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Several years ago, a prominent NIH intramural physician-scientist wanted to translate basic science observations to clinical medicine, but the paperwork involved in taking a protocol from concept to conduct was overwhelming. “It was easier to get a paper published in Nature, Science , or The New

How to read a paper. The basics of evidence based medicine . Bytrisha greenhalgh. (Pp 222, £16.95). Published by BMJ Books, London, 2001. ISBN 0 7279 1578 9 The title of this slim paperback is somewhat misleading, as it covers considerably more than reading scientific papers (including how to deal with a visit from a drug rep!). There are two chapters which orientate the reader on why and how to keep abreast of the medical literature, including its electronic forms, nine on various aspects of reading papers, and one on implementing evidence based data. All necessary skills for the medical academic, of course, or for someone approaching a little aired but thorny issue. However, the author works in primary care, and much of her guidance seems directed towards drug trials, and particularly to the needs of her colleagues who may be wondering “how shall I treat the patient actually sitting in my surgery today?”. Good as the advice she gives may be, it is difficult to picture the general practitioner, medical registrar, or even less the tyro casualty officer, asking the patient to wait while he or she boots the computer and searches the medical literature, starting with a couple of systematic reviews and delving into an …

(1985). “Art Therapy in the Schools” A Position Paper of the American Art Therapy Association. Art Therapy: Vol. 2, No. 1, pp. 19-21.

Now in its third edition, this respected book guides the reader through medical research and the jungle of jargon it comprises. The subject matter is divided into types of research, literature searches, presenting and analysing data, and publication and appraisal of research. Its definitions are superb, and it clearly delineates between commonly confused topics such as reliability and validity, systematic reviews and meta-analyses, and protocol and guidelines. In the 12 years since the book’s inception evidence based medicine has evolved from illegitimacy to prodigy, thanks to champions such as David Sackett, Brian Haines, and Greenhalgh herself. They encourage clinicians to formulate the right question with three specific …

EDITOR—I am a jobbing general practitioner, and the paper by Holland and Weiner on Bell's palsy left me confused.1 To treat somebody is a hard decision—not to treat somebody, even harder. In 2002 the BMJ published an article about recent advances in neurology that proposed that there might be a case for prednisolone but …

EDITOR—Dimoliatis's cri de coeur for better recognition of reviewers of papers has much merit.1 Some of your respondents,2 however, are concerned that the quality of peer review could suffer as reviewers succumb to the temptation of seeing their …

EDITOR——The BMJ includes a small box with each paper, summarising the prior knowledge and what the study adds. This is laudable, but inevitably overlaps with the abstract. We suggest an alternative use for a box. We are torn between …

I read with great interest the recent Editor’s Pages presenting issues that the editors of JACC have found to be of importance in the preparation of a manuscript ([1,2][1]). As a junior research fellow, I found all of these recommendations particularly useful and I wish I knew all of these back

THE US Food and Drug Administration (FDA) has released a draft "concept paper" on guidelines for pharmaceutical company support of scientific or educational programs. The FDA has been requesting comments on the proposed guidelines from industry, medical educators, and other interested parties. According to Dennis K. Wentz, MD, director of the American Medical Association's (AMA) Division of Continuing Medical Education and chair of the Ad Hoc Task Force on Industry-Continuing Medical Education (CME) Provider Collaboration—which includes representatives from the AMA, the Accreditation Council for Continuing Medical Education (ACCME), the pharmaceutical industry, and now observers from the FDA—the task force met last month and will meet again next week (December 12) to discuss the FDA's draft concept paper. It also will examine a proposal, by the pharmaceutical industry's Fred W. Lyons, Jr, to create a self-regulating system. Similar to ACCME, AMA The proposed FDA guidelines are not very different from the

0161-4754/$32.00 Copyright D 2006 by Na doi:10.1016/j.jmpt.2006.1 If one wanted to take the pulse of the current state of chiropractic, this issue of the JMPT would be a good place to start. The contents of this issue represents hundreds of hours of work. Literature searches, manuscript review, discussions, critique, all from some of the best minds in the chiropractic profession, have resulted in a snapshot of where some feel we are and where we need to go.

Despite great progress in the diagnosis and therapy of multiple sclerosis (MS) some problems remain unsolved. For example, should immunologically negative cases also be classified as multiple sclerosis? In addition, we are still waiting for medication which will have a definite impact on the natural course of the disease.

New allegations have been made that German scientists who received major funds from the tobacco industry played down the health effects of smoking. The allegations are in a report published online on 29 November in the American Journal of Public Health (doi:10.2105/AJPH.2004.061507). Earlier this year an article in the magazine Der Spiegel accused several German public health scientists of receiving funds for tobacco friendly research ( BMJ 2005;331:70). The article was based on an analysis of tobacco industry documents available on the internet. The new publication, by researchers from the Royal Free Hospital, London, and the London School of Hygiene and Tropical Medicine, names eminent …

