at scientific boot camp. I readily acknowledges that these are only Australian degrees.

However, on Friday nights I much prefer to share in the opinions of fellow clinicians about their adventures in the art of healing, and I may add, over a pot of Guinness (cold for the Poms) at the pub across the road, than sit alone in my rooms reading Thorax or Chest whose contents are full of soon to be forgotten trivia written by poor blokes searching for the Holy Grail of the triple-zeroed P value.

By the way,just call me, Roger, and not Mr Allen, as it sounds too formal and we are both Aussies, mate. The Pommy Doctors and Misters who read this may not understand this.

Competing interests: None declared

Roger K.A. Allen, Consultant Thoracic and Sleep Physician, Private Practice

Suite 299,St Andrew's Place,33 North St, Spring Hill, Brisbane,Qld 4000, Australia

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Dear Mr Allen,

I am disturbed by your rapid response. Your title seems to indicate that you are one who has spent many years studying. I assume that in your field you need to be kept up to date of the latest research. This research is undertaken by highly educated, dedicated, and skilled scientists.

I wonder, when you hear of something new in your field do you read literature from well-respected, time-honoured, trusted sources. Or do you go down the pub and search for facts amongst the 'bull'.

Sure some publications are flawed. This is why so many research papers are dedicated to duplicating the findings of other researchers. This is why its all a numbers game, and when it comes down to it nothing came by said with absolute certainty. But there is a vast difference between a statistical analysis of data as opposed to someones opinion.

I agree with responses by Floyd, Wong and Wentz. There needs to be mention that an opinion is only an opinion.


Joseph Macri

Competing interests: None declared

Joseph Macri, 4th year Optometry student, Bachelor of Medical Science (Honours)

Sydney, Australia.

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In response to your response to my response to your Letter regarding responses:

I am not 'in awe' of evidence-based medicine, nor do I regard peer- reviewed journal articles as beyond reproach. Medicine however should be based on evidence, not rumour or anecdote. But that's a different issue all together!

My point, as stated by Peter Wong and echoed by Reinhard Wentz, remains - whilst responses are a great read it should be clear to the casual web surfer exactly what they are reading, rather than assuming that something has been published on the basis of the strict criteria one might expect in a leading journal.

Reinhard Wentz's suggestion regarding not having the responses included by default during a search may well assist - or perhaps a different button for 'search responses'? The fact that responses are an open forum could be made clear with a note as you enter the response pages.

Were the tablets you refer to found on Mt Sinai subject to a double blind randomised control trial? Were they compared with injectable options, physical therapies or perhaps something diluted 30 million billion trillion times gently tapped against the mountain?

So many questions! Please forgive me, I am but a student.

I enjoy reading responses too!



Competing interests: None declared

Tony Floyd, Medical Student

Newcastle University, Newcastle Australia

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Dear Mr Floyd,

I am surprised that anyone could feel so awed at the scientific respectibility of evidenced-based information and the power of the "reviewed" article. Thankfully the tablets on Mt Sinai were not subjected to editorial and a peer reviewed critique....

That is one reason we need Rapid Responses. Nearly all of our technological papers have serious flaws, the level of evidence variable, the system fatally flawed, negative studies are rejected, editors and reviewers biased and competitive. The public is completely at the bottom of the scientific food chain.

Most student of medicine here have little training in the arts, expression, languages etc but are natural converts to the system and seem unable to see the emporer's new clothes. We are selecting true believers.

Conferences have become huge, costly and impersonal. That is why Rapid Responses and the like, are here to stay. To use an Australianism, although RR may contain some "bull", it also gives vent to those who can see through the "bull".


Competing interests: None declared

Roger KA Allen, Consultant Thoracic and Sleep Physician, Private Practice

Suite 299, St Andrew's Place, 33 North Street, Spring Hill, Brisbane, Qld, 4000, Australia

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