Fact or Fiction?

Wound care education involves reading many books, journals, and other sources of information. I have addressed this issue in a past editorial (November 2008), and the need to obtain information by way of the printed word has not changed. Are you sure what you’re reading is fact or is it fiction? That is a menacing thought since we depend on scientific writing to be factual. Unfortunately, many articles are sponsored by companies who have much to gain by the publication of favorable words for their products or services. The pressure for publishers to publish substandard articles for profit must be significant. Regrettably, there are a number of instances of this happening in the medical publishing world.¹ Gotzsche and colleagues² have stated, “billions of dollars are being earned undeservedly by drug companies through flaws in research, research articles, reviews, and editorials.”

Ghostwriting is another problem. This is when the author of an article is neither involved in the production of the data nor is given credit for his or her role in the development of the manuscript. When people with significant conflicts of interest write articles for publication, it’s not surprising that they are rarely “fair and balanced.” Would you expect a company to publish a negative article about one of its products? A practice closer to home is when a ghostwritten article has well known people in the field lend their names to articles to give it support and validity. There are reports of distinguished professors lending their names to papers for financial compensation with little concern for the content of the paper.² This is unethical at best, and is considered scientific misconduct by many.

What would be the outcome if a paper with overtly false or misleading information were published and the data seemed so compelling that all adopted the treatment? Patients would suffer and the outcomes of the treatment could be devastating. Is it worth the price?

Let me assure the readers that the majority of publishers are ethical, upright people who would never knowingly publish deceptive information. We as editors and editorial review board members are constantly on guard for this type of submission. There are organizations of medical editors such as the International Committee of Medical Journal Editors and the World Association of Medical Editors (of which I am a member) that help monitor our publications for such problems. Hopefully, with everyone on alert, the publication of misleading information can be avoided. But it is up to you, the reader, to be sure that you are informed about what you are reading and not be fooled into thinking everything you see in print is fact. Unfortunately, some of it may be fiction.

To illustrate this point, a student in Idaho did a project to show how we have become conditioned to believe just about anything someone tells us. His project involved asking people to sign a petition to strictly control or ban the chemical “dihydrogen monoxide.” Among the reasons he gave for banning the chemical were that it can cause excessive sweating and vomiting, it is a major component of acid rain, in its gaseous state it can cause severe burns, accidental inhalation of it can kill you, it contributes to erosion, and it has been found in tumors of terminal cancer patients. Of the 50 people polled, 43 were in favor of banning the chemical, 6 were undecided, and only 1 knew the chemical was water. The title of his project was “How Gullible Are We?”³

I encourage you to read to expand your knowledge of medicine, but also to read with discernment and always ask yourself, “Is it fact or fiction?”