Medical Publishing

The Pseudonymity Laboratory: When Authors and Bloggers Collide

terrasig — Mon, 03 Nov 2008 19:51:07 +0000

The Pseudonymity Laboratory: When Authors and Bloggers Collide

Is snarky honest real-time discussion of a paper's conclusions more constructive to the authors and the larger scientific enterprise than formal, reserved, and staid holding forth in the correspondence section of a classic clinical journal? Fact is that this discussion will be over even before the next issue of the journal comes out.

A really interesting interplay has been ongoing across the sci/med blogosphere following a commentary last Wednesday by Dr Isis on a NEJM correspondence, entitled, "Shifts to and from Daylight Saving Time and Incidence of Myocardial Infarction." (free full text at the time of this post.).

Many of us post commentaries on peer-reviewed publications, often tagging posts with the former BPR3/current ResearchBlogging icon and aggregator founded originally by Dave Munger and colleagues. For some reason, my commentaries and few of others have actually garnered feedback from the original authors.

Well, Isis' commentary drew comments from the original authors of the NEJM correspondence paper, Drs Imre Janszky and Rickard Ljung of the Karolinska Institut and National Board of Health and Welfare in Stockholm.

Long story made short: Isis disagreed with the conclusions made by the authors, DrugMonkey questioned the authors' desire to have the issues discussed on "equal ground" such as in a response to NEJM, Isis discussing the issue further, then Bora Zivkovic holding forth both on the science (circadian rhythm expert he) and the blogosphere culture in frank discussion of science. Then PalMD, my clinical colleague and co-conspirator in a pseudonymity session at an upcoming conference discussed his perspectives on the episode.

Yes, all these links are rather cryptic if you haven't followed the discussion. But here is what I find most interesting:

1. The authors of a paper that garnered substantial international MSM press attention responded to a critique made by someone who I think is a physician-scientist like them.

2. The discussion raises some hackles and misunderstanding on both sides.

3. However, the discussion also drew many people into an interest in and understanding of the biology of circadian rhythms who might not otherwise have been engaged in such an area.

4. A real-time discussion ensued between the authors and researchers in related areas who all agreed that the data generated was top-quality but that the interpretations were worthy of significant debate and vigorous discussion.

5. Despite initial misunderstandings of tone and intent, hundreds if not thousands of bloggers and commenters were exposed to the discussion well before even the next issue of NEJM was released.

As you might suspect from my impressions, I've found this exchange quite fascinating. Since we get NEJM at home because of PharmGirl, I like the letters, responses, and rebuttals from the authors but the medium is terribly static, staid, and very quickly over, with only three or five people actually having the conversation.

In this case, many people discussed the work in several different ways. What strikes me is the discussion of how pseudonymity has some similarities to reading a paper by RealNames who one doesn't actually "know." Bora's addition that formal discourse by a few can actually be much more damaging than the flippant and honest comments of dozens or hundreds we get on blogs is enlightening. Bora's comment on his own post is very insightful:

Briefly: pseudonymity is not anonymity. Pseudonym, JUST LIKE THE REAL NAME, is just a string of letters. Online, just like offline, one builds reputation through one's words and deeds. I've been a science blogger for more than four years (in Internet dog years that is about two centuries) and I have learned to trust many pseudonymous bloggers years before I learned their true identities: SciCurious, Sciencewoman, Dr.Isis, DrugMonkey, Physioprof, Abel PharmBoy, Orac, Revere and others earned their reputation by being smart, honest, well-informed and yes, witty. They demonstrated both their expertise on the topics they write about AND their understanding of the medium. There are some excellent reasons to be Pseudonymous online and this does not detract one bit from the earned authority.

As time went by and I discovered true identities of some of these bloggers, I realized that their real names mean nothing to me. None of them turned out to be Craig Venter or Jim Watson. Their real names were completely new to me - just a few out of thousands of scientists out there. Learning their real names did nothing to enhance or detract their reputation - they earned it under their Pseudonyms. Pseudonym is a name, just like the real name: a string of letters, the former given to oneself, the latter received from parents. It makes no difference whatsoever.

