The Ingelfinger rule revisited

Article Abstract:

In 1969, the editor of the prestigious New England Journal of Medicine instituted a policy of refusing to publish scientific articles if the results had previously been reported elsewhere. This has become known as the Ingelfinger rule, after editor Franz Ingelfinger. Ingelfinger's successors have continued this policy, but the principle remains controversial. While the rule was instituted to preserve the originality of the Journal, it has the effect of requiring many researchers to adhere to the traditional principles of peer review. Under normal circumstances, medical research that is submitted for publication is sent to other researchers in the same field; these ''peers'' review the work, pointing out both flaws and merits. Naturally, this process takes time. Currently, some controversy focuses on the time required for peer review. Should, for example, the report of a promising new AIDS drug be delayed? What about the patients who fail to receive a potentially beneficial drug while a manuscript languishes on the desks of reviewers? Much has been made of the potential problems with the peer review process, but little has been made of the potential problems of hastily announcing medical findings. Medical researchers could not do their work if they were not enthusiastic, but this same enthusiasm may blind them to shortcomings of their work or to possible alternative explanations that might be overlooked. There are several cases in which researchers reported directly to the news media about drugs that seemed promising in the treatment of AIDS. In one case, French scientists announced that cyclosporine was effective, and the Wall Street Journal even chided American researchers for not informing the public rapidly enough. The claim, it turns out, was not supported by the data, and the enthusiasm generated in the media had no scientific basis. Unfortunately, the premature public announcement of claims damages the credibility of medical science as a whole, since the public has no basis on which to decide which claims are valid and which are without foundation. It is clear that publishers and editors must do all they can to hasten the publication of results that have important medical merit. Haste must not, however, result in reporting claims that have not survived scientific scrutiny. (Consumer Summary produced by Reliance Medical Information, Inc.)

Ethical aspects, Medical publishing, Medical literature, Scientific literature, Science literature

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Prepublication release of Journal articles

Article Abstract:

The New England Journal of Medicine waived the Ingelfinger Rule in July, 1997, and permitted a press conference prior to publication of a medical study. Researchers at the Mayo Clinic described heart valve damage which may have been caused by the popular fen-phen diet drugs. Due to widespread use of these drugs and the potential for serious injury, the Journal allowed public discussion of the research weeks before physicians would be able to review the data. In the future, the Journal will use its own web site to provide a study when its findings are released before publication.

Causes of, Complications and side effects, Media coverage, Fenfluramine, Heart valve diseases, Phentermine, The New England Journal of Medicine (Periodical)

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Losing weight - an ill-fated New Year's resolution

Article Abstract:

Doctors should concentrate on prevention of obesity, rather than contribute to the American obsession with thinness. Attempting to lose weight has spawned an enormous industry of diet pills, exercise equipment, low-fat foods, and weight-loss organizations, yet most dieters fail. The quest for thinness also contributes to negative attitudes directed at the overweight, despite the lack of solid evidence that overweight leads to poor health. Doctors should encourage healthy eating and exercise, and limit weight-loss advice to patients who ask for it.

Health aspects, Obesity, Weight loss

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