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We recently read the article by Berger and Ioannidis “The Decameron
of poor research” and applaud the excellent wit and cynicism contained
within its pages.(1) The authors, who declare that they have no wish to
rival the ‘Florentine genius’ Giovanni Boccaccio, are ‘fully confident’ in
writing ‘a very poor paper indeed’. Like the authors and many others, we
are also guilty of producing scientific works of a low level which are
often justly rejected despite the occasional oversights of a few editors
who mistakenly accept them for publication.(2-4) Therefore we would like
to lend our voice to the discussion and comment on Berger and Ioannidis’
paper from three different points of view:
- as people interested in research.
- as people who assist the sick.
- as Florentines
- As people interested in research, we followed the suggestions of
Evidence-based Medicine and perused the entire Decameron to verify the
existence of those characters described by the authors.(5-9) We were thus
able to trace the Boccaccian ‘heroes’ to whom reference was made.(6-9)
This whetted our appetite to learn more about the actual people and
institutions involved in the acts of fraud and ‘petty misdeeds’. It would
be very interesting to read those research papers which were published in
such an underhand manner. We wish that such misdeeds could be revealed and
shame brought upon the perpetrators and hope, no doubt in vain, that in
the future more can be done to unmask such unworthy behaviour in the
research field.
- As people who assist the sick the article makes us wonder about our
choice of medical therapies based, as they often are, on reports from
important medical journals.(5,10-12) Once again we augur that all attempts
to publish fraudulent data be firmly discouraged by publishers and the
scientific community at large. In the first place for the harm that could
be done to the patients’ state of health and secondly for the negative
impression which reflects on the medical profession.
We would like to point out that, just as the authors use the names
of characters in the Decameron to cover misdeeds of physicians nowadays,
medical practitioners did not enjoy an excellent reputation at the time
of Boccaccio either. The cunning Master Simone da Villa, a doctor in
Boccaccio’s Novel IX the Eight Day whom the authors do not mention, is
described in the Decameron in somewhat unflattering terms “…one whose
patrimony was more ample than his knowledge” and “..whose skill did not
reach, perhaps, beyond the treatment of children for the scurf…”.(6-9) He
diagnoses pregnancy in a male patient whom he then miraculously manages to
cure in only three days (Novel III the Ninth Day). However, Boccaccio
fails to inform us whether Master Simone performed deeds as iniquitous as
those described by our two authors. If we may proffer our humble opinion,
despite not having carried out any meta-analysis, the diagnostic error
relative to the male pregnancy has fewer important clinical consequences
than drawing scientific conclusions from a study in which the
randomisation of the patients took place in only a few seconds.(1,10-12)
- As Florentines we are delighted to note that the authors esteem
Florence as the most beautiful city in the world – without being funded by
some important industry to do so!
And as Florentines, proud of our cultural heritage, we would like to
underline some similarities and differences between Boccaccio’s work and
that of Berger and Ioannidis. The Decameron contains 100 tales which are
narrated over a period of ten days with a well-constructed framework.(6-9)
Boccaccio is well in tune with his times; his tales are realistic and
reveal an acute observation of human behaviour. The same can be said of
the misdeeds recounted in the BMJ.(1) Although there are only ten tales in
the article, who knows how many more could be told! The phrase “taking a
leaf out of an old book” makes us hope that other tales will follow to
prick the conscience of those who write, those who judge research, those
engaged in scientific activity and those who work in the health field who
consequently will be affected by the impact factor.
One difference lies in the initial sentence of the book which in the
English translation is addressed to both ladies and gentleman while in the
original work by Boccaccio the tales were dedicated only to ladies.(1,6-9)
This made us wonder whether ‘gentlemen’ had been included by the authors
because males were the main malefactors in their stories or whether the
quotation was based on a non-literal English translation.
In the summary points the authors state that their attempt to
describe variants of poor research is ‘clearly a mess’. Naturally, we are
in strong disaccord with this statement. Indeed, we feel that the points
raised in the article are worthy of profound reflection.
Like the authors we count ourselves among that group of idiots who
“apply for grants with 10% acceptance rate when funds are a telephone call
away”.(1) However, we obdurately refuse to kneel before those in
authority, join exclusive clubs or belong to the ‘correct’ political party
and eagerly await some further pointers from the authors on how to
improve the quality of our work.
