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Healthy Skepticism Library item: 7571

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Tamber PS.
The Trouble with Medical Journals by Richard Smith: an alternative view
BMJ 2007 Jan 20; 334:(7585):125
http://www.bmj.com/cgi/content/full/334/7585/125


Abstract:

I am amazed that the BMJ has published such a negative review of a book that should be shaking medicine’s foundations (BMJ 2007;334:45). Medical publishing has many failings; the fact that this book is not compulsory reading for everyone may well be yet another.

Although starting positively, reviewer Stuart Derbyshire describes Smith’s concerns as not “obviously supportable.” Smith, together with colleagues at JAMA, has probably done more than anyone to search for “evidence” for the true value in the cornerstone of medical publishing: peer review. Much of the research conducted at the BMJ during his tenure showed that there is little or no objective value to the process,1 yet journals and their editors persist with-and advocate-peer review; their only defence is that “there’s nothing better,” even though few have tried to find an alternative (to my mind there is a notable exception, the system used by Biology . . .

 

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Cases of wilful misrepresentation are a rarity in medical advertising. For every advertisement in which nonexistent doctors are called on to testify or deliberately irrelevant references are bunched up in [fine print], you will find a hundred or more whose greatest offenses are unquestioning enthusiasm and the skill to communicate it.

The best defence the physician can muster against this kind of advertising is a healthy skepticism and a willingness, not always apparent in the past, to do his homework. He must cultivate a flair for spotting the logical loophole, the invalid clinical trial, the unreliable or meaningless testimonial, the unneeded improvement and the unlikely claim. Above all, he must develop greater resistance to the lure of the fashionable and the new.
- Pierre R. Garai (advertising executive) 1963