DOES MATERNAL FETAL MEDICINE COMPARE? BRIAN BROST, SUNEET P. CHAUHAN, Mayo Clinic, Obstetrics and Gynecology, Rochester, Minnesota, Spartanburg Regional Healthcare System, Obstetrics and Gynecology, Spartanburg, South Carolina OBJECTIVE: Full written publication of the methods, results and conclusions of research is paramount to the ability of practitioners to evaluate and consider application of the results to their patient populations. Other specialty and subspecialty society’s have reported an 11-78% publication rate. The aim of this study was to determine the full manuscript publication rate of oral abstracts presented to the Society of Maternal Fetal Medicine annual meetings. STUDY DESIGN: Published abstracts presented orally at the annual Society of Maternal Fetal Medicine were obtained from 1998-2001. This would allow at least 4 years after presentation for manuscript preparation and submission. PubMed was searched independently by both investigators in the study by author name(s) and/or keywords in the abstract title. Lists of full publications were confirmed by the other investigator and a second search was performed of all studies where a full manuscript could not be found. RESULTS: Of the 288 oral presentations during these reviewed annual meetings, 208 (72.2%; range 64.5-77.6%) were presented in full manuscript form. These projects could be categorized as animal research-40, basic laboratory projects-52, clinical research-158, multicenter trials-28 and unable to classify-10. The rates of publication by project category were 70%, 82.7%, 71.5%, 78.6%, and 50% respectively. Interestingly, the author order/composition and title were changed significantly in 45.8% and 47.9% from publication of the abstract to the full manuscript. The most common site of publication was the American Journal of Obstetrics and Gynecology (41.0%) followed by Obstetrics and Gynecology (6.3%) and major general medical journals (JAMA, NEJM, and Lancet-4.2%). CONCLUSION: The Society of Maternal Fetal Medicine should be proud of the efforts of its researchers and the ability to publish the results of their scientific study. Efforts to shorten the time from presentation to publication by sections devoted to annual specialty meetings may further increase full review of orally presented SMFM publications.

Sir: Dhar and O'Brien ( Psychiatric Bulletin , February 2001, 25 , 67-68) present a trainees'-eye view of the Critical Review Paper of the Membership examination. They advise setting up evidence-based journal clubs (EBJC) to teach critical appraisal skills, but what is an EBJC? The practice of

In February 1998, the British government published two green papers (consultative policy statements) for England and Scotland: Our Healthier Nation and Working Together for a Healthier Scotland . These outline a strategic approach to public health that build on earlier target setting exercises that have met with limited success. The green papers are especially noteworthy in that the New Labour administration explicitly recognises the strong association between poverty and …

EDITOR— The Journal of Medical Internet Research (http://www.jmir.org/), an open access journal that I edit, has for five years practised routinely what Dimoliatis proposes1: reviewers are acknowledged at the end of each published article. In our experience, concerns over reviewers becoming too uncritical only to see their name published are unfounded. Moreover, editors …

Background Response rates to surveys are declining and this threatens the validity and generalisability of their findings. We wanted to determine whether paper quality influences the response rate to postal surveys Methods A postal questionnaire was sent to all members of the British Society of Gynaecological Endoscopy (BSGE). Recipients were randomised to receiving the questionnaire printed on standard quality paper or high quality paper. Results The response rate for the recipients of high quality paper was 43/195 (22%) and 57/194 (29%) for standard quality paper (relative rate of response 0.75, 95% CI 0.33–1.05, p = 0.1 Conclusion The use of high quality paper did not increase response rates to a questionnaire survey of gynaecologists affiliated to an endoscopic society.

A randomized, crossover study comparing the acceptability of two presentations of the same oral contraceptive, a paper formulation and the conventional tablet, was carried out among two-hundred-and-seventy women attending two urban family planning clinics in Mexico City. During the first three cycles of use, the percentage of women discontinuing the medication for side effects was almost identical in the two groups. Although the paper formulation failed to demonstrate any major advantage in terms of continuation or acceptability, it was preferred by a majority of the women who began oral contraception with its use.

The Internet is becoming increasingly important as a way for patients to acquire medical information and as a means for patient-physician communication. Questions about appropriate use of this new technology have been brought to the fore by the many patients using the Internet to seek sildenafil prescriptions.To present the first description of a physician designed and directed Internet-based prescribing system of sildenafil, together with data covering more than 2,100 patient encounters.Retrospective analysis of a large case series from a medical practice that prescribes sildenafil based on medical and sexual histories obtained through a physician designed and directed World Wide Web (WWW) site, compared against patients from clinics at a Midwestern inner city medical center. We compared all 2,104 Internet patients seeking sildenafil prescriptions online between June 14, 1998, and March 1, 1999, with all 36 medical center patients obtaining sildenafil prescriptions during the same period. The outcome measures compared were: completeness of medical record; patient safety as noted by the follow up responses of all patients requesting refills, any comments received by the internet site (webmaster), and patient or physician comments noted in the clinic medical record; satisfaction as noted by the follow up responses of all patients requesting refills, any comments received by the internet site (webmaster), and patient or physician comments noted in the clinic medical record; examinations and laboratory tests.Fifty-six percent of Internet requests came from 46 states, and 44% from eight foreign countries. Of 2,104 requests, 2,100 were granted. Three hundred ten patients have requested medication refills: all reported erections sufficient for intercourse and 69% said their satisfaction exceeded all expectations; none were at all dissatisfied. Side effect rates were comparable to those in the literature. Comparison of the medical history obtained from Internet patients with that recorded in clinic patients' charts revealed that the former was far more complete. No clinic patient received any examination or laboratory test specific for erectile dysfunction or its causes. There were no reported deaths or serious complications in either group.Internet-based prescription of sildenafil provides the physician with a complete and very detailed medical and sexual history for 100% of patients without denying any information routinely obtained in a direct patient contact setting. Internet-based practice, which may be expected to require far fewer healthcare resources than traditional settings, rates very high in patient satisfaction among patients requesting a refill; no negative comments were received from all other patients. Overall, these data support the safety and effectiveness of Internet prescribing of selected medications.