JAMA follow-up

You might recall my criticism of more or less unprofessional conduct by the Journal of the American Medical Association's current editors. It's a story that began here, continued here, with the last post being this one. Apparently the WALL STREET JOURNAL's health blog (kindly citing my blog) asked JAMA for a reply to the criticism I raised both on this blog as well as on a mailing list of the World Association of Medical Editors. According to the Wall Street Journal's health writers the JAMA editors refused to comment. This is much in line with what I have experienced with re to my open questions on the World Association of Medical Editors' listserv. There has been deafening silence, too. It seems to be the case that JAMA's editors are not accountable to anyone with regard to their conduct. They even get away with rewriting the publishing history of the journal they edit.

As a by-product of their shenanigans they flagged (again) the serious problems the scientific publishing community faces with the dawn of the age of on-line only 'publishing'. With the push of a button, scientific publications that once were can simply be made to disappear (and probably also be changed retrospectively). Scientists who criticise an original paper (as was the case with the JAMA on-line editorial that disappeared into thin air) will look a tad bit daft because the article they commented on has disappeared (presumably a result of the egg-on-editors'-face syndrome...). None of this would be possible with print copy publications!

AMA investigates JAMA Editors' actions

The Wall Street Journal reports today that the American Medical Association, the owner of the Journal of the American Medical Association (JAMA), has ordered its oversight committee to investigate claims that the journal's editors effectively bullied a scientist critical of a study it published. Read more about the background of the matter here and here.

Medical journal primadonnas - the end (not)

I have reported a short while ago (you might want to re-read this before continuing this blog posting) how editorial staff at the Journal of the American Medical Association (JAMA) seemingly bullied Dr Leo after he disclosed in the British Medical Journal (BMJ) an undisclosed conflict of interest of authors of a study JAMA published.

Here now, without further ado, the end of the saga. It's been reported on the websites of the WSJ, JAMAs as well as Dr Leo's. My analysis will make use of content (analysis) provided by subscribers to a bioethics discussion list hosted by the Medical College of Wisconsin.

JAMA's editors have not exactly helped their case. They effectively admit contacting Leo's Dean to complain about his conduct (ie publishing his conflict of interest allegations - 5 months after bringing them to the attention of JAMA's editorial staff) on the BMJ website. They deny having bullied the Dean as well as Leo. However, the Dean confirmed that the gist of the JAMA editors' complaint about Leo contained a threat to the school. Here's an excerpt from said bioethics discussion list: '"In an interview Friday, Dean Ray Stowers said Dr. DeAngelis “flat out” threatened him and attempted to bully him during the conversation. The telephone call was followed by an email exchange. In a March 11 email, Dr. DeAngelis wrote to Dr. Stowers: “As I’ve already expressed to you, I don’t want to make trouble for your school, but I cannot allow Jonathan Leo to continue to seek media coverage without my responding. I trust you have already or soon will speak with him and alert me to what I should expect.” Dr. Stowers responded the next day by saying he couldn’t find any fault in Dr. Leo’s actions and pressed JAMA editors for more specifics on what they believed was wrong with Dr. Leo’s writing or actions. “I think this can be worked out without your continued threats to our institution which are not appreciated and I believe to be below the dignity of both you and JAMA,” he wrote. Dr. Stowers says he has not heard from JAMA since sending that email.'

The JAMA editorial suggests, mistakenly, that Leo was under confidentiality related obligations not to publish his letter to the BMJ until after JAMA had completed its investigation. It's entirely unclear why this should be the case. Leo is perfectly entitled to publish anywhere (as he did) allegations of conflict of interest. After all, everything he reported is a matter of public record (accordingly there were plenty of others who would have been witness to the conflict of interest). What is particularly amusing, perhaps, is that the journal objecting to Leo blowing the whistle on the conflict of interest it omitted to report, had not hesitation to blow the whistle on him (by calling his superior, the Dean of the school). Obviously, one standard for authors, another for editors...