But it is interesting that people who diss pseudonyms tend to all be male. Insensitivity? Total lack of perception of what is going on in the hallways of academia? Male privilege? Reverence for the formal academic hierarchy regardless of merit? Yes, all of the above.

The fact that the authors responded to pseudonymous bloggers criticizing their interpretations (not their work but, rather, their conclusions) is to me a window into the future of scientific discourse (notwithstanding that "discourse" gives my colleague the hives.).

Would all of the pseudonymous bloggers have been so frank and snarky in their initial comments on the work? Are their scientific criticisms valid? Did the authors learn more immediately of concerns regarding their interpretations? Will the authors be better prepared for any and all of the dissenting correspondence NEJM will receive regarding their work? Has the sci/med blogosphere been of benefit to the field of circadian rhythms and interest in health effects of disrupting such cycles?

As fellow middle-aged guy PalMD queried and responded:

"I'm a researcher and I don't know what to do about this blog thing"

Don't fear the new medium---check us out. Google your work and see who's discussing it. Comment on it. Start your own blog, if you dare. But don't reject the blogosphere out of hand, even the cruder bits. Many of your colleagues (especially the younger ones) are out here talking about you, and, as with colonoscopies, it's much better to be a discussant than a subject.

terrasig Mon, 11/03/2008 - 14:51

Tags

community

Medical Publishing

The Pseudonymity Laboratory

Public discussion of science is good and the stodgy "it can only happen in letters to the editor" thing won't fly for much longer in the face of the inevitable march of this medium. The stodgy conservatives may make a stink when they can, and even try to suppress blogging within their institutions out of fear of their lack of control, but as the medium becomes better understood hopefully they'll realize a different standard exists for this type of writing.

Especially considering the popular coverage of the paper it is totally fair game for discussion on blogs and I agree with the points Isis and Bora made. I don't know if every paper is equal in this regard. If you were singling out some obscure research or researcher you had a grudge against, and were anonymous in doing so, this strikes me as less defensible and possibly cowardly. Ultimately I think it's just a matter of passing a smell test. If you have a pseudonym like Abel does, that you use to talk freely about matters of importance without compromising your career, that's great. If you use your pseudonym just so you can level puerile and slanderous attacks against people you have a grudge against, I understand if they decide to hunt you down and make a smudge out of you. In this case a blogger with good intentions critiqued a paper discussed in the popular press and fairly panned it. Go Isis. The teddy bear on the crapper might have been a bit much though.

Anti-stodgy conservatives is always a great narrative, but "It can only happen in letters to the editor" is a strawman in this particular case.
The objection of the authors was more to the tone (a la Roosevelt on the commode) than bloggy medium (else they wouldn't have responded at all, most likely).

That said, it's been a very cool discussion (Bora has a bad habit of writing great, facinating science posts and then moving on without discussing them- drives me nuts. This is the first time that I can remember I've gotten him to reply to my comments... if for that reason alone, I think the 'controversy' generated is great for science).

MarkH raises very good points in the sense that I wonder where the "tone" of blog discussion of papers will reach equilibrium. Certainly less formal and in a peer-reviewed letter to the editor (yes, NEJM letters to the editor and responses are actually peer-reviewed), but just where does lively and substantive scientific objection/discussion end and "compromising your career" begin? Janzsky and Ljung have been quite open to discussion and, IMHO, quite tolerant of the USians lack of full appreciation of cultural differences. Some authors might take offense at even the slightest online criticism while others, Bora for example, might say "bring it" and actively solicit online criticism.

If you use your pseudonym just so you can level puerile and slanderous attacks against people you have a grudge against, I understand if they decide to hunt you down and make a smudge out of you.

Related to my point above, what constitutes puerile and slanderous attacks will vary from recipient to recipient. But I do agree that one will have to be responsible for the content of their public critiques just as one would in leveling a criticism during the Q&A of a major society conference. We had a brief discussion in an earlier post in The Pseudonymity Laboratory series regarding what responsibilities, if any, a pseudonymous sci/med blogger might have. What I infer from Mark's comments is that a pseud-blogger should accept the same responsibilities for their statements as they would if writing under their real, professional name.

very nice web site i found you looking for stuff on our sons birth defect esophageal atresia and other complications i wish you nothing but the best. If there is any way that you would be willing to exchange links i would be so greatful, thanks again so much.

