Comments on: The BMJ launches a fantastic initiative to involve patients in the peer review process

By: M. Cawdery

M. Cawdery — Sat, 21 Jun 2014 11:57:15 +0000

The BMJ recognises that ‘evidence-based medicine’ has some serious issues

Unfortunately “evidence based medicine” is, in reality, “Eminence- based-medicine”, as evidenced by the recent attempt to get papers removed from the BMJ.

Also, ‘benefits’ that may be statistically significant may not be very important clinically.

This is very true. Just look at group sizes; if very large it is obvious that the difference between treatment and placebo (or no treatment) is very small. The larger “N” is the more degrees of freedom and the smaller the difference the study can pick up.

This is then “proved” and supports the hypothesis. But there is a the other side – what is the probability that the individual patient. Frequently this probability = > 0.95+, even >0.99. But this is never reported in any form such as NNT.

I would love to sign up as a reviewer. I have had twenty years writing consultant reports for veterinary (and very occasionally medical) drugs for authorization so while an “amateur” in one sense, experienced in another.

By: Gary

Gary — Sat, 21 Jun 2014 08:59:34 +0000

This sounds good, is the medical community in the UK beginning to realise there is a deep structural problem in the way we examine evidence?

I think one of the advantages of the relative anonymity of ‘ordinary people’ examining the evidence is they are less likely to be inhibited when being critical of evidence or opinions presented from ‘credible people’, I think this is less ‘peer review’ and more like an outside inspection from an enemy, I think this brutality in ripping apart theories is exactly what science needs.

By: Dawn

Dawn — Fri, 20 Jun 2014 21:53:02 +0000

Yes, this would be fantastic. Bring it on!

By: Frederica Huxley

Frederica Huxley — Fri, 20 Jun 2014 20:50:00 +0000

Good heavens! Allowing patients to comment on research? I thought the pharmaceutical companies’ main objective is to make money, not to supply drugs that will be effective (currently 40% as a rule of thumb) and to do no harm to the patient.

By: Mark

Mark — Thu, 19 Jun 2014 11:34:00 +0000

It’ll certainly be interesting to see how well the BMJ’s idea works. The momentum to provide patients with opportunities for broader involvement in the research process has been building for many years now – patients can now get involved right at the beginning of studies. See the NIHR INVOLVE website for more details:

http://www.invo.org.uk/find-out-more/getting-involved/

By: Ellen K

Ellen K — Thu, 19 Jun 2014 08:01:40 +0000

Well, as a patient, all this makes me feel very nervous. Because I would much rather be treated to “protocols” and “clinical guidelines” than it be left to the judgement of some random overworked GP who has seen me for 1 minute, not read my file and has no idea of my history or comorbidities.

Dearie me, what a shambles.