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Can you trust that medical journal?

April 18, 2013

By Ted Gansler, MD, MBA, MPH

 

Ed. note (10/10/13): Dr. Gansler has an update to this blog, originally published 4/18/13.
In an interesting update on this topic, Science magazine recently published results of a "sting operation" intended to identify bogus journals. A journalist from Science fabricated an intentionally bogus article about a fictitious anti-cancer drug, with errors so obvious that, "Any reviewer with more than a high-school knowledge of chemistry and the ability to understand a basic data plot should have spotted the paper's short-comings immediately." Shockingly, the vast majority of journals that received this article failed to notice these obvious flaws and agreed to publish it... for a fee. For more details, see http://www.sciencemag.org/content/342/6154/60.full.

An article in the April 8 New York Times titled "Scientific Articles Accepted (Personal Checks, Too)" caught my attention. It describes the growing availability of free online medical journals that use questionable tactics to gather and publish research of questionable quality.

The article piqued my interest because the experiences of some researchers described in it are similar to my own. I am also an editor of CA: A Cancer Journal for Clinicians, one of the American Cancer Society's medical journals, so I have an interest in the world of journal publishing.

But more importantly, I wanted to write about this topic because this is an issue that can affect cancer patients, survivors, and their loved ones, all of whom increasingly seek out information from medical journals.

Fake experts and copycat journals

 

The NY Times article describes how the companies behind this "parallel world of pseudo-academia" spam and scam researchers in a variety of academic fields. I have been a target myself.

I occasionally receive e-mail messages from an agriculture journal inviting me to review (as an expert) articles about farming methods that have been submitted to their journal. I find this curious because I have no expertise in agriculture (as a professional or even an amateur). In fact, my home garden is remarkably unsuccessful and the tomato plants I buy yearly from a local garden center end up developing spots on their leaves and die before yielding enough food to pay for themselves.

I also receive some invitations to speak as a featured lecturer at medical conferences and to write articles for journals focused on topics far outside of my medical specialization, practice experience, and research. The unifying theme in these messages is that I am expected to pay the company that has organized the conference or journal.

Some researchers have gotten fooled into publishing or presenting their high-quality research in copycat journals or conferences deceptively named to sound like well-respected journals and events. Others take the opportunity to "pad their resumes" by publishing or presenting results of low-quality studies in loosely-supervised journals or conferences that sound more legitimate than they are.

Publication of low-quality research can slow down the pace of progress in developing better ways to prevent, diagnose and treat cancer. Prestigious medical journals are prestigious precisely because they take pains to publish only the most rigorous research, deemed valuable by bona fide experts in the field.

Duping patients, too

 

People facing serious diseases such as cancer, as well as their loved ones, are increasingly seeking information from medical journals. When they read and understand high-quality information and discuss it with their physicians, what they learn can help them make informed decisions about their care.

But the opposite can occur when patients base decisions on low-quality research articles. Unfortunately, it is all too easy these days to find this bad research. Not only are many of these journals freely accessible online, but the findings often get reported in the media (journalists can get fooled, too) or in commercial outlets looking to sell a product.

Learning to spot reliable information


So... what can you do to distinguish high-quality medical research from less reliable studies? The unfortunate answer is that there are no simple rules to accomplish this goal, and even clinicians and researchers are occasionally confused.

However, we can recommend a few helpful suggestions. One is to start your "information journey" with research that has been painstakingly reviewed by an organization you trust, such as:

  • a health or medical group (for example, the American Cancer Society, American Heart Association, American Diabetes Association);
  • a government agency (the National Cancer Institute, US Food and Drug Administration, or Centers for Disease Control);
  • a major medical or nursing organization (American Society of Clinical Oncologists or Oncology Nursing Society);
  • or a prominent academic healthcare center, like Memorial Sloan Kettering Cancer Center or the University of Texas M.D. Anderson Cancer Center, to name but two.


If you want to read medical journals, I suggest starting with journals affiliated with a patient advocacy group or with a prominent healthcare professional society. Some of these include JAMA, published by the American Medical Association; New England Journal of Medicine, published by the Massachusetts Medical Society; and Journal of Clinical Oncology, published by the American Society of Clinical Oncologists. The American Cancer Society publishes 3 journals: CA: A Cancer journal for Clinicians, Cancer, and Cancer Cytopathology.

But, as noted in the NY Times article, you should be wary of organizations with copycat names that sound like those of prominent advocacy groups or medical societies. And limiting your reading to journals affiliated with advocacy and healthcare organizations will exclude some valuable information, because there are some high quality journals that are not associated with such groups.

Because there are no simple "rules of thumb" for including all high-quality journals and excluding all low-quality journals, it is a good idea to discuss information you collect with your healthcare team. Keep in mind that if your doctor is not familiar with a particular journal that publishes research in her or his specialty, that journal is not likely to be a leading source of information.

I've already noticed a few spots on my tomato plants this spring, and I know of one agriculture journal I won't be reading in search of a solution. To be honest, if I have any time to look into my tomato problem, I'll skip journals entirely and just check the website for my state agriculture department. Meanwhile, my lettuce still looks OK.

 

Dr. Gansler is director of medical content and editor of CA: A Cancer Journal for Clinicians at the American Cancer Society.

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General | Ted Gansler

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