Comment
9
10
Kissela BM, Khoury JC, Alwell K, et al. Age at stroke: temporal trends in stroke incidence in a large, biracial population. Neurology 2012; 79: 1781–87. Medin J, Nordlund A, Ekberg K. Increasing stroke incidence in Sweden between 1989 and 2000 among persons aged 30 to 65 years: evidence from the Swedish Hospital Discharge Register. Stroke 2004; 35: 1047–51.
11
12
George MG, Tong X, Kuklina EV, Labarthe DR. Trends in stroke hospitalizations and associated risk factors among children and young adults, 1995–2008. Ann Neurol 2011; 70: 713–21. de los Ríos F, Kleindorfer DO, Khoury J, et al. Trends in substance abuse preceding stroke among young adults: a population-based study. Stroke 2012; 43: 3179–83.
In December, 2013, Randy Schekman received a Nobel Prize in Physiology or Medicine for his codiscovery (with James Rothman and Thomas Südhof) of the cellular machinery regulating vesicle traffic. He used the occasion to launch a ferocious attack against what he called “luxury journals”—Nature, Science, and Cell. Although he didn’t mention The Lancet, JAMA, or The New England Journal of Medicine, it probably isn’t unreasonable to think he would include us in his definition of “luxury journal”. This is what he wrote in The Guardian: “These luxury journals are supposed to be the epitome of quality, publishing only the best research. Because funding and appointment panels often use place of publication as a proxy for quality of science, appearing in these titles often leads to grants and professorships. But the big journals’ reputations are only partly warranted. While they publish many outstanding papers, they do not publish only outstanding papers. Neither are they the only publishers of outstanding research.”1 Schekman and his lab are now boycotting those luxury journals and he is encouraging other scientists to do the same. Another 2013 Nobel Laureate, Peter Higgs, won the physics prize (along with François Englert) for the theoretical discovery of a mechanism that helps us understand the origin of mass. In an interview, also with The Guardian, Higgs described himself as an “embarrassment“ to his Edinburgh University department because he published so little: “Today”, he said, “I wouldn’t get an academic job. It’s as simple as that. I don’t think I would be regarded as productive enough.”2 There is clearly a strong feeling among many scientists, and not only Nobel Prize winners, that something has gone wrong with our system for assessing the quality of scientific research. Does the fault lie with myopic university administrations led astray by perverse incentives or with journals that put profit and publicity above quality? The likely answer is that it is a mix of both. But perhaps the discussion provoked by the latest Nobel awards needs to be widened still further. Perhaps all of us www.thelancet.com Vol 383 January 18, 2014
engaged in the enterprise we call “science” need to pause and reflect on the present state of what we do. In 2009, we published a Viewpoint by Iain Chalmers and Paul Glasziou called “Avoidable waste in the production and reporting of research evidence”, which made the extraordinary claim that as much as 85% of research investment was wasted.3 It seemed an unbelievable figure. But the useful discussion their paper triggered led to a spate of seminars and meetings to explore what could be done about what all agreed was a wholly unsatisfactory situation—wrong questions being asked by scientists, poor study designs being applied, research that was inaccessible, and findings that were distorted by selective reporting and other types of bias. The Series we now publish addresses these issues in far greater depth than the paper we published in 2009. The authors of each paper make specific recommendations to increase the value of—and reduce waste from—scientific research.4–9 Our belief is that research funders, scientific societies, school and university teachers, professional medical associations, and scientific publishers (and their editors) can use this Series as an opportunity to examine more forensically why they are doing what they do—the purpose of science and science communication—and whether they are getting the most value for the time and money invested in science. The Lancet Research: Increasing Value, Reducing Waste Series, is not intended to be the last word on these matters. Consideration should be given by conference organisers to raising these questions at all scientific meetings—these issues matter to all those interested in research. One special venue for further discussion is the 4th World Research Integrity Conference, to be held in Rio de Janeiro, Brazil, next year. The theme of that gathering will be “Research rewards and integrity: improving systems to promote responsible research”, one of the key subjects of this Series. Randy Schekman asked this question in his attack on “luxury journals” last year: “How do you think scientific
Baumgarten via Getty Images
How should medical science change?
