5 ms·

No, you don't understand this. The Lancet is one of the most impactful journals in medicine, and has played an important role in shaping how medicine is practi

No, you don't understand this. The Lancet is one of the most impactful journals in medicine, and has played an important role in shaping how medicine is practiced. It is rigorous in its process, but it's not foolproof. So yes, there are some bad studies that come through, but that is why healthcare professionals are TRAINED to interpret studies--we separate all the bullshit from the legitimately useful stuff. You should see some of the crap that comes through in some of the lower-impact journals. > The combination of preprint servers + twitter has proven far more effective in looking after humanity’s best interests. This view is incredibly false and dangerous for so many reasons.

Gatsky 6y ago
I am a healthcare professional, and I've published in one of the Lancet Journals. I understand perfectly fine. Here's the thing - The Lancet is not impactful. Researchers choose to publish their impactful research in The Lancet. Other researchers donate their time to peer review this research. It is the researchers that have shaped how medicine is practiced, not The Lancet. It is the researchers and the peer reviewers that are rigorous. The Lancet itself is none of these things, it is a business run by people who don't do research. Without the people who actually do the work, or the patients that volunteer for the research, it is nothing. The Lancet, like all top tier journals, has long forgotten this distinction. The problem isn't healthcare professionals lacking training. Take the Wakefield study. Did any doctor decide to stop offering vaccines because of that study? No. But it had a large impact on a the anti-vax narrative. These top journals have influence far beyond the professional sphere. This is why your suggestion we should give them a free pass is dangerous. I think it is clearly true that rapid publication and out in the open discussion and peer review is very healthy. I don't see how you could argue otherwise? Why wouldn't I want to be able to read the opinion of someone I respect intellectually eg Andrew Gelman, on a study they have decided to comment on? How is that 'dangerous' if I am a healthcare professional who should be able to critically review a published paper as you suggest? Why do I need to rely on the reviewers the journal has chosen? The Journals want to keep things as they are to maintain their importance and their bottom line. We suffer as a result.
- DiogenesKynikos 6y ago
  How can you criticize The Lancet for a small number of faked studies that have gotten through, but then praise pre-print servers, which are rife with complete nonsense? Pre-print servers are great for getting results out quickly, but the level of quality control is extremely low. Journals are slower, but have a higher level of quality control. There is a trade-off between speed and quality control, and both pre-print servers and journals sit at useful points in that trade-off. Given the pressure to get information that might help fight CoVID-19 out quickly, journals have probably shifted towards the "quick/low-quality" end of the spectrum in the past few months. They'll move back when things calm down.
  - rscho 6y ago
    Journals have been hype/politically-driven since as long as one can remember. And peer-review quality is a joke. Preprints are not perfect, but I'd wager that anything free and truly open to review is better than what we have now.
  - Gatsky 6y ago
    Specifically I am praising pre-print servers in the current crisis, not in general. I don't propose they can replace journals wholesale in the near future. The harm done by bad research in the Lancet is colossal because the results are widely read and disseminated, that is obvious isn't it? Pre-print servers are still quite obscure. Anyway, arxiv has been running for a long time with much success in certain fields, and hasn't been overwhelmed with nonsense, so your characterisation of pre-print servers is poorly calibrated and hyperbolic. Also the Lancet charges money for its products, and can therefore expect to be held to greater account.
    - DiogenesKynikos 6y ago
      So the pre-print servers are better because not a lot of people read pre-prints? > arxiv has been running for a long time with much success in certain fields, and hasn't been overwhelmed with nonsense, your characterisation of pre-print servers is poorly calibrated and hyperbolic I just said that the level of quality control on pre-print servers is extremely low - which it is. They check for very little beyond blatant plagiarism and obvious junk (determined within minutes). I didn't say that pre-print servers are useless. They're very useful, but it's undeniable that prestigious journals apply an additional filter, which is much more exacting. If you were to pick a random study from a pre-print server, and a random study from the Lancet, which do you think is more likely to be reliable? Which do you think has undergone more thorough peer-review?
loulouxiv 6y ago
Well if healthcare professionals are trained to interpret study, and separate the wrong from the useful stuff I guess it won't be so hard for The Lancet to hire some of them to review papers... I tend to believe Didier Raoult when he says in his last interview that anybody who works in medecine could easily tell this paper smelled really fishy, and I am sure it would be less costly for The Lancet than the reputation loss they are going to suffer.
- devin 6y ago
  You act as if highly-trained professionals don't ever disagree.
  - notahacker 6y ago
    Most professionals found Raoult's own published claims of the 100% cure rate of hydrochloroquine combined with azithromycin based on small groups without proper controls fishy, for a start.
ColanR 6y ago
> You should see some of the crap that comes through in some of the lower-impact journals. Thank goodness that "healthcare professionals are TRAINED to interpret studies."
creaghpatr 6y ago
That they have that level of impact would appear to be problematic, given this news, rather than the other way around.
macinjosh 6y ago
> So yes, there are some bad studies that come through, but that is why healthcare professionals are TRAINED to interpret studies So healthcare professionals are trained to separate the wheat from the chaff, but peer reviewers are not?
bobcostas55 6y ago
You are confusing impact with quality. They are not the same thing.
aksss 6y ago
I tend to agree with you in whole, with caveat that past contributions don't speak to current value, necessarily. I'm always reminded of the ruthless statement, "God cares not what you have done, but what you are doing". I say it tongue-in-cheek, but there's wisdom to it. Also, can we all stop describing any view or information as "dangerous"? It sounds like my mom, or religious people from the 80's. False is one judgement and objectively proven. "Dangerous" smacks of a censorious nature, which is subjective and, sorry, often based on a conflict of interest/agenda. Encourage everyone to read Matt Taibbi's recent article about the recent rise of "virtuous" censorship as food for thought: https://taibbi.substack.com/p/temporary-coronavirus-censorship https://taibbi.substack.com/p/temporary-coronavirus-censorsh...