JAMA claims in its editorial that Leo's disclosure of his allegations would hamper its ability to undertake its own investigation. As it happens, however, according to JAMA's own reported timeline, it actually completed its investigation some time before Leo's letter in the BMJ was published. The journal claims, however, that it was unable to publish the subsequent 6 line conflict of interest declaration (even on-line) that it received some time in January until some time in March due to space considerations. Of course, there are no on-line space considerations, as everyone knows. In addition to this, the editors were capable of rushing their above mentioned editorial on-line within about a week. Not overly credible the editorial explanation of space constraints here...

JAMA's new policy on this issue is truly pointless. It aims to enforce censorship on people reporting potential omissions of conflicts of interest declarations to the journal and expects them to keep quiet until it has investigated the matter. Anyone who goes instead directly to the news media would accordingly be in the clear as far as the new JAMA policy is concerned. The solution then would be, instead of waiting for JAMA's breathtakingly long 'investigation' of a simple matter (did you omit to declare a potential conflict of interest?), to issue a press release straightaway, or to write a letter to a different medical journal (as Leo did).

Significantly, the BMJ that published Leo's complaint has refused to withdraw his letter, because, according to the BMJ editor, the complaint was factually accurate.

It is deeply disconcerting that a leading biomedical journal such as JAMA tried to bully an academic as well as a medical school dean for doing nothing other than report the omission of a conflict of interest declaration. A clear abuse of the powers that journal editors are invested with by virtue of the job they hold. This is what really is at issue here!

Medical journal primadonnas

Interesting story on conflict-of-interest reporting in biomedical journals. As you may or may not know, most leading biomedical journals require their authors (as well as peer reviewers and editors) to declare any kind of conflict of interest that they might have with regard to the manuscript/content under consideration by the journal. JAMA, the high-impact journal of the American Medical Association published a piece on the use of a particular anti-depressant in stroke patients. The study duly underwent anonymous peer review, passed peer review and so it went into print. Standard operating procedure as far as as biomedical peer reviewed content publishing is concerned.

The Wall Street Journal health blog reports an interesting fall-out between a neuro-anatomy professor in the USA and some of JAMA's editors. What happened, according to the WSJ blog is this: Jonathan Leo, the neuro-anatomy professor in question, published a letter on the website of the British Medical Journal's website alleging that the authors of the study in question failed to disclose a financial conflict of interest. Turns out that the allegations were correct. JAMA published in its March 11, 2009 issue an erratum including the omitted conflict of interest declaration as well as an apology from the study's lead authors.

What's interesting, however, is what happened in-between. Jonathan Leo, a professor at a small college in Tennessee received shortly after publication of his letter on the BMJ website a call from one of the editors of JAMA. He claims that that bloke threatened him this way: 'He said, ‘Who do you think you are,’ ” says Leo. “He then said, ‘You are banned from JAMA for life. You will be sorry. Your school will be sorry. Your students will be sorry." That's the story according to Leo. JAMA claims, not unexpectedly perhaps seeing the inappropriateness of this, that Leo's recollection of the conversation was incorrect.

Leo gets a second call from another editor at JAMA, someone even higher up than the first caller. Things didn't exactly improve... - Here's what the WSJ reports: 'The call from Fontanarosa was followed up by one from JAMA editor-in-chief Catherine DeAngelis to Leo’s superiors, Leo says. He said she asked his superiors to get him to retract his article in the BMJ. Leo says he decided to call DeAngelis directly to find out what, in particular, she might be objecting to. He said she was “very upset” but didn’t make specific complaints about the article. In a conversation with us, DeAngelis was none too happy to be questioned about the dust-up with Leo. “This guy is a nobody and a nothing” she said of Leo. “He is trying to make a name for himself. Please call me about something important.” She added that Leo “should be spending time with his students instead of doing this.”When asked if she called his superiors and what she said to them, DeAngelis said “it is none of your business.” She added that she did not threaten Leo or anyone at the school.'

So, clearly it's a he says - she says story but it's not insignificant that Leo seems to have received two critical calls from JAMA editors. As it turns out, however, his claims in his letter on the BMJ website were actually substantively correct.

Makes you wonder about JAMA's ethics standards. It is quite remarkable - in a bad way - to call a biomedical scientist who correctly flags the omission of an important conflict of interest disclosure with regard to a paper your journal published 'a nobody and a nothing'. Seriously, JAMA, you'd reconsider how you deal with such matters!