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.

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

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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!

Announcing the Winners of the Negative Pressure Wound Therapy Publishing Competition!

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The SIQ scoring period has ended and the scores have been tabulated. We are pleased to announce the following articles as winners of the Negative Pressure Wound Therapy with Instillation publishing competition:

1st place – 8.3 SIQ ($5,000): “Negative Pressure Wound Therapy with Instillation in a Chronic Non-Healing Right Hip Trochanteric Pressure Ulcer” by Broder, Nguyen and Broder

2nd place – 8.0 SIQ ($2,000): “A Case Review Series of Christiana Care Health System’s Experience with Negative Pressure Wound Therapy Instillation” by Felte, Gallagher, Tinkoff and Cipolle

3rd place – 7.0 SIQ ($1,000): “Utilizing the VeraFlo™ Instillation Negative Pressure Wound Therapy System with Advanced Care for a Case Study” by Rita K. Driver

We’ll be reaching out to the corresponding author of each article to arrange for award delivery.

As is the case with all of our publishing competitions, please keep in mind that only scores submitted during the competition scoring period are included when determining the winners.

We’d like to extend a big thank you to the Cureus community for their efforts in reading and scoring competition articles over the past few months. Without you, this competition would not be possible.

And remember – even though the competition is over, you can still access and score all of the articles. Thanks for your support!

Optimization Strategies for Organ Donation and Utilization Competition Winners!

novartis-donate-life-email-winners-announcedThe SIQ scoring period has ended and the scores have been tabulated. We are pleased to announce the following articles as winners of the Optimization Strategies for Organ Donation and Utilization publishing competition:

Winner, Organ Utilization – 9.3 SIQ: Trends in Usage and Outcomes for Expanded Criteria Donor Kidney Transplantation in the United States Characterized by Kidney Donor Profile Index” by Rege, Irish, Castleberry et al.

Winner, Organ Donation – 5.5 SIQ: “Envisioning and Leading Organizational Transformation: One Organ Procurement Organization’s Journey” by Orlowski

As a reward for their efforts, each author group will be awarded $5,000. (We’ll be reaching out to the corresponding author of each article to arrange for award delivery.)

As is the case with all of our publishing competitions, please keep in mind that the above scores represent only those scores submitted during the competition scoring period.

We’d like to extend a big thank you to the Cureus community for their efforts in reading and scoring competition articles over the past few months. Without you, this competition would not be possible.

And remember – even though the competition is over, you can still access and score all of the articles. Thanks for your support!

Autologous Epidermal Grafting: Announcing the Competition Winner!

kci-competition-email-winners-announcedThe SIQ scoring period has ended and the scores have been tabulated. We are pleased to announce the following articles as winners of the Clinical and Economic Benefits of Autologous Epidermal Grafting publishing competition:

1st place, 9.3 SIQ: “Clinical and Economic Benefits of Autologous Epidermal Grafting” by Maderal & Kirsner

2nd place, 9.0 SIQ: “A Case Series of Complex Recalcitrant Wounds Treated with Epidermal Grafts Harvested from an Automated Device” by Cai, Gowda, Chopra et al.

3rd place, 6.0 SIQ: “Autologous Epidermal Grafting Using a Novel Negative Pressure Epidermal Harvesting System in a Case of Stable Vitiligoby” by Krishna, Thirunavukkarasu, Krishnan et al.

As you can see, the battle for first place came down to the wire with only a handful of scores separating first and second place. (Keep in mind that the above scores represent only those scores submitted during the competition scoring period.)

We’d like to extend a big thank you to the Cureus community for their efforts in reading and scoring competition articles over the past few months. Without you, this competition would not be possible.

And remember – even though the competition is over, you can still access and score all of the articles. Thanks for your support!

Scholarly Roulette: Impact Factor & Scientific Quality

A friend and colleague referred me to a recent publication that represents a major indictment of the peer-reviewed journal cartel.

This article summarizes a blog published by what is arguably a Cureus competitor, the open access-publishing house, Frontiers, which in this study could find no correlation between rates of rejection and journal impact factor.

