The Trouble with Medical Journals by Richard Smith: an alternative view

I am amazed that the BMJ has published such a negative review of a book that should be shaking medicine's foundations (BMJ 2007;334:45). Medical publishing has many failings; the fact that this book is not compulsory reading for everyone may well be yet another.

Although starting positively, reviewer Stuart Derbyshire describes Smith's concerns as not “obviously supportable.” Smith, together with colleagues at JAMA, has probably done more than anyone to search for “evidence” for the true value in the cornerstone of medical publishing: peer review. Much of the research conducted at the BMJ during his tenure showed that there is little or no objective value to the process,¹ yet journals and their editors persist with—and advocate—peer review; their only defence is that “there's nothing better,” even though few have tried to find an alternative (to my mind there is a notable exception, the system used by Biology Direct²).

Derbyshire also talks of the …