Editor`s Opinion: On Scientific Publishing: A Few Bad Apples Can Spoil the Bunch

     Descriptive publications in the medical literature, commonly in the form of case studies or case series, always have provided an important venue for clinicians to illustrate a problem, share novel observations and methods to solve clinical challenges, and/or demonstrate a need for research. In wound and ostomy care in particular, clinicians often rely on case studies to help them manage the unusual and the complex; many case study observations have provided an impetus for research.

Case-in-point: this issue of OWM. Articles describe the care of a nonhealing wound following a crush injury of the hand, a novel approach to closing a colocutaneous fistula within the laparotomy wound after esophageal reconstruction, the challenges of managing a high-output gastrointestinal fistula, and wound biopsy results 10 months following the application of bilayered living-cell therapy that warrant further research.

     Although the scientific value of descriptive articles may be limited, their value for practicing clinicians remains. Distorting the former by, for example, suggesting that one management approach is better than another based on the results of a case study reduces the credibility and general reputation of descriptive studies and their value for clinicians. Widely available on the world-wide-web and in some printed materials, these descriptive publications are generally designed to sell a product or service and have tainted the true value of descriptive articles published in the peer-reviewed literature.

     While we are on the subject of tainting reputations, negative newspaper headlines and Senate investigations (as we observed earlier this year) reflect poorly on all involved in the scientific publication process.¹ Recently presented data from a study by the editors of The Journal of the American Medical Association indicating that approximately 8% of scientific publications are written by medical writers who are not listed as authors made for more negative news.² In their February 2009 publication on ghostwriting, Gøtzsche et al³ observe that medical writers have a long history of helping busy researchers and clinicians; banning their involvement in preparing publications would further increase the amount of research data that are never published. However, the practice of letting others make substantial contributions to a publication (writing, data review, and the like) without including their names in the list of authors violates existing guidelines for authorship used by most major journals, including OWM.⁴ Ghostwriting also “debases fundamental tenets of the medical profession, violates authors’ personal integrity, responsibility, and accountability, and …. threatens the very fabric of science and thus the validity of our medical knowledge, and in doing so it jeopardizes patient care.”³ Ghostwriters have tainted the legitimate value of medical writers.

     Although readers can help maintain the credibility of their profession by sending letters to the editor alerting everyone to discrepancies or omissions, the task of identifying, eliminating, or treating the bad apples in the context or process of medical publishing in order to protect the public at large falls largely on the shoulders of journal editors and their editorial and advisory boards.^1-4 This is an arduous, time-consuming, and expensive process. Reporting on the recently held Sixth International Congress on Peer Review and Biomedical Publication, the editorial director and interim editor-in-chief of the American Journal of Nursing⁵ asked, “Who will pay for the ‘public good’ of medical editing and oversight at a time when many healthcare professionals feel that they can get information free on the internet?” How much would you pay for the process?

     With the help of our (all-volunteer) Editorial Advisory and Review Board members, we will continue to try and find the bad apples in order to help protect the bunch. Meantime, we welcome readers’ opinions on this topic and their letters to the editor if we missed a few blemishes.

This article was not subject to the Ostomy Wound Management peer-review process.

1. van Rijswijk L, Zeiger B. The process of trust. Ostomy Wound Manage. 2009;55(1):4.

2. Wilson D, Singer N. Study says ghostwriting rife in medical journals. NY Times Business. September 11, 2009.

3. Gøtzsche PC, Kassirer JP, Woolley KL, et al. What should be done to tackle ghostwriting in the medical literature? PLoS Med. 2009;6(2):0122–0125.

4. International Committee of Medical Journal Editors. Uniform Requirements for Manuscripts Submitted to Biomedical Journals. Available at: www.icmje.org/. Accessed September 15, 2009.

5. Kennedy S. You get what you pay for. American Journal of Nursing blog. Available at: www.ajnoffthecharts.wordpress.com/. Accessed September 20, 2009.