Patrick Holford Is Not the Only Nutritionist to Confuse Eletters for Published Letters

Cat menaces Dave
Patrick Holford makes several grand references to his reply in the British Medical Journal (BMJ). When he does so, he fails to communicate that pretty much anyone (and that would include Dr Ben Goldacre’s late, lamented, feline companion, Hettie if she were not past worldly considerations) can get a comment published in the online version of the BMJ. Writing a letter to a journal that makes it into the print edition is a very different matter because it goes through more than a cursory glance, it may even be peer-reviewed.

It seems that Patrick Holford is not the only nutritionist who fails to understand this. Neil Levin of Honest Nutrition dramatically asks, Am I biased? He then describes the scientific method, praises his own understanding of it, and lambasts the author of a paper who argues that the Use of antioxidants during chemotherapy and radiotherapy should be avoided.

I believe that everyone has to deal with the issue of bias, and the Scientific Method is supposed to help us all overcome these biases by focusing on valid, reproduceable data. Unfortunately, some of us seem to be trying harder than others to fairly represent unbiased data.

For one example, my peer-reviewed letter published by the cancer journal CA, the Journal of the American Cancer Society rebutted an article positing that antioxidants should be avoided during cancer therapies. However, none of the references provided in that article showed any evidence of risk!

Now, an eletter does not have the same standing as a peer-reviewed letter, but I thought that I had better check in Entrez Pubmed, which doesn’t contain any references to published comments, i.e., comments that were reviewed and accepted for official publication in the print journal. This is not a minor point; actually being accepted for print means that you will be listed in the records of indexed journals. It is a honour to be published in this way and it is not an accolade that one should claim lightly.

I’m sure that this is a misunderstanding rather that misrepresentation but it does make it difficult when people are commenting on journals and the process of peer-review as if they actually, you know, understood them. Particularly when publications are so important to the whole notion of Evidence-Based Medicine.

I also pointed out the 40% of cancer patients who die of malnutrition while under their doctors’ care, much of which may be preventable if physicians actually follow evidence-based medicine instead of clinging to conventional therapies and theories.

…I think that you’ll find that I presented relevant published scientific reports to counter a biased opinion that was not even supported by the author’s references. How did that crappy opinion even get published in a peer-reviewed journal in the first place?

Updated: July 24, 19:30, as per the comments, Neil Levin has amended his original post to clarify the matter which is both commendable and classy.

Click on the image for I can has cheezburger detail.



Filed under nutrition, patrick holford

3 responses to “Patrick Holford Is Not the Only Nutritionist to Confuse Eletters for Published Letters

  1. You do make a good point, and I apologize for the confusion. My letters are reviewed by editors, rather than peer-reviewed, but are not posted without a critical review process.

    Thanks for the criticism! I will change my site to reflect this.

  2. In the case of this particular letter, the journal editors also told me that they would consult with the author of the piece that I criticized as part of their decision process. That, combined with the editorial review, could be seen as a form of peer-review, and I did consider it as such, but perhaps not the usual process that people would think of when hearing that term.

    In any case, I have corrected the reference on my site, which you were certainly correct to question. Thanks for that!

    Hopefully, that will remove any possibility of confusion as to how the piece was reviewed and published online. I will be more precise in these descriptions in the future.

    Best wishes.

  3. Hi Neil Levin,

    Thanks for the note – I do note that the journal says this about its Rapid Responses:

    All eLetter responses that contribute substantially to the topic under discussion will be published on the CA Online Web site at the discretion of the journal.

    Which looks promising, but having flicked through the other responses for that piece and those for some others, I think that you might agree that the quality of some responses is variable and that, like the Rapid Responses to the BMJ, they do not always add to the debate. In those cases, I really don’t see much editorial input…

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