Have these guys ever heard of the internet?

Have these guys ever heard of the internet?

From the Boston Globe (Article urging heat exams shows conflicting interests):

The recommendation carried the seal of approval of an established medical journal: virtually every middle-aged man and woman should be screened routinely for heart disease, using sophisticated and pricey technology to take snapshots of clogged vessels.

Usually, such a seismic shift in medical practice — it would affect 50 million US adults and easily cost $25 billion or more — emerges from a government agency or a major professional organization. But the guidelines that appeared earlier this month under the banner of The American Journal of Cardiology reflected the passions of a few dozen researchers.

The story of how the guidelines wound up in that journal illustrates how money and medicine intersect and opens a window into the arcane world of the medical publications that land on doctors’ desks and influence the treatment patients receive.

The guidelines appeared in a supplement to the 30,000-circulation journal instead of in its regular pages, meaning that the recommendations, which even the authors concede are not supported by rock-solid evidence, were not subjected to the standard review process.

It also meant the authors had to pay to have their recommendations published. To raise the money, the physicians sent letters of appeal to a half-dozen major pharmaceutical companies, receiving $55,800 from the maker of the blockbuster cholesterol-lowering drug Lipitor, Pfizer Inc., which might benefit if more people are diagnosed with heart disease.

“The whole thing sounds like a conflicted mess, from the recommendations that they’re making to the issue of how these journal supplements work,” said Dr. Jerome P. Kassirer, top editor of The New England Journal of Medicine through most of the 1990s and an outspoken critic of the intrusion of financial interests into the scientific process.

Authors of the recommendations also got tired of waiting for the support of the American Heart Association and the American College of Cardiology. So, they drafted a document making the case for the tests and then asked The American Journal of Cardiology to publish it.

Journal editor Dr. William C. Roberts told the group that, in contrast to how it works in the regular pages of the magazine, if they wanted their recommendations published, they “would have to have some financial support.”

About 50 of the 500 journals published by Elsevier Inc., the company that produces The American Journal of Cardiology, have supplements, said Craig Smith, manager of Elsevier’s supplement division. Those supplements, Smith said, are intended to showcase educational material, not present the type of groundbreaking research that appears in the regular pages. Because of that, they may not be reviewed by a panel of experts, as other research articles would be.

If they couldn’t get a journal to publish their article in standard ways, why didn’t they just put it up on the Web instead of going around with their tin cup?

Perhaps journals should annotate all articles so readers will know whether they are reviewed by peers, journal editors, conference organizers or no one at all. In these days in which an author can put material on the Web essentially for free, review of a paper has become the essence of what a journal is selling.

July 25, 2006

One thought on “Have these guys ever heard of the internet?”

  1. ” . . .review of a paper has become the essence of what a journal is selling.”

    Well said, David. I was a community newspaper editor for many years, and my marching orders were quite clear. We gave our readers stuff they couldn’t get anywhere else, which was news only about our community. That was the only thing that separated us from the competing big-city dailies and the nearby TV stations. If we didn’t do that, we were sunk.

    The editor and publisher of this journal have obviously forgotten what separates them from other media.

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