Currently, teachers experience a general problem, a surge of published systematic reviews where slightly modified search criteria have led to slightly different bunch of papers with slightly different results of meta-analyses. Systematic reviews have once been welcomed as valuable tool to either end a story once and forever (if evidence for or against a certain treatment or association was overwhelming), or call for more conclusive randomized controlled trials (RCT) after still open questions had been identified. If, after any new RCT, editors of our professional journals would accept considering a new systematic review for publication, which basically ruminates already published RCT summaries but adds just another study without changing main conclusions, it will in fact become difficult to keep pace with what some call “emerging evidence”.
One main reason why evidence based medicine has to be taught to undergraduate students is to provide future health care workers with proper tools and train specific skills to conduct brief systematic reviews of identified randomized controlled trials themselves. Here on this blog, I had posted a couple of quick examples, see here, here and here.
In particular the latter of the above examples has dealt with the question whether the large multi-center trial by Engebretson et al. (2013), which had reported no effects of periodontal therapy on HbA1c levels in diabetics, would nullify the conclusion (that nonsurgical periodontal treatment may reduce HbA1c levels by about 0.4%) of previous meta-analyses of smaller and mainly single-center RCTs with similar settings.
Engebretson et al. (2013) had listed possible shortcomings of their study. However, that oral hygiene of study participants had not improved was considered by most of our professional leaders scandalous. Further issues for unprecedented criticism included “nearly normal” HbA1c levels at the outset and extreme obesity of participants. Engebretson’s unwelcome results had been reviled by an armada of 21 editors of our key journals, presidents of our main scientific societies, and further periodontal experts. Criticism had culminated in a very strange recommendation.
“Given the inconlusive nature of these data, we recommend that the existing body of evidence in which meta-analyses consistently conclude that successful periodontal therapy appears to improve glycemic control, should instruct us until results from future studies are reported. We urge all interested parties to refrain from using these study results as a basis for future scientific texts, new research projects, guidelines, policies, and advice regarding the incorporation of necessary periodontal treatment in diabetes management.” (My emphasis.)
In other words, forget about Engebretson et al. and continue quoting more favorable results from existing meta-analyses of RCTs on the effect of periodontal therapy on diabetes control. A quick analysis revealed that it won’t nullify a mean HbA1c reduction in diabetics by nonsurgical periodontal therapy, but that considerable heterogeneity was introduced by including Engebretson’s study which may in fact lower the grade of evidence. I had entered meta-data of Engebretson and Kocher 2013 in an amazing tool for meta-analysis and had added findings by Engebretson et al. (2013). That might have been premature, see below.
Leading publisher of scientific information John Wiley & Sons promotes its growing open access program by offering scientific societies “manuscript transfer” of rejected papers to affiliated open access journals. From the Wiley Open Access website,
An increasing number of societies and journals are taking advantage of the Wiley Open Access program. Here are two ways to get involved with open access at Wiley.
1. Support a Wiley Open Access Journal
A number of society journals support our open access journals through the Manuscript Transfer Program.
The Manuscript Transfer Program
As well as accepting direct submissions, a number of Wiley Open Access journals also operate a Manuscript Transfer Program, in which the journal is supported by other journals, including society-owned titles. The supporter journals refer articles not accepted after peer review and offer authors the option to submit to a Wiley Open Access journal. Authors benefit both from the speed and efficiency of the referral process and by not having to re-enter the peer review process from the beginning.
Once a progressive trend of scientists who strongly believe that in particular medical knowledge must be freely accessible to the public, global players like Springer and Elsevier have long understood the undeniable advantages of charging authors instead of libraries for publication expenses in times of limited university budgets. Since fees only fall due if a manuscript was accepted, open access has challenged the current peer review system since publishers have no interest in a rejected manuscript.
As an update to “Just Say ‘No!'”, Japanese open access Dental Materials Journal and its publisher J-STAGE have retracted three papers because authors did not pay publication charges. They are
Mahmoudi M, Saidi A, Gandjalikhan Nassab SA, Hashemipour MA. A three-dimensional finite element analysis of the effects of restorative materials and post geometry on stress distribution in mandibular molar tooth restored with post-core crown. Dent Mater J 2014; 33(1): 147.
Santander S, Alcaine C, Lyahyai J, Pérez MA, Rodellar C, Doblaré M, Ochoa I. In vitro osteoinduction of human mesenchymal stem cells in biomimetic surface modified titanium alloy implants. Dent Mater J 2014; 33(1): 148.
Boonanantanasarn K, Janebodin K, Suppakpatana P, Arayapisit T, Rodsutthi JA, Chunhabundit P, Boonanuntanasarn S, Sripairojthikoon W. Morinda citrifolia leaves enhance osteogenic differentiation and mineralization of human periodontal ligament cells. Dent Mater J 2014; 33(1): 149.
One may trust in (but should actually doubt) proper peer review of these papers from Iran, Spain, and Thailand.
Every day I am contacted by open-access journals for either to submit a paper, or to review a paper, or to serve on the editorial board of a new scientific journal. Most of them are hosted by Hindawi Publishing Corp., an obscure “growing academic publisher with 567 peer-reviewed, open access journals covering a wide range of academic disciplines”, based in Cairo, Egypt. A couple of years ago, out of idealistic desire to help, I had even agreed to the latter and immediately regretted. I resigned from the job after just four weeks since manuscripts which I received were unrelated to my field, potential reviewers I had contacted declined and, after just one round of reviews, it was the editor-in-chief who made a final decision of acceptance regardless whether authors had actually improved their manuscript (they had not). I was told that one round was sufficient. So, quality standards of peer review were effectively circumvented. Only later I learned that, due to the open-access publishers’ business model, rapid acceptance of a manuscript is crucial since authors had to pay enormous fees for getting their paper “in”. In the meantime I have marked respective publishers’ emails as spam and delete what anyway finds it way into my account.
The News contribution in Science magazine this week by John Bohannon is revealing since it confirms my strong suspicion of improper quality control. Bohannon had submitted more than 300 versions of a faked paper about a wonder drug for cancer therapy to open-access journals in a sting operation, authored by fictional, for instance, Ocorrafoo Cobange at faked Wassee Institute of Medicine. More than half of the journals had accepted the paper, “failing to notice its fatal flaws.”