Publicising trial results before peer review
BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l556 (Published 12 February 2019) Cite this as: BMJ 2019;364:l556
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Dear Editors
Another day, another example of why healthcare professionals need to be familiar with what is factual, what is speculative, what conclusions can and cannot be made from results obtained, and how research design can be easily be biased, study results be misinterpreted, or worse still blatantly misrepresented.
Ref 1 - 4 illustrates how even BMJ with its peer-reviewed process can publish research which have obvious flaws; one is so significant it requires corrections (ref 5).
Similarly we are increasingly concerned by authors of Cochrane reviews and national guidelines, whose conflict of interests is so significant, that it should have been placed in the first paragraph of the documents rather than somewhere down the bottom.
Conversely there are some professionals who apply inappropriate questions to justfy their use or rejection of guidelines and recommendation; this is equally worrying.
This is 2019, not 1949. Information are easily within reach literally at our fingertip, yet many of us cry time poor and rely on sound bites. abstracts, executive summary or even the evening news for our decision making in clinical practice.
Granted we are busy, more often with administrative work rather patient interaction, that there are too many studies and research literature out there, many in predatory journals. I accept that the demands and expectation upon doctors are far more than previous generations, particular when everyone and their dog seemed to be their own experts now that medical (mis-)information and quackery are easily available and pimped by various lobby groups.
But that is the challenge for the doctors of modern medicine. Some other craft-group may dispense some form of medicine via their (often limited) scope of practice on low acuity condition and the role creep from many directions will become a siege in the future where everyone wants a piece of the action.
Despite this, doctors are still obliged to practice Evidence based medicine with vigorous attention to detail and within the limit of safety. This means medical practitioners should be reviewing major research work themselves and learn to understand statistical techniques as well as knowing what conclusion can be made and what can't. We can no longer assume national guidelines are not flawed or biased or up to date.
Those who are not prepared to do this, can only put their practice at risk, harm to their patients and bring the medical fraternity into disrepute.
References
1. https://www.bmj.com/content/364/bmj.k5432/rr-0
2. https://www.bmj.com/content/363/bmj.k4790/rapid-responses
3. https://www.bmj.com/content/364/bmj.l42/rapid-responses
4. https://www.bmj.com/content/363/bmj.k5232/rapid-responses
5. https://www.bmj.com/content/364/bmj.l333
Competing interests: No competing interests
Re: Publicising trial results before peer review
Despite some criticisms and fallacies pointed out , peer review remains the standard tool to ensure fairness and authenticity of the content published
.Most clinicians would confirm that material published is in a peer reviewed journal before translation into clinical practice is considered. Only few trials have been terminated prematurely when the mounting evidence suggested that continuing the trial further would deprive the patients of all the potential benefit could accrue. Press release before trial being published in a peer reviewed journal appears to be a story in reverse and is becoming a trend. Motives could be different but hype is a clear consequence. When marketing overtakes research trial , good science and its translation into practice is but for sure to suffer. Dr Murar Yeolekar., Mumbai.
Competing interests: No competing interests