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Goodbye to all that
THE LANCET
THE LANCET Volume 348, Number 9043 EDITORIAL
Goodbye to all that 1996 began for The Lancet with the hope that evil might become the recipient of some respectable investigation. We were disappointed. Yet we end the year on a slightly more optimistic note by offering readers brief clips of medicine in all its exotic disguises—the newly reported but clinically devastating emarceepy disease (p 1718) or the mysteries of an ataxic 3-year-old (p 1705). In between has been a mix of the creative and the curious. Infection, for instance, continues to preoccupy a remarkably large proportion of our authors, especially those who send us case reports: human anthrax, salmonella in a lizard owner, hantavirus in the Bosnian war, syphilis in a butcher, rheumatic fever in an emotional 13-year-old girl, influenza A in a fractious 13-year-old boy, and, perhaps most alarming of all, the captivating body odour caused by a mixture of acids from clostridial infection. And then there was new-variant CJD. For general medical journals, randomised controlled trials are a staple and we published over 50 this year. Still, it is often not the results of clinical trials that catch the journalist’s eye. More likely, it will be the findings of an observational study, raising the possibility of (but never providing the proof about) a new treatment or a new risk. This year has seen its fair share: gene transfer to the artery of a patient with peripheral vascular disease (successful); a relation between oestrogen use in postmenopausal women and onset of Alzheimer’s disease (delayed); a link between calcium channel blockers and cancer (positive); and reports of alcohol and drug use among university students (high). What effect does this differing focus have on those who read about the work we publish in places other than The Lancet? The journal has a friend who is a former biology teacher. He remains a prolific writer of textbooks for school students and he keeps a keen eye on newspapers for interesting clinical vignettes that might be suitable for inclusion in his latest project. His requests for copies of original Lancet articles provide a useful barometer on the perceptions of non-medical readers interested in medical news. Two recent examples. In the Oct 26 issue, we published a randomised trial on the treatment of
Vol 348 • December 21/28, 1996
chronic suppurative otitis media in Kenyan schoolchildren; a meta-analysis showing that respiratory rehabilitation was an effective treatment for patients with chronic airways disease; a review considering how HIV prevention strategies might be organised in developed countries; and a proposal for a new way to plan research into cancer. The article covered most widely in newspapers, the one requested by our interested friend, was a report on the frequency of varicoceles (higher) in young soccer players: “New medical research hits footballers where it hurts”. In the Nov 9 issue, three papers threw further light on the fetal-origins hypothesis. There was also a withering critique of the way in which funding organisations, many receiving tax-payers’ money, go about distributing their largesse. The item covered in the general news media was neither of these papers. Rather, it was a summary of laboratory work describing how Limburger cheese could ward off Anopheles mosquitoes (“Cheesy feet can help the fight against malaria”). Our biologist associate plans to base his presentation to a forthcoming science education conference on this letter. The editor of a British tabloid newspaper, the Daily Mirror, said recently that “I only judge a story on what sells and what doesn’t”. We have criteria too: topicality, originality, and validity, for example. What news values should a medical journal live by compared with any other news medium and how do journal editors overcome journalistic bias towards the offbeat? Our interests are best expressed in the material we publish rather than in any pretentious mission statement fashioned from the thesaurus of a management course. But one way to circumvent misinterpretation about what we publish is to go direct to the public, bypassing newspapers and television altogether. And that seems to be happening through our website, where over half of those who register are not medically qualified. Perhaps, then, it is too early after all to adopt Drummond Rennie’s advice and compose our own living structured auto-obituary. We’ll see.
The Lancet
1671
THE LANCET Volume 348, Number 9043 EDITORIAL
Goodbye to all that 1996 began for The Lancet with the hope that evil might become the recipient of some respectable investigation. We were disappointed. Yet we end the year on a slightly more optimistic note by offering readers brief clips of medicine in all its exotic disguises—the newly reported but clinically devastating emarceepy disease (p 1718) or the mysteries of an ataxic 3-year-old (p 1705). In between has been a mix of the creative and the curious. Infection, for instance, continues to preoccupy a remarkably large proportion of our authors, especially those who send us case reports: human anthrax, salmonella in a lizard owner, hantavirus in the Bosnian war, syphilis in a butcher, rheumatic fever in an emotional 13-year-old girl, influenza A in a fractious 13-year-old boy, and, perhaps most alarming of all, the captivating body odour caused by a mixture of acids from clostridial infection. And then there was new-variant CJD. For general medical journals, randomised controlled trials are a staple and we published over 50 this year. Still, it is often not the results of clinical trials that catch the journalist’s eye. More likely, it will be the findings of an observational study, raising the possibility of (but never providing the proof about) a new treatment or a new risk. This year has seen its fair share: gene transfer to the artery of a patient with peripheral vascular disease (successful); a relation between oestrogen use in postmenopausal women and onset of Alzheimer’s disease (delayed); a link between calcium channel blockers and cancer (positive); and reports of alcohol and drug use among university students (high). What effect does this differing focus have on those who read about the work we publish in places other than The Lancet? The journal has a friend who is a former biology teacher. He remains a prolific writer of textbooks for school students and he keeps a keen eye on newspapers for interesting clinical vignettes that might be suitable for inclusion in his latest project. His requests for copies of original Lancet articles provide a useful barometer on the perceptions of non-medical readers interested in medical news. Two recent examples. In the Oct 26 issue, we published a randomised trial on the treatment of
Vol 348 • December 21/28, 1996
chronic suppurative otitis media in Kenyan schoolchildren; a meta-analysis showing that respiratory rehabilitation was an effective treatment for patients with chronic airways disease; a review considering how HIV prevention strategies might be organised in developed countries; and a proposal for a new way to plan research into cancer. The article covered most widely in newspapers, the one requested by our interested friend, was a report on the frequency of varicoceles (higher) in young soccer players: “New medical research hits footballers where it hurts”. In the Nov 9 issue, three papers threw further light on the fetal-origins hypothesis. There was also a withering critique of the way in which funding organisations, many receiving tax-payers’ money, go about distributing their largesse. The item covered in the general news media was neither of these papers. Rather, it was a summary of laboratory work describing how Limburger cheese could ward off Anopheles mosquitoes (“Cheesy feet can help the fight against malaria”). Our biologist associate plans to base his presentation to a forthcoming science education conference on this letter. The editor of a British tabloid newspaper, the Daily Mirror, said recently that “I only judge a story on what sells and what doesn’t”. We have criteria too: topicality, originality, and validity, for example. What news values should a medical journal live by compared with any other news medium and how do journal editors overcome journalistic bias towards the offbeat? Our interests are best expressed in the material we publish rather than in any pretentious mission statement fashioned from the thesaurus of a management course. But one way to circumvent misinterpretation about what we publish is to go direct to the public, bypassing newspapers and television altogether. And that seems to be happening through our website, where over half of those who register are not medically qualified. Perhaps, then, it is too early after all to adopt Drummond Rennie’s advice and compose our own living structured auto-obituary. We’ll see.
The Lancet
1671