Unfortunately, this letter was not written on a ‘nice Florentine
estate’ but in a 120-year-old children’s hospital in the centre of
Florence. We look after patients afflicted by cystic fibrosis (2-4) rather
than dealing with the plague which Boccaccio’s Brigata sought refuge
from.(6-9) Our letter was written in the cold, rainy winter season rather
than the warm summer of the Decameron – a fact which obviously depends on
the date of the publication of the original article in BMJ.(1) However, to
enter more fully into the spirit of the article and add a touch of realism
we carried out the final draft of the article in front of Santa Maria
Novella.
References
1. Berger VW, Ioannidis JPA. Taking a leaf out of an old book. The
Decameron of poor research. BMJ 2004; 329: 1436-1440
2. Taccetti G, Festini F, De Martino M. Telephone use in primary
care. Telephones have proved useful in managing cystic fibrosis. BMJ 2002;
325: 547.
3. Taccetti G, Festini F, Braccini G, Campana S, De Martino M. Sweat
testing in newborns positive to neonatal screening for cystic fibrosis.
Arch Dis Child 2004;89:F-463-F464.
4. Taccetti G, Repetto T, Procopio E, Farina S, Campana S. Early
Pseudomonas aeruginosa colonisation in cystic fibrosis patients. Lancet
2002 ; 359 : 625-626
5. Leung GM, Johnston JM, Tin KY, Wong IO, Ho LM, Lam WW, Lam TH.
Randomised controlled trial of clinical decision support tools to improve
learning of evidence based medicine in medical students BMJ 2003; 327:
1090
6. Boccaccio G. Il Decameron. (ms B.R. 37, f. 5v). Florence -
National Library
7. Boccaccio G. Il Decameron. (ms Plut. 42.6, f. 150 v). Florence -
Laurenziana Library
8. Muscetta C. Giovanni Boccaccio e i novellieri. In: Cecchi E,
Sapegno N eds. Storia della letteratura italiana. Garzanti Editore,
Milano, 1965 pp.317-558
Methodology of research: a Florentine comment.
We recently read the article by Berger and Ioannidis “The Decameron
of poor research” and applaud the excellent wit and cynicism contained
within its pages.(1) The authors, who declare that they have no wish to
rival the ‘Florentine genius’ Giovanni Boccaccio, are ‘fully confident’ in
writing ‘a very poor paper indeed’. Like the authors and many others, we
are also guilty of producing scientific works of a low level which are
often justly rejected despite the occasional oversights of a few editors
who mistakenly accept them for publication.(2-4) Therefore we would like
to lend our voice to the discussion and comment on Berger and Ioannidis’
paper from three different points of view:
- as people interested in research.
- as people who assist the sick.
- as Florentines
- As people interested in research, we followed the suggestions of
Evidence-based Medicine and perused the entire Decameron to verify the
existence of those characters described by the authors.(5-9) We were thus
able to trace the Boccaccian ‘heroes’ to whom reference was made.(6-9)
This whetted our appetite to learn more about the actual people and
institutions involved in the acts of fraud and ‘petty misdeeds’. It would
be very interesting to read those research papers which were published in
such an underhand manner. We wish that such misdeeds could be revealed and
shame brought upon the perpetrators and hope, no doubt in vain, that in
the future more can be done to unmask such unworthy behaviour in the
research field.
- As people who assist the sick the article makes us wonder about our
choice of medical therapies based, as they often are, on reports from
important medical journals.(5,10-12) Once again we augur that all attempts
to publish fraudulent data be firmly discouraged by publishers and the
scientific community at large. In the first place for the harm that could
be done to the patients’ state of health and secondly for the negative
impression which reflects on the medical profession.
We would like to point out that, just as the authors use the names
of characters in the Decameron to cover misdeeds of physicians nowadays,
medical practitioners did not enjoy an excellent reputation at the time
of Boccaccio either. The cunning Master Simone da Villa, a doctor in
Boccaccio’s Novel IX the Eight Day whom the authors do not mention, is
described in the Decameron in somewhat unflattering terms “…one whose
patrimony was more ample than his knowledge” and “..whose skill did not
reach, perhaps, beyond the treatment of children for the scurf…”.(6-9) He
diagnoses pregnancy in a male patient whom he then miraculously manages to
cure in only three days (Novel III the Ninth Day). However, Boccaccio
fails to inform us whether Master Simone performed deeds as iniquitous as
those described by our two authors. If we may proffer our humble opinion,
despite not having carried out any meta-analysis, the diagnostic error
relative to the male pregnancy has fewer important clinical consequences
than drawing scientific conclusions from a study in which the
randomisation of the patients took place in only a few seconds.(1,10-12)
- As Florentines we are delighted to note that the authors esteem
Florence as the most beautiful city in the world – without being funded by
some important industry to do so!