Published Online January 8, 2014 http://dx.doi.org/10.1016/ S0140-6736(13)62678-1 See Series pages 257 and 267 See Online/Series http://dx.doi.org/10.1016/ S0140-6736(13)62229-1, http://dx.doi.org/10.1016/ S0140-6736(13)62227-8,and http://dx.doi.org/10.1016/ S0140-6736(13)62297-7
197
Comment
journals should help advance science and careers?” That is a perfectly fair question to ask. But it does not go far enough. On the basis of the evidence we present in this Series, a far broader question should be posed: how should the entire scientific enterprise change to produce reliable and accessible evidence that addresses the challenges faced by society and the individuals who make up those societies?
2
3 4
5
6
Sabine Kleinert, Richard Horton The Lancet, London, NW1 7BY, UK
7
We thank Iain Chalmers and Paul Glasziou for leading the Lancet Series on Research: Increasing Value, Reducing Waste and the Department of Health, UK, for supporting the launch symposium.
8
1
Schekman R. How journals like Nature, Cell, and Science are damaging science. The Guardian (London) Dec 9, 2013. http://www.theguardian.com/ commentisfree/2013/dec/09/how-journals-nature-science-cell-damagescience (accessed Dec 16, 2013).
9
Aitkenhead D. Peter Higgs: I wouldn’t be productive enough for today’s academic system. The Guardian (London) Dec 6, 2013. http://www. theguardian.com/science/2013/dec/06/peter-higgs-boson-academicsystem (accessed Dec 16, 2013). Chalmers I, Glazsiou P. Avoidable waste in the production and reporting of research evidence. Lancet 2009; 374: 86–89. Macleod MR, Michie S, Roberts I, et al. Biomedical research: increasing value, reducing waste. Lancet 2014; published online Jan 8. http://dx.doi. org/10.1016/S0140-6736(13)62329-6. Chalmers I, Bracken MB, Djulbegovic B, et al. How to increase value and reduce waste when research priorities are set. Lancet 2014; published online Jan 8. http://dx.doi.org/10.1016/S0140-6736(13)62229-1. Ioannidis JPA, Greenland S, Hlatky MA, et al. Increasing value and reducing waste in research design, conduct, and analysis. Lancet 2014; published online Jan 8. http://dx.doi.org/10.1016/S0140-6736(13)62227-8. Al-Shahi Salman R, Beller E, Kagan J, et al. Increasing value and reducing waste in biomedical research regulation and management. Lancet 2014; published online Jan 8. http://dx.doi.org/10.1016/S0140-6736(13)62297-7. Chan A-W, Song F, Vickers A, et al. Increasing value and reducing waste: addressing inaccessible research. Lancet 2014; published online Jan 8. http://dx.doi.org/10.1016/S0140-6736(13)62296-5. Glasziou P, Altman DG, Bossuyt P, et al. Reducing waste from incomplete or unusable reports of biomedical research. Lancet 2014; published online Jan 8. http://dx.doi.org/10.1016/S0140-6736(13)62228-X.
The Minamata Convention on Mercury: risk in perspective
Michael S Yamashita/Corbis
Published Online October 10, 2013 http://dx.doi.org/10.1016/ S0140-6736(13)62000-0
198
On Oct 10, 2013, a document is to be signed in Kumamoto, Japan that will not only be historic in its ambitions, but also a memorial to local history where the first case of Minamata disease was identified in 1956. Minamata disease is caused by mercury poisoning and results in severe neurological damage. In the first identified case of the debilitating disease in Minamata city, mercury poisoning was traced to chemical waste, which had been dumped into the nearby sea by the Chisso Corporation. The waste led to accumulated mercury poisoning of fish, and consequent devastating effects including severe neurological disorders for
thousands who had consumed the fish as their main food source. More than 900 died due to mercuryrelated poisoning and others lived with long-term disabling conditions.1 There could not be a more appropriate venue for the signing of what has been named the Minamata Convention on Mercury, a global treaty whose terms have been developed and negotiated through five regional consultations since the launch of the initiative in 2009, supported by the UN Environmental Programme. The mercury treaty process was reendorsed at the 2012 Conference on Sustainable Development.2 The Minamata Convention is about the future—it is about acting on the lessons learned, such as from the Minamata tragedy, and minimising mercury risks before they have grave environmental and health consequences. The objective of the Minamata Convention is “to protect the human health and the environment from anthropogenic emissions and releases of mercury and mercury compounds”.3 Anthropogenic emissions are a serious threat to human and environmental health. But weaning the world off mercury-related processes and products brings new challenges. Each change needed to be implemented will have its implications, with one risk traded for another. Each one needs to be put in perspective. www.thelancet.com Vol 383 January 18, 2014
9
10
Kissela BM, Khoury JC, Alwell K, et al. Age at stroke: temporal trends in stroke incidence in a large, biracial population. Neurology 2012; 79: 1781–87. Medin J, Nordlund A, Ekberg K. Increasing stroke incidence in Sweden between 1989 and 2000 among persons aged 30 to 65 years: evidence from the Swedish Hospital Discharge Register. Stroke 2004; 35: 1047–51.