What I infer from Mark's comments is that a pseud-blogger should accept the same responsibilities for their statements as they would if writing under their real, professional name.

I beg to differ. I hear something a bit different in such statements.

When people have a professional set-to, it tends to be limited to the arena in question. The professional one.

You don't find someone who thinks their scientific peer is a raging jerkwad "hunting down" this person in other arenas. Say, trying to "discredit" them with their local neighbors or charity board or something. They stick to trying to discredit or revenge themselves professionally.

I draw the analogy here to the online blog world. That is the legitimate area of discourse. If you want to discredit, attack and vilify the psuedonymous identity that's all perfectly fair game. The question is why people like MarkH are so frighteningly fixated on outing real-life identities. To go back to the professional science/medical arena, this puts such people in company with extreme animal rights or anti-abortion activist/terrorists who "hunt down" the personal lives of scientist and doctors with whom they have beef on their professional activities.

Academic freedom and open inquiry is a good thing for science.

I understand if they decide to hunt you down and make a smudge out of you.

Who talks like this? Does it creep anyone out other than me?

"If you use your pseudonym just so you can level puerile and slanderous attacks against people you have a grudge against, I understand if they decide to hunt you down and make a smudge out of you."

I think that people understand what a troll is. If someone tries to make up libelous stuff in the blog world under a pseudoname, people understand that this could be some 13 year old with nothing better to do and they will take this into consideration when trying to determine if what they're saying is true. Also, there is a difference betwen libel and stating ones opinion. I can say the FDA is full of criminals based on everything everyone already know about them, and that's just my opinion (I'm just re - interpreting the same facts that everyone already knows). But if I claim that a specific high ranking member of the FDA murdered his wife and I know that's false, that's libel (though, if I really thought it was true, I can claim that it is my opinion that it's true based on what we already know and state the facts I think support my claim). If I claimed that I saw the high ranking member of the FDA kill his wife and I know it's false, that's libel (libel is written slander). That would be like claiming I saw OJ Simpson killing his wife even though I didn't. I can claim he killed his wife based on the agreed upon facts and someone else can look at the same facts and claim he didn't. Neither of us are committing libel. People should be perfectly free to criticize someone all they want under a pseudoname (they can call them criminals, but if they claim something like, "I saw him kill his wife" and they didn't, that would be libel) so long as they don't deliberately tell people something they know is false.

Alzheimer's disease and risky sexual behavior?

terrasig — Thu, 15 Nov 2007 06:30:08 +0000

Alzheimer's disease and risky sexual behavior?

No..it's a false alarm. [***or not - see note added at end of post]

But I had to do a double-take last night when reading my e-mail notification of the new HealthCentral newsletter with the subject line:

Celebrate Alzheimer's Awareness Month; How risky is your sexual behavior?

For the grammar police out there, this is a great example of the difference in meaning of a semi-colon vs. a colon. However, given the size of the print on my screen and my pending need for bifocals, I couldn't tell the difference.

Anyway, I blame the editors of the e-mail release for alarming me.

Or maybe it was intentional. After all, I've written a blog post about it and linked to their site.

On the more serious side, Alzheimer's is a terribly devastating disease that is only due to increase in incidence as baby boomers move toward their more senior years.

For those interested, the links to the two separate stories are:

Celebrate Alzheimer's Awareness Month
Learn about the symptoms of Alzheimer's, the struggles of caregiving, and take our Alzheimer's IQ Test! Educate yourself, in honor of the 5 million Americans suffering from Alzheimer's Disease.

How risky is your sexual behavior?
Everyone knows you can't judge a book by its cover - but neither can you judge someone's sexual health by their good looks and charm. Take this quiz to find out whether or not you're taking the right precautions in your sex life.

