- Email: [email protected]
Reviewer conflicts of interest should be disclosed
538 Letters
J AM ACAD DERMATOL MARCH 2005
More T.R.U.E Test allergens are needed 1
To the Editor: In a recent article by Saripalli et al in the Journal, the authors retrospectively examined the ability of 23 allergens, all of which were included in T.R.U.E. Test panels, to detect all relevant patient reactions over a 7-year period. Not surprisingly, they discovered that less than a third of the patients would have been fully evaluated using these 23 allergens alone. They also determined that even with the use of 50 test allergens, less than half of the patients would have been completely diagnosed. We concur with these and other investigators in this field that more than 23 allergens are usually required for complete diagnostic patch testing. However, the number of allergens required for a successful diagnosis also depends greatly on the training and experience of the physicians. Therefore, in addition to supporting the development of new test materials, we also encourage further training and education for physicians in this field. Mekos Laboratories AS (Denmark) is developing a third T.R.U.E. Test panel of 12 additional allergens. Because of the stringent regulations of the US Food and Drug Administration, the manufacturer must provide documentation about formulation parameters, allergen stability and degradation, manufacturing processes, and analytical methods. Until the Food and Drug Administration expedites their current allergen approval program, at least 3 years of development work are required. The demands of this time-consuming process underscore the commitment of Mekos Laboratories AS to provide convenient and accurate patch test products. Ulla Lisbeth Hoeck, MScPharm Mekos Laboratories AS Hillerød, Denmark Disclosure: The author is an employee of Mekos Laboratories AS REFERENCE 1. Saripalli YV, Achen F, Belsito DV. The detection of clinically relevant contact allergens using a standard screening tray of twenty-three allergens. J Am Acad Dermatol 2003;49:65-9. doi:10.1016/j.jaad.2004.07.042
Reviewer conflicts of interest should be disclosed To the Editor: In the review of our monograph devoted to the matter of sentinel node biopsy (SNB),1 Kelly M. McMasters, MD, PhD, sounds very angry about a point of view, advanced by us, that is contrary to his own. Perhaps that reflects the admission by him that he is an advocate for sentinel
node biopsy (‘‘For those of us who are advocates of SNB. . .’’). I write now to express, dispassionately, the opinion that: (1) it is not academic for a journal of an Academy to select, as a reviewer for a volume that slams SNB, a fervent advocate of the procedure; and (2) it is only fitting and proper that a revieweradvocate be compelled to disclose whether he has a conflict of interest (to wit, is he a surgeon who performs the procedure for a fee?). Dr Medalie and I are pleased to inform that we have no conflict of interest, being the dermatopathologists that we are. Can Dr McMasters state that? A. Bernard Ackerman, MD Ackerman Academy of Dermatopathology New York, New York REFERENCE 1. McMasters KM. Review of: Medalie N, Ackerman AB. Sentinel lymph node biopsy has no benefit for patients with primary cutaneous melanoma: An assertion based on comprehensive, critical analysis. Seattle (WA): Ardor Scribendi, 2003. J Am Acad Dermatol 2004;51;152-4. doi:10.1016/j.jaad.2004.10.010
Reply To the Editor: Dr Ackerman suggests that, because I am a surgeon who performs sentinel node biopsy (SNB), I have a conflict of interest in commenting about the value of this procedure. Using the same logic, Dr Ackerman should have a conflict of interest in writing or commenting about any issues in dermatopathology. Dr Ackerman also asserts that it was not ‘‘academic’’ for me, as one who believes that SNB is valuable, to have been selected to review his monograph. Would it have been more academically prudent to select someone who agrees with his viewpoint? Finally, I certainly am not ‘‘angry’’ about any of Dr Ackerman’s writings, and I apologize if this was inferred from the tone of my review. I did feel, however, that the vehemence of Dr Ackerman’s monograph required a commensurate response. Kelly M. McMasters, MD, PhD Sam and Lolita Weakley Professor of Surgical Oncology University of Louisville School of Medicine Louisville, Kentucky doi:10.1016/j.jaad.2004.10.011
Editor’s comment We asked Dr McMasters to review Dr Ackerman’s monograph (from Dr Ackerman’s Contrary Review
