Medical Journals are Not Just for Docs in Ivory Towers

Why do we publish? As the editor-in-chief of a medical journal, I struggle a lot with this question. After more than 200 years, peer-reviewed journals have clearly established themselves as medicine’s best arbitrator of truth. They are, or at least ideally should be, at the center of everything we practice in our clinics. Yet somehow we physicians, even those of us in academia, are blind to many of the important roles that journals serve in medicine today.

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Hospital Rankings: Can Docs Make the Process Less Stupid?

It’s that time of the year. As Halloween decorations give way to Thanksgiving and now Christmas ornamentation, I, like many other American academic physicians, am sent an array of end-of-the-year email reminders from hospital and medical school leadership about sundry matters ranging from holiday parties to Press Ganey Scores. However none of these notifications stands out quite like being urged to update my membership with Doximity and thereby ensure my good standing with the social media network.

And what lofty academic or clinical function is being served? None other than the academic medical community’s best effort to get out the faculty vote for Doximity’s upcoming and all-important hospital and departmental yearly reputation scoring – a number which ultimately feeds into the even more important, annual hospital rankings among the US News and World Report.

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Fake Science: More Common Than You Think

Yet again the edifices of peer review were shaken by recent retractions in The New England Journal of Medicine and Cochrane Reviews. The article (and another “expression of concern publication”) retracted in the NEJM was authored by a Brigham and Women’s Hospital researcher (an institution of which I am a graduate), Dr. Piero Anversa, who has been implicated in the fraudulent publication of as many as 31 cardiac stem cell articles. Meanwhile, under seeming political pressures from a group of patient activists that decried an analysis entitled: “Exercise as treatment for patients with chronic fatigue syndrome,” deeming it a personal affront to their suffering, the editors of the prestigious Cochrane Reviews decided to withdraw it. The scientist who did the actual review for the journal lodged a bitter complaint about this “editorial” decision; it is hard to miss the irony here of Cochrane Reviews being a supposed impartial arbitrator of medical scientific quality that drives clinical decision-making. Fraudulent scientific results, politics trumping science, what is a reader to believe?

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Towards a Cureus Data Repository

*Co-authored by John R. Adler & Achim Schweikard

Most scientific articles come with some form of data. For Cureus, our data includes medical images, graphics, drawings and tables. Access to such data enables a reader to verify the content and credibility of an article while also better understanding it. Many types of data, provided they are findable via search, can have value to readers independent of the article with which it was originally connected; medical imagery and genetic sequencing information being cases in point. For example, with modern methods of machine learning requiring large data sets for training, journals are a logical repository for such information. Therefore a peer-reviewed article that provides access to data will oftentimes prove much more valuable than that same article without data. Especially for internet-based media with access to large amounts of digital storage space, data sharing between authors and readers would and should become a standard. As an example, instead of showing data for a single representative case in an article, which is typical for traditional journals, we could make data for all cases in this article available to readers. Readers could then download such enhanced data sets directly in electronic format.

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Conflicts of Interest and Financial Disclosures: It’s Time to Take a Stand Against Dishonest Authors

The recent announcement that the Chief Medical Officer of Memorial Sloan Kettering Cancer Center failed multiple times to report significant financial conflicts of interest in journal articles and letters authored or co-authored by him has justifiably stirred up quite a hornets nest of controversy.

Truth be told, I too am personally quite angry about his glaring oversight, which at its worst, involved opinions communicated broadly to the medical community via the New England Journal of Medicine. As a physician innovator, entrepreneur and scholar I have sought to play by these disclosure rules, which simply mandate transparency, because I think they are the best tools for fairly communicating possible bias to readers.

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Our Founder & Editor-in-Chief won the AANS Cushing Award!

We are delighted to announce that Cureus Founder and Editor-in-Chief Dr. John Adler was presented with the American Association of Neurological Surgeons’ Cushing Award for Technical Excellence and Innovation in Neurosurgery!

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Presented at the 2018 AANS annual meeting in New Orleans on Monday April 30th, the Cushing Award could well be considered the Nobel Prize for Neurosurgery. The award was established in 2013 to honor innovation, skill and technical prowess in the development of new procedures which have become part of the arsenal neurosurgeons use to treat disease or trauma. John’s formative role in founding Cureus, “a disruptive platform for creating and sharing medical knowledge” was cited during the award presentation. Here at Cureus we are proud to call John our leader as his lifetime of professional accomplishments, including the creation of Cureus, led him to this point.

Founded by Harvey Cushing, after which the award is named, the 2018 AANS Annual Scientific Meeting is attended by neurosurgeons, neurosurgical residents, medical students, neuroscience nurses, clinical specialists, physician assistants, allied health professionals and other medical professionals, the AANS Annual Scientific Meeting is the largest gathering of neurosurgeons in the nation, with an emphasis on the field’s latest research and technological advances.

Congratulations, John!

Is it Time to Start Publicly Shaming Plagiarists?

Publishing is a privilege, not a right. The vast majority of Open Access journals, such as PloS, Frontiers, BioMed Central, etc., charge authors several thousand dollars for this privilege. Part of the publisher’s service to the author (and ultimately readers) involves a plagiarism check, the cost of which is readily borne by the substantial Open Access fees paid by authors. Alternatively, authors are afforded a similar service when they surrender their copyright to subscription journals.

In Cureus’ free publication model plagiarism, and the cost of checking for plagiarism, represents a bigger challenge. Each and every article we publish must be checked for plagiarism. When we discover that content has been taken from other sources without proper attribution, the article is blocked and the academic department leadership of the offending institution is notified. This process costs our journal meaningful time and money.

Because plagiarism undermines Cureus’ philosophy of providing free Open Access publishing, we want to do everything in our power to deter and prevent plagiarists from submitting to Cureus. This is no easy task, but we believe it’s worth it. How might we do this? One idea is the use of old-fashioned public shaming. Perhaps if the offending authors are suitably exposed, these “authors” and/or institutions will clean up their act. After all, we at Cureus know who the plagiarists are and where they’re located. The question I would now like to pose to the community of Cureus users is, how far do you think we should go? Should we list plagiarists by name on a digital “Wall of Shame”?

While most of the institutions where plagiarists were situated have taken their responsibilities seriously when confronted, one such institution, located in Srinagar, India, recently refused to acknowledge the seriousness of their offense; what type of ethics is such an institution teaching its students and residents?. Regardless, in a first step to put a spotlight on plagiarists, the following world map illustrates the location of authors who have submitted articles with plagiarized content to Cureus in the past 2 years. We want to protect the integrity of our responsible authors, and you can help. I urge you, our Cureus users to sound off on this topic of concern for all of us!

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