And as Florentines, proud of our cultural heritage, we would like to
underline some similarities and differences between Boccaccio’s work and
that of Berger and Ioannidis. The Decameron contains 100 tales which are
narrated over a period of ten days with a well-constructed framework.(6-9)
Boccaccio is well in tune with his times; his tales are realistic and
reveal an acute observation of human behaviour. The same can be said of
the misdeeds recounted in the BMJ.(1) Although there are only ten tales in
the article, who knows how many more could be told! The phrase “taking a
leaf out of an old book” makes us hope that other tales will follow to
prick the conscience of those who write, those who judge research, those
engaged in scientific activity and those who work in the health field who
consequently will be affected by the impact factor.
One difference lies in the initial sentence of the book which in the
English translation is addressed to both ladies and gentleman while in the
original work by Boccaccio the tales were dedicated only to ladies.(1,6-9)
This made us wonder whether ‘gentlemen’ had been included by the authors
because males were the main malefactors in their stories or whether the
quotation was based on a non-literal English translation.
In the summary points the authors state that their attempt to
describe variants of poor research is ‘clearly a mess’. Naturally, we are
in strong disaccord with this statement. Indeed, we feel that the points
raised in the article are worthy of profound reflection.
Like the authors we count ourselves among that group of idiots who
“apply for grants with 10% acceptance rate when funds are a telephone call
away”.(1) However, we obdurately refuse to kneel before those in
authority, join exclusive clubs or belong to the ‘correct’ political party
and eagerly await some further pointers from the authors on how to
improve the quality of our work.
Unfortunately, this letter was not written on a ‘nice Florentine
estate’ but in a 120-year-old children’s hospital in the centre of
Florence. We look after patients afflicted by cystic fibrosis (2-4) rather
than dealing with the plague which Boccaccio’s Brigata sought refuge
from.(6-9) Our letter was written in the cold, rainy winter season rather
than the warm summer of the Decameron – a fact which obviously depends on
the date of the publication of the original article in BMJ.(1) However, to
enter more fully into the spirit of the article and add a touch of realism
we carried out the final draft of the article in front of Santa Maria
Novella.
References
1. Berger VW, Ioannidis JPA. Taking a leaf out of an old book. The
Decameron of poor research. BMJ 2004; 329: 1436-1440
2. Taccetti G, Festini F, De Martino M. Telephone use in primary
care. Telephones have proved useful in managing cystic fibrosis. BMJ 2002;
325: 547.
3. Taccetti G, Festini F, Braccini G, Campana S, De Martino M. Sweat
testing in newborns positive to neonatal screening for cystic fibrosis.
Arch Dis Child 2004;89:F-463-F464.
4. Taccetti G, Repetto T, Procopio E, Farina S, Campana S. Early
Pseudomonas aeruginosa colonisation in cystic fibrosis patients. Lancet
2002 ; 359 : 625-626
5. Leung GM, Johnston JM, Tin KY, Wong IO, Ho LM, Lam WW, Lam TH.
Randomised controlled trial of clinical decision support tools to improve
learning of evidence based medicine in medical students BMJ 2003; 327:
1090
6. Boccaccio G. Il Decameron. (ms B.R. 37, f. 5v). Florence -
National Library
7. Boccaccio G. Il Decameron. (ms Plut. 42.6, f. 150 v). Florence -
Laurenziana Library
8. Muscetta C. Giovanni Boccaccio e i novellieri. In: Cecchi E,
Sapegno N eds. Storia della letteratura italiana. Garzanti Editore,
Milano, 1965 pp.317-558
9. Decameron Web (Accessed January 19, 2005, at
http://www.brown.edu/Departments/Italian_Studies/dweb/project/index.shtml)
10. Bailar JC. The promise and problems of meta-analysis. N Engl J
Med 1997; 337: 559-561
11. Rothwell PM. External validity of randomised controlled trials:
“To whom do the result of this trial apply?”. Lancet 2005; 365: 82-93
12. Rothwell PM. Subgroup analysis in randomised controlled trials:
importance, indications, and interpretation. Lancet 2005; 365: 176-186
Giovanni Taccetti, MD, g.taccetti@meyer.it
Filippo Festini, RN, BA, BSN
Silvia Campana DSc
Competing interests:
None declared
Competing interests: No competing interests