Doctors and medical scientists will usually point to peer-reviewed journals as the most reliable source of new medical knowledge. This view has been strengthened recently by the proliferation of recommendations on medicine and health in social media. The provenance of much of this advice is not evidence-based and the source is often a celebrity with no credentials as a biomedical scientist. For these reasons doctors will often advise patients against searching the internet when enquiring into medical matters.

Perhaps we need to examine our antipathy to information that emanates from other than the conventional and reassuring peer-reviewed sources with which we are familiar and feel most comfortable. First, the credibility of celebrity is not new. Most of us know that the original recommendation to take large doses of vitamin C to prevent the common cold was proposed by Linus Pauling and the veracity of this advice depended on Pauling’s status as a Nobel laureate. The fact that his Nobel Prize was in quantum physics and not in medicine tends to be overlooked. More important, however, is the need to evaluate and exploit new media that may expedite the promulgation of new medical knowledge. 

The need for scientific advances to be shared as quickly as possible was highlighted in a leading article in The Economist recently,¹ which pointed out the common practice of medical researchers needing to hoard their results for lengthy periods until research is published in an academic journal. Editorial policy of journals will often prohibit or at least discourage release of the results in other fora. The incentive to withhold findings is powerful. Journal papers and the citation indices that accompany them are the measure of a scientist’s productivity and status. To win research money and get promoted, scientists need to accrue an impressive list of publications.

The Economist cites an example of delay in disseminating knowledge that had the capacity to do real harm: during the Zika crisis, sponsors of research had to persuade publishers to declare that scientists would not be penalised for releasing their findings early. 

The Economist article suggests three reforms that would ensure that researchers’ results could be communicated to more people more quickly, without any compromise on quality:

For the organisations that finance research to demand that scientists put their academic papers, along with their experimental data, in publicly-accessible ‘repositories’ before being sent to a journal. This would allow other researchers to use  the findings without delay 

To improve the process of peer review itself by doing away with anonymous peer reviewers, which is increasingly seen as open to abuse. (The Gates foundation has announced its support for an online repository where peer reviews of papers are open and the reviewers identified. The repository was launched last year by the Wellcome Trust, meaning that the world’s two largest medical charities support it)

To cease the reliance on journal publication as the only recognised credential for researchers and the only path to career progression. 

Reference

1. The shackles of scientific journals (and how to cast them off). The Economist 2017 (Mar 25); http://www.economist.com/news/leaders/21719480-and-how-cast-them-shackles-scientific-journals?frsc=dg%7Ca