11
12
George MG, Tong X, Kuklina EV, Labarthe DR. Trends in stroke hospitalizations and associated risk factors among children and young adults, 1995–2008. Ann Neurol 2011; 70: 713–21. de los Ríos F, Kleindorfer DO, Khoury J, et al. Trends in substance abuse preceding stroke among young adults: a population-based study. Stroke 2012; 43: 3179–83.
In December, 2013, Randy Schekman received a Nobel Prize in Physiology or Medicine for his codiscovery (with James Rothman and Thomas Südhof) of the cellular machinery regulating vesicle traffic. He used the occasion to launch a ferocious attack against what he called “luxury journals”—Nature, Science, and Cell. Although he didn’t mention The Lancet, JAMA, or The New England Journal of Medicine, it probably isn’t unreasonable to think he would include us in his definition of “luxury journal”. This is what he wrote in The Guardian: “These luxury journals are supposed to be the epitome of quality, publishing only the best research. Because funding and appointment panels often use place of publication as a proxy for quality of science, appearing in these titles often leads to grants and professorships. But the big journals’ reputations are only partly warranted. While they publish many outstanding papers, they do not publish only outstanding papers. Neither are they the only publishers of outstanding research.”1 Schekman and his lab are now boycotting those luxury journals and he is encouraging other scientists to do the same. Another 2013 Nobel Laureate, Peter Higgs, won the physics prize (along with François Englert) for the theoretical discovery of a mechanism that helps us understand the origin of mass. In an interview, also with The Guardian, Higgs described himself as an “embarrassment“ to his Edinburgh University department because he published so little: “Today”, he said, “I wouldn’t get an academic job. It’s as simple as that. I don’t think I would be regarded as productive enough.”2 There is clearly a strong feeling among many scientists, and not only Nobel Prize winners, that something has gone wrong with our system for assessing the quality of scientific research. Does the fault lie with myopic university administrations led astray by perverse incentives or with journals that put profit and publicity above quality? The likely answer is that it is a mix of both. But perhaps the discussion provoked by the latest Nobel awards needs to be widened still further. Perhaps all of us www.thelancet.com Vol 383 January 18, 2014
engaged in the enterprise we call “science” need to pause and reflect on the present state of what we do. In 2009, we published a Viewpoint by Iain Chalmers and Paul Glasziou called “Avoidable waste in the production and reporting of research evidence”, which made the extraordinary claim that as much as 85% of research investment was wasted.3 It seemed an unbelievable figure. But the useful discussion their paper triggered led to a spate of seminars and meetings to explore what could be done about what all agreed was a wholly unsatisfactory situation—wrong questions being asked by scientists, poor study designs being applied, research that was inaccessible, and findings that were distorted by selective reporting and other types of bias. The Series we now publish addresses these issues in far greater depth than the paper we published in 2009. The authors of each paper make specific recommendations to increase the value of—and reduce waste from—scientific research.4–9 Our belief is that research funders, scientific societies, school and university teachers, professional medical associations, and scientific publishers (and their editors) can use this Series as an opportunity to examine more forensically why they are doing what they do—the purpose of science and science communication—and whether they are getting the most value for the time and money invested in science. The Lancet Research: Increasing Value, Reducing Waste Series, is not intended to be the last word on these matters. Consideration should be given by conference organisers to raising these questions at all scientific meetings—these issues matter to all those interested in research. One special venue for further discussion is the 4th World Research Integrity Conference, to be held in Rio de Janeiro, Brazil, next year. The theme of that gathering will be “Research rewards and integrity: improving systems to promote responsible research”, one of the key subjects of this Series. Randy Schekman asked this question in his attack on “luxury journals” last year: “How do you think scientific
Baumgarten via Getty Images
How should medical science change?