***Note added 16 Nov 2007: Evil Monkey at Neurotopia 2.0 notes that there may indeed actually be a link between sexual behavior and risk of Alzheimer's. It's a great read - who knew?

terrasig Thu, 11/15/2007 - 01:30

Reed Elsevier's Experiment With Online Free Access

terrasig — Mon, 10 Sep 2007 10:45:52 +0000

Reed Elsevier's Experiment With Online Free Access

Today's New York Times notes this weekend's launch of Elsevier's OncologySTAT website:

But now Reed Elsevier, which publishes more than 400 medical and scientific journals, is trying an experiment that stands this model on its head. Over the weekend it introduced a Web portal, www.OncologySTAT.com, that gives doctors free access to the latest articles from 100 of its own pricey medical journals and that plans to sell advertisements against the content.

The new site asks oncologists to register their personal information. In exchange, it gives them immediate access to the latest cancer-related articles from Elsevier journals like The Lancet and Surgical Oncology. Prices for journals can run from hundreds to thousands of dollars a year.

The article questions whether Reed Elsevier runs a risk of cannibalizing their print journal business by offering some on-line content for free. However, advertising revenue is the carrot for this mainstay of the publishing industry (both of whose namesakes data back to the late 1800s):

But Reed Elsevier executives hope that OncologySTAT.com users will be an attractive target for advertisers, providing a model for an array of portals they could set up for health care professionals. Future sites may focus on specialties like neurology, psychiatry, cardiology and infectious diseases, company officials said.
Monique Fayad, an Elsevier senior vice president, said the total online advertising market was growing "in double digits" and added, "We expect it will be a $1 billion opportunity within the next two years."

Here, specifically, is what OncologySTAT.com offers:

- Search and download current articles from 100+ Elsevier cancer related journals.
- Literature scans from the top 20 cancer related journals (JCO, JNCI, CA, Blood, NEJM, JAMA, etc.)
- Daily medical and regulatory news from Elsevier Global Medical News Group and FDC Reports' "The Pink Sheet Daily."
- 25+ Cancer Type Spotlights (Breast, Lung, Prostate, etc)
- Professional Drug Monograph and Interactions Database; patient handouts
- Chemotherapy Regimens (The Elsevier Guide to Oncology Drugs & Regimens, 2006 edition)
- Coverage of all major cancer conferences and meetings
- Plus MEDLINE, expert interviews, blogs, videos, and more

Yes, buried in there are blogs, a feature that the NYT article did not address. Who might Elsevier recruit to write blogs? So, kill me - I registered to check out the offerings.

Lo and behold, I learned that one of the two Elsevier bloggers is none other than Nick Genes, MD, PhD, author of Blogborygmi and founder of the weekly medical blog carnival, Grand Rounds. In addition to Dr Genes, an ER resident at Mt Sinai in NYC, Elsevier also tagged Edwina Baskin-Bey, at surgical resident at Mayo Clinic. Dr Baskin-Bey has been a freelance writer for lifetips.com but, to my knowledge, has not previously been a medical blogger.

I think that it's a pretty impressive coup for Reed Elsevier to tag Nick Genes as an inaugural blogger. Nick is a long-time med blogger and has grown to make medical writing a big part of his professional life. He writes both for medgadget.com and does interviews of Grand Rounds hosts for Medscape, a feature called Pre-Rounds.

I intend no offense to either of the good doctors, but it is striking that neither Dr Genes nor Dr Baskin-Bey are practicing oncologists (although Genes' Pre-Rounds appears on Medscape Hematology-Oncology). There are oncologist-bloggers that could have been recruited but one must admit that Genes is a superb writer.

Getting back to the content, it seems that the Reed Elsevier effort is less for academic oncologists as it is for those in the community:

But Dr. Leonard B. Saltz, a colon cancer expert at Memorial Sloan-Kettering Cancer, said, "Another Web site was not what we desperately need." He added, "I know the literature of my area often before it is published." Beyond that, he uses the government site, PubMed, and the Google Scholar search engine to drill into research issues.

But not every oncologist has the luxury of Dr Saltz:

Doctors like Dr. Saltz who work at the big teaching centers have free access to most, if not all, of the journals. But oncologists away from those centers, like Dr. Yi in Princeton, see 85 percent of all cancer patients and rely on the Internet as their link to the knowledge base. [emphasis mine]

Reed Elsevier certainly draws a lot of grief among the scientific community. But improving access to the primary oncology literature for community oncologists is certainly an idea I can support.

terrasig Mon, 09/10/2007 - 06:45