{"id":11399,"date":"2012-01-31T03:26:05","date_gmt":"2012-01-31T08:26:05","guid":{"rendered":"http:\/\/pmedicine.org\/epatients\/?p=11399"},"modified":"2012-02-01T12:30:20","modified_gmt":"2012-02-01T17:30:20","slug":"opening-the-door-to-closeted-science","status":"publish","type":"post","link":"https:\/\/participatorymedicine.org\/epatients\/2012\/01\/opening-the-door-to-closeted-science.html","title":{"rendered":"Opening the Door to Closeted Science"},"content":{"rendered":"

NOTE: We’re happy to welcome back Sarah Greene, one of the founding members in 2009 of SPM and its journal. She left a while ago for London, where she’s continued her work at the leading edge of thought about medical knowledge.\u00a0<\/em><\/p>\n

Sarah is ahead of most of us. Only in the past six months did I begin to comprehend what she was talking about in her “revolution” post three years ago, cited below. So consider that what she says here will quite likely be accepted some years into the future, and we would do well to listen. (e-Patient Dave)<\/em><\/p>\n

Here in London, \u2018peerage\u2019 has a special meaning: as the Free Dictionary puts it, \u201cthe rank, title, or jurisdiction of a peer or peeress; a duchy, marquisate, county, viscountcy, or barony.\u201d So when I ran across a recent blog post about Peerage of Science<\/a> (PoS) \u2013 a new peer review invention started in Finland by scientists, for scientists \u2013 I thought perhaps they were using the word naively, or tongue-in-cheek. But having now read the PoS-About page, it seems the service may represent a genuflection before that sovereignty which has ruled the research kingdom for the past century.<\/p>\n

\"\"<\/a>It was the subtitle of the Nature Network blog post by ecologist Mike Fowler Peerage of Science: A Publishing Revolution?<\/a> \u00a0that caught my attention, as it hearkened back to a piece I wrote for e-Patients.net \u2013 Participatory Medicine as Revolution! Think Critically! Communicate!<\/a> \u2013 some while ago. I\u2019m on permanent watch for the \u201cR\u201d word, and though I\u2019ve been on the sidelines of PM for a couple of years, I\u2019m working with a true revolutionary of scientific publishing, Vitek Tracz, to help build his post-publication peer review (PPPR) service, Faculty of 1000. Arguably the originator of the open access publishing platform, Vitek believes there should be no gatekeepers for the deposition of research, and that all refereeing, debating, and revisions should be done transparently after publication. More about this in a minute.
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\nWhat does the machinery of peer review have to do with participatory medicine (PM), and why am I disappointed in the newly announced PoS that some consider to be revolutionary? \u00a0To begin with, many argue that it\u2019s not the concept of peer review that\u2019s holding back scientific discovery, but rather its unrivaled status as the backbone and pre-requisite of journal publishing.\u00a0 One of the best critiques of the current system was written for the Journal of Participatory Medicine<\/em>, sister of this blog.\u00a0 In its inaugural issue Richard Smith, MD, former editor of the British Medical Journal<\/em>, summarized his observations<\/a>:<\/p>\n

After 30 years of practicing peer review and 15 years of studying it experimentally, I\u2019m unconvinced of its value. Its downside is much more obvious to me than its upside, and the evidence we have on peer review tends to support that jaundiced view.<\/em><\/p><\/blockquote>\n

Not only does the current system delay valuable findings for months or even years, but it can prevent discoveries from ever seeing the light of day. Furthermore, studies have been conducted demonstrating that referees routinely miss serious errors. And in an editorial titled Is Peer Review Censorship?<\/a>, Infection and Immunity<\/em> editors Arturo Casadevall and Ferric C. Fang wrote:<\/p>\n

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If editors are overzealous in screening manuscripts for perceived newsworthiness or consistency with prevailing dogma, there is a danger of blurring the distinction between peer review and censorship. If a reviewer obstructs the publication of a manuscript because it competes with or questions his or her own work, there is an ethical dimension as well.<\/em><\/p>\n<\/blockquote>\n

Yet worse than the delays, worse than the errors that creep through, and worse than censorship and obstruction of competition, is how pre-publication peer review limits what\u2019s available to other researchers to build upon, and to all citizens, including patients who are on the front line, to broaden their perspectives and contribute to the armamentarium. Neuroscientist Bjoern Brembs states it vividly in his blog post Scientific Discoveries are Like Orgasms: You Can\u2019t Have a Bad One<\/a>. In today\u2019s world of small-N clinical trials, genomic medicine, and a highly networked public, you can be sure that crowd-sourced knowledge will come from unexpected quarters, and will become critical to the discovery process.<\/p>\n

Back to our \u201crevolution\u201d: Peerage of Science is assembling qualified peer reviewers and offering credits for their work, which can then be used to publish the reviewers\u2019 own research. Articles are reviewed in a single round and participating journal editors can then track, accept, and publish the refereed content. I\u2019m pleased that a \u2018reputation system\u2019 (explained helpfully<\/a> by Peter Frishauf, founder of Medscape) for the work of peer reviewing is being tested.\u00a0 But as stated on their website, PoS is (bold emphasis their own):<\/p>\n

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