J AM ACAD DERMATOL MARCH 2005
More T.R.U.E Test allergens are needed 1
To the Editor: In a recent article by Saripalli et al in the Journal, the authors retrospectively examined the ability of 23 allergens, all of which were included in T.R.U.E. Test panels, to detect all relevant patient reactions over a 7-year period. Not surprisingly, they discovered that less than a third of the patients would have been fully evaluated using these 23 allergens alone. They also determined that even with the use of 50 test allergens, less than half of the patients would have been completely diagnosed. We concur with these and other investigators in this field that more than 23 allergens are usually required for complete diagnostic patch testing. However, the number of allergens required for a successful diagnosis also depends greatly on the training and experience of the physicians. Therefore, in addition to supporting the development of new test materials, we also encourage further training and education for physicians in this field. Mekos Laboratories AS (Denmark) is developing a third T.R.U.E. Test panel of 12 additional allergens. Because of the stringent regulations of the US Food and Drug Administration, the manufacturer must provide documentation about formulation parameters, allergen stability and degradation, manufacturing processes, and analytical methods. Until the Food and Drug Administration expedites their current allergen approval program, at least 3 years of development work are required. The demands of this time-consuming process underscore the commitment of Mekos Laboratories AS to provide convenient and accurate patch test products. Ulla Lisbeth Hoeck, MScPharm Mekos Laboratories AS Hillerød, Denmark Disclosure: The author is an employee of Mekos Laboratories AS REFERENCE 1. Saripalli YV, Achen F, Belsito DV. The detection of clinically relevant contact allergens using a standard screening tray of twenty-three allergens. J Am Acad Dermatol 2003;49:65-9. doi:10.1016/j.jaad.2004.07.042
Reviewer conflicts of interest should be disclosed To the Editor: In the review of our monograph devoted to the matter of sentinel node biopsy (SNB),1 Kelly M. McMasters, MD, PhD, sounds very angry about a point of view, advanced by us, that is contrary to his own. Perhaps that reflects the admission by him that he is an advocate for sentinel
node biopsy (‘‘For those of us who are advocates of SNB. . .’’). I write now to express, dispassionately, the opinion that: (1) it is not academic for a journal of an Academy to select, as a reviewer for a volume that slams SNB, a fervent advocate of the procedure; and (2) it is only fitting and proper that a revieweradvocate be compelled to disclose whether he has a conflict of interest (to wit, is he a surgeon who performs the procedure for a fee?). Dr Medalie and I are pleased to inform that we have no conflict of interest, being the dermatopathologists that we are. Can Dr McMasters state that? A. Bernard Ackerman, MD Ackerman Academy of Dermatopathology New York, New York REFERENCE 1. McMasters KM. Review of: Medalie N, Ackerman AB. Sentinel lymph node biopsy has no benefit for patients with primary cutaneous melanoma: An assertion based on comprehensive, critical analysis. Seattle (WA): Ardor Scribendi, 2003. J Am Acad Dermatol 2004;51;152-4. doi:10.1016/j.jaad.2004.10.010
Reply To the Editor: Dr Ackerman suggests that, because I am a surgeon who performs sentinel node biopsy (SNB), I have a conflict of interest in commenting about the value of this procedure. Using the same logic, Dr Ackerman should have a conflict of interest in writing or commenting about any issues in dermatopathology. Dr Ackerman also asserts that it was not ‘‘academic’’ for me, as one who believes that SNB is valuable, to have been selected to review his monograph. Would it have been more academically prudent to select someone who agrees with his viewpoint? Finally, I certainly am not ‘‘angry’’ about any of Dr Ackerman’s writings, and I apologize if this was inferred from the tone of my review. I did feel, however, that the vehemence of Dr Ackerman’s monograph required a commensurate response. Kelly M. McMasters, MD, PhD Sam and Lolita Weakley Professor of Surgical Oncology University of Louisville School of Medicine Louisville, Kentucky doi:10.1016/j.jaad.2004.10.011
Editor’s comment We asked Dr McMasters to review Dr Ackerman’s monograph (from Dr Ackerman’s Contrary Review