Publishing surgery

Abstract

I was disappointed, but not surprised, to see that only two of 112 original articles published in the BMJ in the first 6 months of 1999 could be categorised as surgical (Jan 29, p 413).1Magos A Cumbis A Katsetos C Bias against publication of surgical papers.Lancet. 2000; 355: 413Summary Full Text Full Text PDF PubMed Scopus (5) Google Scholar The proportion of surgical articles was almost as low in three other general journals, including The Lancet.Adam Magos and his colleagues ask why the proportions are so low and imply bias by general journals against surgical research. Unfortunately, the authors do not even consider what I fear is the answer to their question—that the quality of surgical research is poor. The Lancet's editor made this point in a 1996 commentary that compared surgical research to comic opera.2Horton R Surgical research or comic opera: questions, but few answers.Lancet. 1996; 347: 984-985Abstract PubMed Scopus (304) Google ScholarRandomised controlled trials remain unusual in surgical research whereas surgical series are common. 10 years ago the BMJ did publish surgical series, and we published many more casereports, some of which were surgical. Now we hardly ever publish such articles because confident conclusions are impossible. Nor do we want to publish studies of surgical technique—because these do not carry a useful message to a general audience. We are also reluctant to publish pathophysiological studies. We want to publish POEMS (“patient oriented research that matters).3Shaughnessy AF Slawson DC Changing the doctor-patient relationship: are we providing doctors with the training and tools for lifelong learning?.BMJ. 1999; 319: 1280Crossref PubMed Scopus (50) Google ScholarI would like to think—although I may deceive myself—that far from being biased against surgical papers we are biased towards them. We are well aware that we publish little original surgical research, and so we try to compensate with material we commission. We have twice at our editorial board meetings had sessions on how the BMJ can become more useful to surgeons, and I would welcome any further suggestions. I was disappointed, but not surprised, to see that only two of 112 original articles published in the BMJ in the first 6 months of 1999 could be categorised as surgical (Jan 29, p 413).1Magos A Cumbis A Katsetos C Bias against publication of surgical papers.Lancet. 2000; 355: 413Summary Full Text Full Text PDF PubMed Scopus (5) Google Scholar The proportion of surgical articles was almost as low in three other general journals, including The Lancet. Adam Magos and his colleagues ask why the proportions are so low and imply bias by general journals against surgical research. Unfortunately, the authors do not even consider what I fear is the answer to their question—that the quality of surgical research is poor. The Lancet's editor made this point in a 1996 commentary that compared surgical research to comic opera.2Horton R Surgical research or comic opera: questions, but few answers.Lancet. 1996; 347: 984-985Abstract PubMed Scopus (304) Google Scholar Randomised controlled trials remain unusual in surgical research whereas surgical series are common. 10 years ago the BMJ did publish surgical series, and we published many more casereports, some of which were surgical. Now we hardly ever publish such articles because confident conclusions are impossible. Nor do we want to publish studies of surgical technique—because these do not carry a useful message to a general audience. We are also reluctant to publish pathophysiological studies. We want to publish POEMS (“patient oriented research that matters).3Shaughnessy AF Slawson DC Changing the doctor-patient relationship: are we providing doctors with the training and tools for lifelong learning?.BMJ. 1999; 319: 1280Crossref PubMed Scopus (50) Google Scholar I would like to think—although I may deceive myself—that far from being biased against surgical papers we are biased towards them. We are well aware that we publish little original surgical research, and so we try to compensate with material we commission. We have twice at our editorial board meetings had sessions on how the BMJ can become more useful to surgeons, and I would welcome any further suggestions.