Ken Gillman: Medical science publishing: A slow-motion train wreck

John Court’s comments


         Dr. Ken Gillman’s astute observations on the “slow-motion train wreck” of medical journal publishing is clearly a significant contribution.  Rather than his focus on structure and process, my perspective on the topic has dealt with unraveling content.  The Star newspaper of Toronto, for example, published “Inside the flawed world of medical publishing that allowed a lie in a paper co-authored by Dr. Gideon Koren to pollute the scientific record”  (Mendleson, Henry and Bailey 2018).  A follow-up article reported that a medical journal, Canadian Family Physician, corrected two flawed articles by Gideon Koren that “were not properly reviewed and failed to disclose a conflict of interest…” (Henry and Mendleson 2019).

         We have much to admire and little to criticize in Dr. Gillman’s outline of the impacts and ramifications of structural problems in medical publishing.  Useful comment at this stage might continue the thread by moving in the direction of remedies and solutions.

         With  a nod to Gillman’s clever epigraph (in Latin) from Juvenal, “But who will guard the guardians?” or “Who’s watching the watchers?”, we should focus on journals’ “watchers,” such as the slowly-evolving system of impact factors -- given that they can now be bypassed in Google searches.  More should be done to update impact factors, to publicize them to scientific communities and to reap the advantages -- e.g., perhaps legitimate journals’ referees and editors should red-flag or refuse inclusion in text or citations material drawn from low-impact or unrated journals.

         Could market forces be strengthened?  Since “even the wealthiest North American libraries cannot afford the subscriptions,” academic departments could form committee-delegations and individual scientists could act by advising their libraries about the journals to which they should subscribe and which ones to overlook.  They might also encourage libraries to negotiate (ideally collectively) with journals on a sliding scale according to their value, through metrics -- impact factor, paid circulation and appraisals/recommendations.  We are bombarded daily by e-mail solicitations from fake journals and symposia, as well as those of poor quality; should we ask our libraries’ watchdog-assessors to determine if those outlets have any legitimacy and make known to us the duds?

         Under his heading “Failure to do quality literature searches” Dr. Gillman points to another solution to be achieved through better use of the professional training and experience of our respective institutional librarians.  The University of Toronto library system, for example, has specialist librarians available for advice through their Systematic and Scoping Review service. In addition, certain teaching-hospital libraries offer a similar service, such as Canada’s University Health Network’s (UHN) “HealthSearch,” on a fee-for-service basis.


Mendleson R, Henry M, Bailey A. Inside the flawed world of medical publishing that allowed a lie in a paper coauthored by Dr. Gideon Koren to pollute the scientific record. The Star, Toronto, Dec. 21, 2018.

Henry M, Mendleson R.  Medical journal corrects two flawed articles by Dr. Gideon Koren.  The Star, Toronto, Feb. 1, 2019.


June 20, 2019