Intended for healthcare professionals

Rapid response to:

Research

How citation distortions create unfounded authority: analysis of a citation network

BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b2680 (Published 21 July 2009) Cite this as: BMJ 2009;339:b2680

Rapid Response:

Chinese Whispers and there is a crack in everything. It's how the light gets in.

Already this important paper and its Rapid Responses have
been smothered in the avalanche of publications. The steam
roller rolls on and this paper will probably be hidden in
the innumerable crates in the warehouse like in Raiders of
the Lost Ark.

I will post the comments below that I have made on doc2doc
in the hope that such ideas might find fertile soil but
somehow I am not very optimistic.

Chinese whispers and the emperor's new clothes
posted at 13/08/2009 10:40:52 PM GMT+1000 on doc2doc.

"We have a children's game in Australia and I am sure it is
done everywhere. A child is whispered a brief message and
is told to whisper in the ear of the child next and so on
down the line until at the end of the line the last child
has to tell everyone what was said.

We are no better than children playing dress ups in fancy
clothes, white coats, with alpha males and females, a long
line of people who are not game to tell it as it really is
until the original observation becomes a distortion, a lie
and even worse, something harmful. Politicians are masters
at this.

It is also my observation that we no longer value or honour
clinical observation, clinical experience or clinical
wisdom unless it has a p value. A lot of work, experience
never sees the light of print. I could write a book on my
experience with difficult cases of a certain disease close
to my heart but no one wants such unless it is
statistically valid.

The irony is that we rely on such experience in the day to
day management of our patients and the teaching of
students. Give me a consultant or a pilot who has weathered
a thousand thunder storms.

We have thrown the baby out with the bath water. Even
clinical case reporting has been devalued to the extent
that we can now buy your way into having your case report
published. However it was with case reports and studies
with small numbers than most of the seminal advances in
modern medicine occurred. Had there been the current
publication hurdles we would be back using leeches and
cupping.

We are stifling the art of medicine and replaced it with a
rat race of ephemeral mind numbing papers most of which
are not cited within a year or two of publication. After
all, it's all based on Chinese Whispers and the emperor's
new clothes."

As Leonard Cohen sings, "There is a crack in everything.
It's how the light gets in." Perhaps the light has finally
sneaked in?

Competing interests:
None declared

Competing interests: No competing interests

14 August 2009
Roger K.A. Allen
Professor, Bond University and Thoracic & Sleep Physician
Wesley Medical Centre, Brisbane, Qld, Australia, 4066