Editor's Choice

Claims and counter claims

BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7423.0-g (Published 06 November 2003) Cite this as: BMJ 2003;327:0-g
  1. Kamran Abbasi (kabbasi{at}bmj.com), deputy editor

    Are journal editors more worried about libel than ensuring that research is valid? Peter Wilmshurst, a consultant cardiologist famous for exposing research misconduct, believes so (p 1113). He tells Annabel Ferriman: “I have submitted many scientific articles for publication, and many had implications for survival of patients, but no journal has ever asked me to prove that I got the results claimed. This might suggest that medical journals are more concerned with the reputations of academics and their institutions than the lives of patients.” We like to think that we do care more about patients than reputations, but we don't routinely ask authors to prove the results they claimed. Perhaps we should–though it would probably be unworkable.

    As usual, this week's journal is full of claims and counter claims. Venous thromboembolism after air travel was first recorded in 1954, yet the risk is unclear. Australian researchers investigated this question by linking hospital data from Western Australia with records on air travel (p 1072). Of just under 10 million people landing in Perth over an 18 year period, 246 developed venous thromboembolism within 14 days–representing a small increase in absolute risk.

    Others have suggested that improving management of obesity in primary care would improve patient outcomes. Using a cluster randomised design, Helen Moore's team evaluated a training programme promoting evidence based treatment of obesity (p 1085). Doctors' knowledge improved, but patients in the intervention group were 1 kg heavier after 12 months. Was it a failure of implementation? You might think so.

    You might also think that acute viral illnesses in children “get better in a few days.” Investigators from Wales found that over half of children with a viral infection of the upper respiratory tract are still unwell four days after their initial consultation, 1 in 20 after two weeks (p 1088). Will any of this have, in Wilmshurt's words, any implications for the lives of patients? Two articles in our debate section certainly will. US doctors and medical students claim that reframing HIV and AIDS as a disaster would be the most effective approach (p 1101), and a separate team believes that focusing on prevention fails millions of people already affected and treatment should not be ignored (p 1104).

    At one time, experts claimed that chickenpox and shingles were caused by two distinct viruses. Robert Hope-Simpson thought differently. His radical hypothesis was that there was only one virus (p 1111). To prove it he took his team of researchers to Yell, the second largest of Scotland's Shetland islands–famous for otters and uninhabited beaches and moorland–to follow up every known case in a closed community. Denis Pereira Gray believes that Hope-Simpson's conclusion that a virus–later known as varicella zoster–lay dormant for decades before reappearing in another form is “the most important clinical discovery in general practice in the 20th century.”

    Footnotes

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