Just for argument’s sake, let’s assume that impact factor does correlate with scientific quality. So if this study is correct, it means by extension that the rate of rejection also doesn’t correlate with quality. In turn this means that the standard peer review process (which totally dominates the journal industry) has no bearing on article quality. In other words, getting published, or not, appears to be a random event.

Accepting this fact (parenthetically one which I already subscribe to) means that despite all the process and rituals of scientific journal publishing, and the huge importance of this matter to society and academic tenure decisions, there is currently no objective index for assessing research article quality. Of course if one believes that impact factor is not a measure of quality, then the above random publication process is even more random than I implied in my argument! Based on this observation, I would like to sarcastically suggest we should rename this current process “scholarly roulette.”

Clearly there are huge shortcomings to the Frontiers study, such as selection bias and the non-medical nature of many scholarly journals. However, to a huge research community that has invested so much of their lives into the existing peer review process these type of findings must be dispiriting. Nevertheless, this current set of observations does resonate with our philosophy at Cureus, where we subscribe to the belief that as long as the medical science within is credible, there is no reason not to publish an article. In other words, we believe that we are, on average, no better equipped to discern quality than any other journal.

A big part of our confidence stems from Cureus’ unique post-publication SIQ scoring system. Although we are no smarter in finding scientific quality up front, we do believe that it is quite possible for the medical community-at-large to find quality over time, post publication. Nevertheless, to make this a reality, every reader has a role to play, which of course includes you!

Measles, the Anti-Vaccine Crowd and the Peer-Reviewed Article Partially to Blame

A big measles outbreak in the US is generating considerable news of late. Much of the blame, rightfully so in my opinion, is centered on parents who have refused to vaccinate their children out of ill-founded paranoia. Most of their anti-vaccine “thinking,” if you can call it that, is grounded in muddled anti-science. However, one of the intellectual pillars of the anti-measles movement is rooted in peer-reviewed science. And not just any science, but none other than the acclaimed high impact journal Lancet. To my way of thinking this is a big part of the problem.

Andrew Wakefield’s much ballyhooed and eventually discredited 1998 Lancet article, concluded that childhood vaccines were a possible cause for autism. Parents of autistic children seized upon this possibility, especially A-list celebrity Jenny McCarthy, invoking the Wakefield article as proof of their fears. Unable to weigh the scientific merits for themselves, the fanatical anti-vaccine public at large ascribed considerable veracity and power to the Wakefield article in large part because of its publication in Lancet; although undoubtedly this article also reinforced a narrative they wanted to believe. Like most of its peers within the “luxury” journal domain, Lancet revels in every opportunity to burnish its reputation for publishing “important,” high quality science and in doing so, laughing all the way to the bank. It is impossible to believe that had the Wakefield article been published in the Burmese Journal of Gastroenterology it would have gotten nearly the same zealous respect it did in Lancet.

Don’t get me wrong. I don’t fault Lancet for publishing a bad paper; such risk is intrinsic to publishing a peer-reviewed journal. However I do take issue with the reputation Lancet seeks to foster around impact factor and by intimating that their peer review process results in a meaningfully more valid scientific publication; the Wakefield article being a perfect case in point of why this thinking is flawed. Any scientist with integrity knows that the proper perspective for approaching all scientific publications involves a substantial dose of skepticism until the findings within have been replicated, oftentimes more than once.

Despite its subsequent retraction, Wakefield anti-vaccine believers refuse to relent, claiming even today that allegations of scientific misconduct are a conspiracy at the highest levels of science. If the Wakefield article had instead been refuted by a democratic barrage of post-publication critique and scoring, ala SIQ, it would be much harder for the anti-vaccine fanatics to keep believing in discredited science. That said, as long as luxury journals are perceived as having a uniquely rigorous peer review system, and therefore uniquely truthful, the public health will be disserved as we are currently witnessing in this measles outbreak. We at Cureus continue to believe that there is a better process via more rigorous post-publication review, as implemented in our SIQ. Give it a chance – you’ll be surprised.