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Print Journals Are Not How We Get Our Information Anymore

This morning in the Chicago Tribune’s business section appeared an article entitled “Just What the Doctor Ordered” that included an interview with Dr. Howard Bauchner, the new editor for the Journal of the American Medical Association (JAMA). He plans to pursue a strategy of “intelligent innovation” for the journal:

…looking for ways to get information to doctors and consumers through several new platforms, such as social media, video and other forms. “If you look at TED or Big Think, they have been experimenting with video clips,” Bauchner said. “I could imagine having some of our authors do video clips where they speak about the meaning of their research for eight or 10 minutes, and then that’s easily linked to a smart phone.”

He also wants shorter on-line version of articles that condense the topic to 500 words from the typical 2,500- to 3,000-word articles not too dissimilar, I suppose, to the abstract.

Which leads to the inevitable end result: Read more »

*This blog post was originally published at Dr. Wes*

Exaggerated Claims Can Be Found In Respected Medical Journals

e-Patients who want to collaborate with their physicians, and be responsible for their medical decisions, need to clearly understand what constitutes good evidence. It’s not always easy.

Now Richard Smith, a 25 year editor of the British Medical Journal, has written another piece for the BMJ blog, citing a JAMA study showing “that of the 49 most highly cited papers on medical interventions published in high profile journals between 1990 and 2004 a quarter of the randomised trials and five of six non-randomised studies had been contradicted or found to be exaggerated by 2005.”

What’s an e-patient to do?? Especially when we “patients who google” are so often sneered at by physicians who rely on these same journals.

Well, we need to educate ourselves, and learn to speak calmly, confidently and understandingly to anyone who doesn’t understand – just as we expect clinicians to do with us.:–) In short, we need to Read more »

*This blog post was originally published at e-Patients.net*

Independent Peer-Reviewed Scientific Journals: Just How Independent Are They?

On September 27, 2010, the peer-reviewed scientific journal Europace published online-before-print a case report entitled “Spontaneous explosion of implantable cardioverter-defibrillator” by Martin Hudec and Gabriela Kaliska. In the pdf of that case report a figure containing a color photo of the affected patient’s chest, chest X-ray, and two pictures of the extracted device (one seen here) were included.

The pictures and case presentation were dramatic and the case very rare. Both were perfect reasons to report such an important case to the medical literature. And so these doctors sent the case to Europace on June 29, 2010, and the article was accepted after revision on August 16, 2010, with the article appearing online September 27, 2010.

The authors must have felt very proud to have an article published relatively quickly, and the editors and reviewers of Europace must have thought the case was unique enough and important enough to have the article revised according to their specifications, then published online — until I reported the case on this blog on October 5, 2010, and included images from a portion of the case report’s figure.

Remarkably, later that same day, Europace removed the case report from its website without comment. The article simply vanished. I attempted to e-mail the editor of Europace to inquire about the reason for the retraction but received no reply, so I contacted the lead author, Martin Hudec, M.D. He kindly responded and I included his email response in the comments to my post two days later. Read more »

*This blog post was originally published at Dr. Wes*

Why Negative Medical Studies Are Good

This is a guest column by Ivan Oransky, M.D., who is executive editor of Reuters Health and blogs at Embargo Watch and Retraction Watch.

One of the things that makes evaluating medical evidence difficult is knowing whether what’s being published actually reflects reality. Are the studies we read a good representation of scientific truth, or are they full of cherry-picked data that help sell drugs or skew policy decisions?

That question may sound like that of a paranoiac, but rest assured, it’s not. Researchers have worried about a “positive publication bias” for decades. The idea is that studies showing an effect of a particular drug or procedure are more likely to be published. In 2008, for example, a group of researchers published a New England Journal of Medicine study showing that nearly all — or 94 percent — of published studies of antidepressants used by the FDA to make approval decisions had positive results. But the researchers found that when the FDA included unpublished studies, only about half — or 51 percent — were positive.

A PLoS Medicine study published that same year found similar results for studies long after drugs were approved: Less than half — 43 percent — of studies used by the FDA to approve 90 drugs were published within five years of approval. It was those with positive results that were more likely in journals.

All of that can leave the impression that something may work better than it really does. And there is at least one powerful incentive for journals to publish positive studies: Drug and device makers are much more likely to buy reprints of such reports. Such reprints are highly lucrative for journals. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Medical Journal Retractions: A Transparency Issue

Interesting case study raised by the Retraction Watch blog.

A 2009 journal article in the Proceedings of the National Academy of Sciences (PNAS) – promoted in a news release by the journal and picked up by many news organizations — has now been retracted by the authors. But the journal issued no news release about the retraction — an issue of transparency that the RW blog raises. And you can guess how much news coverage the retraction will get.

And this was all over a molecule that could supposedly “make breast tumors respond to a drug to which they’re not normally susceptible” — as the RW blog put it. But it was also a molecule, RW points out, that wasn’t even in clinical trials yet.

He or she who lives by the journal news release risks one’s long-term credibility.

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

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Latest Book Reviews

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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