In response to Rapid Responses about Users' Guides
The tone and scope of the rapid responses to our Users Guides confirm
the central assumption of our Guides: that there are emotional and
economic interests that affect the objectivity of science. We think that
these guides will help readers form their own opinions about the evidence.
While we appreciate all of the responses thus far, some require comment.
Roberts outlines the complexities of conflict of interest surrounding
the Cochrane Albumin review (the NHS funded the review group, the NHS is
the major producer of albumin in the UK, the NHS did not release
unpublished data to the reviewers, the NHS ultimately pays for albumin use
in the UK, and the NHS was embarrassed by the conclusions of the review) –
one wonders how this situation would have played out if a commercial
interest funded the review. Wilkes and Navickis, authors of one such
review and who alert readers of our effort to market our editorial
products through this paper, emphasize methodological differences between
the Cochrane review and theirs as the explanation for their different
conclusions. We recognize that the evidence that each review summarizes
was somewhat different. We also recognize that the studies that each
summarized were small, the results heterogeneous, and continue to believe
that this evidence did not warrant strong statements of either danger or
Penston pointed out an inconsistency between our title and our first
guide – how can one detect misleading claims if one is not exposed to the
Discussion section where those claims are often made? Perhaps our original
title (Guides for clinicians to defend themselves from misleading claims…)
was more appropriate. Others have seen in our guides validation of their
concerns about specific studies and scientists’ behaviors, and
justification for a broader evaluation of research protocols in ethics
boards. It seems that the process our guides are intended to foster -
frank dialog on more effective ways for decision makers to deal with data
that comes wrapped in conflict – is ongoing.
VMM, RJ, HJS, PJD, and GHG are associate editors of the ACP Journal Club and Evidence-Based Medicine. JLB and RJ edit an evidence based medicine journal in Poland. MB is editor of the evidence based orthopaedic trauma section in the Journal of Orthopaedic Trauma.
Competing interests: No competing interests