Harvard's Continued Embrace of Alternative Medicine Finds a Partner, and a New Conflict of Interest

By Chuck Dinerstein, MD, MBA — Aug 24, 2017
The literature is filled to overflowing with "publish or perish" articles. So how do we know what to read? Well, the same people that brought you so, so many articles have a curated solution to your current awareness overload.
Courtesy the.Firebottle

The Osher Center for Integrative Medicine, Harvard’s outreach into complementary medicine recently announced a partnership where “three researchers associated with the Harvard Osher Center will each summarize a top recent publication from the burgeoning mind-body literature and provide commentary on why they chose to shine a light on it. Harvard is not alone in this effort. Just Tuesday Wolters Kluver announced “Ovid Insights, a current awareness service,” citing the exponentially expanding volume of research.

“As the volume of research worldwide continues to increase, staying current on the latest medical findings and practice guidelines is an overwhelming, yet necessary, task for healthcare professionals.”

Ironically, the academics first filled, in the sense of a firehouse filling a cup, the journals with studies predicated on the concept of “publish or perish.” And having overwhelmed our attention, they now introduce a solution, the era of curated journal reading.

Harvard’s collaborative partner is the Journal of Alternative and Complementary Medicine (JACM) considered to be in the top quartile of journals covering this area. To give you a sense of the journals academic reach you might consider two reported measures of citation rates. The SJR, a size independent measure of scientific influence is 0.581, for comparison, the New England Journal of Medicine's (NEJM) is 17.736. The SJR puts JACM 17th among their peers (96 journals) after the Journal of Natural Products and Journal of Ginseng Research. Citations per document reflect how often a journal is cited; it is a commonly used measure of the journal’s impact on research. Here JACM has a value of 1.537 (the NEJM is 33.902) placing it 22nd amongst its peers, just after Chiropractic and Manual Therapies but before Chinese Medicine [1]

The three Harvard faculty members [2], all JACM associate editors, select a theme and then choose one study from the literature to abstract and to comment upon. I read the articles they presented, while they are a bit too touchy feely for me, and have the usual problems that plague the literature (small sample size, p-hacking, and data mining), they were all thoughtful articles to read and consider. My concern was the descriptions of studies within their abstracts, for example:

“Cherkin and colleagues' beautiful randomized prospective study…This powerful study demonstrates…”

“In an elegantly designed and rigorously conducted comparative effectiveness trial supported by the National Center for Complementary and Integrative Health (NCCIH)/National Institutes of Health (NIH)…”

“Stephen Ross and colleagues conducted a small but methodologically elegant double-blind, placebo-controlled, crossover trial…”

Perhaps it is me, but I detect a tone of advocacy, and with advocacy comes conflicted interests. I have no issue with knowledgeable people suggesting reading, but there is a fine line between organizing and sorting of information dispassionately and content curation that is, “an editorial process. It's a mix of art and science. It requires a clear and definable voice, and editorial mission, and an understanding of your audience and community.”[3] Can we reliably expect these academics to cite articles that do not favor alternative and complementary medicine? So far, in the year of this collaboration, no article they have chosen has taken an unfavorable view. Are the Harvard faculty acting as fair witness or advocates, do they shed light or only increase the echo? The goals of JACM’s editor, John Weeks, JACM’s editor, provides additional clues when he states that his goal that JACM “becomes an arbiter of the conversation and content that shapes the course of healthcare.” Perhaps I am mistaken, but I want my journals to provide me with unbiased research so that I can form my own view and be the arbiter of my conversations.

 

[1] The SCImago Journal & Country Rank is a publicly available portal that includes the journals and country scientific indicators [that] can be used to assess and analyze scientific domains.

[2] Osher Center's Director of Research Peter Wayne, PhD, Gloria Yeh, MD, MPH, Research Fellowship Director, and Darshan Mehta, MD, MPH, the center's Director of Education

[3] Is Curation Overused? The Votes Are In

 

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Chuck Dinerstein, MD, MBA

Director of Medicine

Dr. Charles Dinerstein, M.D., MBA, FACS is Director of Medicine at the American Council on Science and Health. He has over 25 years of experience as a vascular surgeon.

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