Gatsky 6y ago

I am a healthcare professional, and I've published in one of the Lancet Journals. I understand perfectly fine. Here's the thing - The Lancet is not impactful. Researchers choose to publish their impactful research in The Lancet. Other researchers donate their time to peer review this research. It is the researchers that have shaped how medicine is practiced, not The Lancet. It is the researchers and the peer reviewers that are rigorous. The Lancet itself is none of these things, it is a business run by people who don't do research. Without the people who actually do the work, or the patients that volunteer for the research, it is nothing. The Lancet, like all top tier journals, has long forgotten this distinction. The problem isn't healthcare professionals lacking training. Take the Wakefield study. Did any doctor decide to stop offering vaccines because of that study? No. But it had a large impact on a the anti-vax narrative. These top journals have influence far beyond the professional sphere. This is why your suggestion we should give them a free pass is dangerous. I think it is clearly true that rapid publication and out in the open discussion and peer review is very healthy. I don't see how you could argue otherwise? Why wouldn't I want to be able to read the opinion of someone I respect intellectually eg Andrew Gelman, on a study they have decided to comment on? How is that 'dangerous' if I am a healthcare professional who should be able to critically review a published paper as you suggest? Why do I need to rely on the reviewers the journal has chosen? The Journals want to keep things as they are to maintain their importance and their bottom line. We suffer as a result.

DiogenesKynikos 6y ago
How can you criticize The Lancet for a small number of faked studies that have gotten through, but then praise pre-print servers, which are rife with complete nonsense? Pre-print servers are great for getting results out quickly, but the level of quality control is extremely low. Journals are slower, but have a higher level of quality control. There is a trade-off between speed and quality control, and both pre-print servers and journals sit at useful points in that trade-off. Given the pressure to get information that might help fight CoVID-19 out quickly, journals have probably shifted towards the "quick/low-quality" end of the spectrum in the past few months. They'll move back when things calm down.
- rscho 6y ago
  Journals have been hype/politically-driven since as long as one can remember. And peer-review quality is a joke. Preprints are not perfect, but I'd wager that anything free and truly open to review is better than what we have now.
- Gatsky 6y ago
  Specifically I am praising pre-print servers in the current crisis, not in general. I don't propose they can replace journals wholesale in the near future. The harm done by bad research in the Lancet is colossal because the results are widely read and disseminated, that is obvious isn't it? Pre-print servers are still quite obscure. Anyway, arxiv has been running for a long time with much success in certain fields, and hasn't been overwhelmed with nonsense, so your characterisation of pre-print servers is poorly calibrated and hyperbolic. Also the Lancet charges money for its products, and can therefore expect to be held to greater account.
  - DiogenesKynikos 6y ago
    So the pre-print servers are better because not a lot of people read pre-prints? > arxiv has been running for a long time with much success in certain fields, and hasn't been overwhelmed with nonsense, your characterisation of pre-print servers is poorly calibrated and hyperbolic I just said that the level of quality control on pre-print servers is extremely low - which it is. They check for very little beyond blatant plagiarism and obvious junk (determined within minutes). I didn't say that pre-print servers are useless. They're very useful, but it's undeniable that prestigious journals apply an additional filter, which is much more exacting. If you were to pick a random study from a pre-print server, and a random study from the Lancet, which do you think is more likely to be reliable? Which do you think has undergone more thorough peer-review?

loulouxiv 6y ago

Well if healthcare professionals are trained to interpret study, and separate the wrong from the useful stuff I guess it won't be so hard for The Lancet to hire some of them to review papers... I tend to believe Didier Raoult when he says in his last interview that anybody who works in medecine could easily tell this paper smelled really fishy, and I am sure it would be less costly for The Lancet than the reputation loss they are going to suffer.

devin 6y ago
You act as if highly-trained professionals don't ever disagree.
- notahacker 6y ago
  Most professionals found Raoult's own published claims of the 100% cure rate of hydrochloroquine combined with azithromycin based on small groups without proper controls fishy, for a start.

ColanR 6y ago

> You should see some of the crap that comes through in some of the lower-impact journals. Thank goodness that "healthcare professionals are TRAINED to interpret studies."

creaghpatr 6y ago

That they have that level of impact would appear to be problematic, given this news, rather than the other way around.

macinjosh 6y ago

> So yes, there are some bad studies that come through, but that is why healthcare professionals are TRAINED to interpret studies So healthcare professionals are trained to separate the wheat from the chaff, but peer reviewers are not?

bobcostas55 6y ago

You are confusing impact with quality. They are not the same thing.

aksss 6y ago

I tend to agree with you in whole, with caveat that past contributions don't speak to current value, necessarily. I'm always reminded of the ruthless statement, "God cares not what you have done, but what you are doing". I say it tongue-in-cheek, but there's wisdom to it. Also, can we all stop describing any view or information as "dangerous"? It sounds like my mom, or religious people from the 80's. False is one judgement and objectively proven. "Dangerous" smacks of a censorious nature, which is subjective and, sorry, often based on a conflict of interest/agenda. Encourage everyone to read Matt Taibbi's recent article about the recent rise of "virtuous" censorship as food for thought: https://taibbi.substack.com/p/temporary-coronavirus-censorship https://taibbi.substack.com/p/temporary-coronavirus-censorsh...