Editor`s Opinion: The Emperor’s Clothes

    Watching the OWM mailbox fill up with manuscripts after the holidays always brightens the often gloomy days of January and February. We feel honored that authors ask us to review, and hopefully publish, their labors of love. Personally, watching those manuscripts arrive makes me feel less lonely and out of the holiday hullabaloo. Clearly, I was not the only person spending more time behind my desk finishing long overdue papers than shopping, cooking, cleaning, or whatever else one is supposed to do during the last 2 weeks of December. And so it happened that, between your feedback about our November 2005 “Word Warrior Alert,”¹ our January 2006 call for a science-based wound care future,² a recently published consumer’s view of the world of science,³ and being immersed in reading and writing, the story about the emperor’s clothes came to mind. Let me explain.

    Airborne (Knight-McDowell Labs, Carmel, Calif), a common-cold prevention supplement experiencing phenomenal sales, is proudly advertised to have been developed by a school teacher.³ Not a scientist, not a clinician, a school teacher. “Don’t we want to fight seasonal ailments with things created by, for instance, doctors and scientists?”³ Apparently not. Consumer confidence in the medical establishment and the people who develop treatments and remedies has waned considerably in recent years – in part because the lines between information, promotion, and advertising have been crossed once too often and treatments were found to be less safe and effective than originally proclaimed. We – the expert clinicians, scientists, and developers of remedies for skin, wound, and ostomy care – also risk losing our credibility if we continue to, among other professional compromises, use words that have no operational definition, proliferate paradigms that have no validity, and employ algorithms, instruments, products, or treatments that have not been tested.^1,2 In short, we risk being found to have no clothes.

    Obviously, it is impossible to conduct the massive amounts of research needed to outfit the emperors of skin, wound, and ostomy care overnight. In the meantime, you – our authors and readers – can help maintain credibility through your honesty and forthrightness. For example, when the research doesn’t exist, say so. Examine the references authors use to describe a procedure, justify a treatment approach, or explain a phenomenon and determine whether a study has been referenced or if the “fact” is merely someone quoting yet another reference or opinion, not the original research. Anyone who has ever written – a manuscript, a policy and procedures manual, anything at all – knows nothing is more frustrating than tracking references only to find the evidence so confidently cited by the “expert author” doesn’t exist. The evidence has no clothes and the author is about to be “undressed.”

    Our authors know that OWM reviewers often ask them to describe the content and context of their references. Although this may increase the length of some manuscripts (and increase editing time for some authors), this thoroughness enhances reader ability to gauge the robustness of the available evidence and helps maintain the scientific integrity of our publications. Trust and confidence are precious – they are difficult to attain and easily lost. Just ask the pharmaceutical companies and the teacher who is doing quite well marketing her formulation because “People trust a school teacher.”³ As researchers, authors, and professional healthcare providers, we need to select and wear our clothes with care, lest we be disrobed of our vestments of trust.

1. van Rijswijk L. Protecting science: a word warrior alert. Ostomy Wound Manage. 2005;51(11):8.

2. van Rijswijk L. A new year: a therapeutic future for wound care? Ostomy Wound Manage. 2006;52(1):10–12.

3. Walker R. Cold call. NY Times Magazine. January 8, 2006;Section 6:24.