Published Online January 8, 2014 http://dx.doi.org/10.1016/ S0140-6736(13)62678-1 See Series pages 257 and 267 See Online/Series http://dx.doi.org/10.1016/ S0140-6736(13)62229-1, http://dx.doi.org/10.1016/ S0140-6736(13)62227-8,and http://dx.doi.org/10.1016/ S0140-6736(13)62297-7
197
Comment
journals should help advance science and careers?” That is a perfectly fair question to ask. But it does not go far enough. On the basis of the evidence we present in this Series, a far broader question should be posed: how should the entire scientific enterprise change to produce reliable and accessible evidence that addresses the challenges faced by society and the individuals who make up those societies?
2
3 4
5
6
Sabine Kleinert, Richard Horton The Lancet, London, NW1 7BY, UK
7
We thank Iain Chalmers and Paul Glasziou for leading the Lancet Series on Research: Increasing Value, Reducing Waste and the Department of Health, UK, for supporting the launch symposium.
8
1
Schekman R. How journals like Nature, Cell, and Science are damaging science. The Guardian (London) Dec 9, 2013. http://www.theguardian.com/ commentisfree/2013/dec/09/how-journals-nature-science-cell-damagescience (accessed Dec 16, 2013).
9
Aitkenhead D. Peter Higgs: I wouldn’t be productive enough for today’s academic system. The Guardian (London) Dec 6, 2013. http://www. theguardian.com/science/2013/dec/06/peter-higgs-boson-academicsystem (accessed Dec 16, 2013). Chalmers I, Glazsiou P. Avoidable waste in the production and reporting of research evidence. Lancet 2009; 374: 86–89. Macleod MR, Michie S, Roberts I, et al. Biomedical research: increasing value, reducing waste. Lancet 2014; published online Jan 8. http://dx.doi. org/10.1016/S0140-6736(13)62329-6. Chalmers I, Bracken MB, Djulbegovic B, et al. How to increase value and reduce waste when research priorities are set. Lancet 2014; published online Jan 8. http://dx.doi.org/10.1016/S0140-6736(13)62229-1. Ioannidis JPA, Greenland S, Hlatky MA, et al. Increasing value and reducing waste in research design, conduct, and analysis. Lancet 2014; published online Jan 8. http://dx.doi.org/10.1016/S0140-6736(13)62227-8. Al-Shahi Salman R, Beller E, Kagan J, et al. Increasing value and reducing waste in biomedical research regulation and management. Lancet 2014; published online Jan 8. http://dx.doi.org/10.1016/S0140-6736(13)62297-7. Chan A-W, Song F, Vickers A, et al. Increasing value and reducing waste: addressing inaccessible research. Lancet 2014; published online Jan 8. http://dx.doi.org/10.1016/S0140-6736(13)62296-5. Glasziou P, Altman DG, Bossuyt P, et al. Reducing waste from incomplete or unusable reports of biomedical research. Lancet 2014; published online Jan 8. http://dx.doi.org/10.1016/S0140-6736(13)62228-X.
The Minamata Convention on Mercury: risk in perspective
Michael S Yamashita/Corbis
Published Online October 10, 2013 http://dx.doi.org/10.1016/ S0140-6736(13)62000-0
198
On Oct 10, 2013, a document is to be signed in Kumamoto, Japan that will not only be historic in its ambitions, but also a memorial to local history where the first case of Minamata disease was identified in 1956. Minamata disease is caused by mercury poisoning and results in severe neurological damage. In the first identified case of the debilitating disease in Minamata city, mercury poisoning was traced to chemical waste, which had been dumped into the nearby sea by the Chisso Corporation. The waste led to accumulated mercury poisoning of fish, and consequent devastating effects including severe neurological disorders for
thousands who had consumed the fish as their main food source. More than 900 died due to mercuryrelated poisoning and others lived with long-term disabling conditions.1 There could not be a more appropriate venue for the signing of what has been named the Minamata Convention on Mercury, a global treaty whose terms have been developed and negotiated through five regional consultations since the launch of the initiative in 2009, supported by the UN Environmental Programme. The mercury treaty process was reendorsed at the 2012 Conference on Sustainable Development.2 The Minamata Convention is about the future—it is about acting on the lessons learned, such as from the Minamata tragedy, and minimising mercury risks before they have grave environmental and health consequences. The objective of the Minamata Convention is “to protect the human health and the environment from anthropogenic emissions and releases of mercury and mercury compounds”.3 Anthropogenic emissions are a serious threat to human and environmental health. But weaning the world off mercury-related processes and products brings new challenges. Each change needed to be implemented will have its implications, with one risk traded for another. Each one needs to be put in perspective. www.thelancet.com Vol 383 January 18, 2014
