Intended for healthcare professionals

Editor's Choice

Spotlights and letters

BMJ 2010; 341 doi: (Published 22 September 2010) Cite this as: BMJ 2010;341:c5226
  1. Fiona Godlee, editor, BMJ
  1. fgodlee{at}

    This week’s journal includes a new feature, a BMJ Spotlight. It’s modelled on Nature’s Insight supplements, commissioned by the journal’s editors, and sponsored by one or more not-for-profit organisations. We plan to publish four a year, each exploring a topic from a range of angles through a specially commissioned collection of reviews.

    Readers helped us choose the topics for our first two Spotlights via a poll we ran in 2008. We asked where improvements to health care would make the greatest difference to patients (, and palliative care beyond cancer topped the poll. We quickly found sponsors committed to improving this area of health care: the British Heart Foundation and the National Council for Palliative Care. As Tony Delamothe, Mike Knapton, and Eve Richardson say in their editorial introducing the Spotlight (doi:10.1136/bmj.c5028), while much has been learnt about the care of patients dying from cancer, these lessons haven’t necessarily been transferred to caring for patients dying from other causes. Yet many more of us die after gradual physical and mental decline than from cancer.

    Our next Spotlight, due for publication in the spring, takes on the topic that came second in our reader poll—drug resistant infections in the developing world. Already recognised as one of global health care’s most urgent problems, it is newly topical with the emergence of antibiotic resistant bacterial strains carrying the gene for New Delhi metallo-β-lactamase-1 (NDM-1) (doi:10.1136/bmj.c5124, doi:10.1136/bmj.c5116). As Anthony So and colleagues say in their editorial, this strain has now spread well beyond its first appearance in New Delhi, with reports in several countries including the UK. The dearth of novel antibiotics in the pipeline means we must conserve the effectiveness of existing antibiotics as much as possible. Our editorialists are cautiously optimistic. Medical tourism has been blamed for the emergence of NDM-1. They hope that the desire to protect and grow this billion dollar global business will focus attention and investment on responsible antibiotic prescribing

    Finally, this week we publish some letters about our study (BMJ 2010;341:c3926) and linked editorial (BMJ 2010; 341:c3803) on whether authors reply to criticism in rapid responses. The study found that the rate and quality of authors’ replies was disappointing. In his letter, Fergus Macbeth illustrates the point with a story of non-response to his criticisms of an article as first the journal, then the authors, and then the drug’s manufacturer failed to engage with his concerns (doi:10.1136/bmj.c5147).

    Richard Smith, former BMJ editor, thinks the whole system for publishing research is broken and that post publication peer review is much more than just letters in journals (doi:10.1136/bmj.c5148). I agree, but at the risk of appearing to fiddle while Rome burns, we will continue to do what we can to improve the current system. From now on we will expect authors to respond to all substantial criticisms of their articles and will remind them of this obligation when their articles are accepted for publication. Authors are already automatically alerted to feedback to their articles. Where no response has been received within a reasonable time we will ask the authors to respond and record in rapid responses that we have done so. If no response is received we will make this explicit.

    This week we publish letters critical of the editorial on UK cancer survival statistics, without a response by the editorial’s authors, Valerie Beral and Richard Peto. These authors have told us they are too busy to reply at present but will do so in due course.


    Cite this as: BMJ 2010;341:c5226


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