Author’s reply to Scott and colleagues and Gough and Foo
BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d7052 (Published 01 November 2011) Cite this as: BMJ 2011;343:d7052
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Competing interests: No competing interests
Competing interests: No competing interests
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test data
Competing interests: No competing interests
I am reluctant to get into dialogue but it is important not to let
half truths and inaccurate statements persist.
Saying 'I don't think so' when I suggest that the bad medicine
articles reflect badly on the BMJ does not help. I and many other
colleagues are readers of the BMJ and we, the readers, DO think so. So
what you think here, doesn't really matter. If a restaurant has many
customers thinking one of it's dishes is poor, it doesn't matter what one
of the chefs thinks!
I tried not to make my initial response too lengthy but knew that we
would have to pick up on the 'fibromyalgic variant' issue. These are
basics in rheumatology and we are having this discussion because you are
lacking some of the basic knowledge. This does not reflect badly on you,
it is not your area of expertise. But being so absolute is unhelpful to
the readers. One paper, speaks of fibromyalgic RA. What they are referring
to, is the small but significant percentage of people in whom the two
conditions COEXIST. In rheumatology, this consideration is everyday
practice. We cannot label the patient with psoriasis and Crohn's disease
(known to be associated) the 'psoriatic variant' of Crohn's disease. Using
that label, suggests that Crohn's with psoriasis has a different
underlying pathophysiology. Like fibromyalgia and RA, it is an important
coexistence, but not a disease subset.
You have been 'corrected' by people (I am not referring to myself)
who have spent most of their life studying RA. Not arrogant people, but
humble, wise people whom we know to have a deep understanding of the
condition and its epidemiology. And you are still insisting that you are
right. That also reflects badly on the BMJ. And in my humble opinion it
does a lot of harm. Because people who may not know that much about the
subject, think, 'how great, Dr Spence is a freedom fighter against the
established views on some conditions' without realising that what he says
is based on wrong or misinterpreted facts.
Competing interests: No competing interests
I don't think so. You may not like how I interpretate the data but I
am factually correct. What you deem correct may not be so.I am very
careful about of what I write because I know many people will disagree
with me. I concede I might be wrong but it is time others did likewise.
The evidence base for osteoporosis is very poor and I am not aware of
any errors in my article. As for fibromyalgic variant RA please see the
reference below. I do make spelling mistakes but some people spell "ulnar"
as "ulna" , just google and see !
Pollard LC, Kingsley GH, Choy EH, Scott DL. Fibromyalgic rheumatoid
arthritis and disease assessment. Rheumatology (Oxford)2010;49(5):924-8.
Epub 2010 Jan 25.
Competing interests: No competing interests
Like many colleagues, I struggle to understand how the BMJ can
continue to publish inaccurate and misleading material by Dr Spence. He
thinks clearly, writes well and sounds convincing. So the fact that what
he says is not based on correct facts or on proper understanding of the
evidence, remains concealed. The danger is that many will take his word
for things and draw the wrong conclusions. If you have a regular column in
the BMJ, when you wrongly claim there is a 'fibromyalgic variant' of
rheumatoid, or call ulnar deviation 'ulna deviation', these things stick
in the minds of many readers. It is the responsibility of the editorial
board to prevent this from happening. Saying that we are all free to
submit a response is no excuse. Many people do not follow the responses so
the damage is done by the original column. We expect better quality from
the pages of the BMJ.
Competing interests: The author has had to respond to a previous 'bad medicine' article, which included inaccuracies regarding osteoporosis. This may have resulted in a lower level of tolerance for the wrong messages frequently arising from this column.
Re: Author’s reply to Scott and colleagues and Gough and Foo
Competing interests: No competing interests