What happened to medical journal quality?

[Dusn]

Bilateral Retinal Detachments in a Healthy 22-year-old Woman After Moderna SARS-COV-2 Vaccination

Although uncommon, retinal detachments are medically urgent and can result in permanent vision loss if untreated. Bilateral retinal detachments in healthy individuals are even more rare. In addition, there are no cases to date of retinal detachment associated with either coronavirus disease 2019...

www.jem-journal.com

In case anybody here reads this journal, this patient’s bilateral retinal detachments were not caused by her covid vaccine. I’m a retina specialist and retina specialists commonly see bilateral retinal detachments in young very high myopes like this. Her retinal images show predisposing risk factors like lattice degeneration and numerous retinal holes. There is no good reason to think that her covid vaccine was one of the risk factors that led to this.

Is this a respected EM journal? Why have medical journals started publishing garbage with no good supporting evidence ever since covid started?

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[southerndoc]

It's the journal of AAEM. It's OK, but not the best. A case report isn't the same as a study.

I do appreciate you explaining the reasoning behind the patient's higher risk of retinal detachment and explaining the fact that bilateral retinal detachments aren't unheard of. Most of us have never seen bilateral detachments, but as a retina specialist, they're probably a frequent occurrence for your office. People try to pin everything on COVID vaccines.

 

[Apollyon]

The JEM is normally good. One of the authors is an ophtho at Shiley in SD, along with the other authors at UCSD, in EM. I don't know who does the peer review.

 

[Dr Mantis Toboggan]

I do know a resident who had transient severe bilateral vision impairment after dose 1 of Pfizer. He got better with steroids. I forget what his formal diagnosis was.

Bilateral Retinal Detachments in a Healthy 22-year-old Woman After Moderna SARS-COV-2 Vaccination

Although uncommon, retinal detachments are medically urgent and can result in permanent vision loss if untreated. Bilateral retinal detachments in healthy individuals are even more rare. In addition, there are no cases to date of retinal detachment associated with either coronavirus disease 2019...

www.jem-journal.com

In case anybody here reads this journal, this patient’s bilateral retinal detachments were not caused by her covid vaccine. I’m a retina specialist and retina specialists commonly see bilateral retinal detachments in young very high myopes like this. Her retinal images show predisposing risk factors like lattice degeneration and numerous retinal holes. There is no good reason to think that her covid vaccine was one of the risk factors that led to this.

Is this a respected EM journal? Why have medical journals started publishing garbage with no good supporting evidence ever since covid started?

 

[southerndoc]

I do know a resident who had transient severe bilateral vision impairment after dose 1 of Pfizer. He got better with steroids. I forget what his formal diagnosis was.

Dramaticus hystericus? 😉

 

[GassYous]

I do know a resident who had transient severe bilateral vision impairment after dose 1 of Pfizer. He got better with steroids. I forget what his formal diagnosis was.

Conservatism? 😉

 

[sylvanthus]

Conservatism? 😉

This one wins.

 

[DeadCactus]

This is what you get when peer-reviewers are unpaid laborers for journals focused on impact factor and page views publishing articles by people who don't care about research but need to check a box to advance.

 

[Fart Daddy Smooth]

This is what you get when peer-reviewers are unpaid laborers for journals focused on impact factor and page views publishing articles by people who don't care about research but need to check a box to advance.

Yes, also makes you wonder how they justify exorbitant subscription/article pricing considering the peer review is performed by volunteers.

 

[Tenk]

I don’t know who this guy is but he sure doesn’t take any **** and I like that.

 

[Birdstrike]

Bilateral Retinal Detachments in a Healthy 22-year-old Woman After Moderna SARS-COV-2 Vaccination

Although uncommon, retinal detachments are medically urgent and can result in permanent vision loss if untreated. Bilateral retinal detachments in healthy individuals are even more rare. In addition, there are no cases to date of retinal detachment associated with either coronavirus disease 2019...

www.jem-journal.com

Is this a respected EM journal? Why have medical journals started publishing garbage with no good supporting evidence ever since covid started?

This didn't start with COVID and isn't limited to one EM journal. It's been obvious and well documented for a long time that most medical research is false. Is this a new discovery for you?

 

[Mount Asclepius]

This didn't start with COVID and isn't limited to one EM journal. It's been obvious and well documented for a long time that most medical research is false. Is this a new discovery for you?

Isn’t it interestingly somewhat not very reassuring that medicine is ‘evidence based’ when a lot of research/literature is drug company funded, biased, statistically manipulated, false, fraudulent, equivocal or conflicting?

Makes me fall into the late majority category of the technology adoption curve more so anymore.

I once heard the quote (paraphrasing), ‘In the future 1/3rd of what you practice will still be practiced, 1/3rd will be disproven and no longer practiced, and 1/3rd will someday be considered malpractice.’

 

[Birdstrike]

I once heard the quote (paraphrasing), ‘In the future 1/3rd of what you practice will still be practiced, 1/3rd will be disproven and no longer practiced, and 1/3rd will someday be considered malpractice.’

It's possible you heard that from me, since I've been known to post that quote on here (below). But I can't take credit for it. I was told that my first day of medical school 25 years ago from an old school pediatrician, who I now realize was brilliant. I wish I remembered his name. I also remember a lecture he gave us on the "Gold Standard," and that you need to think about every diagnosis in terms of the gold standard for it's diagnosis. The point was not to order the gold standard test every time, as often you can't. The point was that if you think in those terms you'll always be aware of how hard can often be to be 100% sure about a diagnosis, and that unless you have an accurate idea of what your pre- and post- test probabilities are, you have no way of knowing how to hedge your bets, i.e. "cover your @$$."

Many gold standards are obscure and unorderable, but you can't ever forget about them, because doing so allows you to forget you're ordering a substandard test, that you're lulled into thinking is the "best." "Best available test" doesn't equal "best" test.

"A third of what you learn, you'll forget. A third will turn out to be completely wrong. A third will turn out to be right. And a there's no way to know right now, which third is which." (I added the last line).

 

[The Knife & Gun Club]

It's possible you heard that from me, since I've been known to post that quote on here (below). But I can't take credit for it. I was told that my first day of medical school 25 years ago from an old school pediatrician, who I now realize was brilliant. I wish I remembered his name. I also remember a lecture he gave us on the "Gold Standard," and that you need to think about every diagnosis in terms of the gold standard for it's diagnosis. The point was not to order the gold standard test every time, as often you can't. The point was that if you think in those terms you'll always be aware of how hard can often be to be 100% sure about a diagnosis, and that unless you have an accurate idea of what your pre- and post- test probabilities are, you have no way of knowing how to hedge your bets, i.e. "cover your @$$."

Many gold standards are obscure and unorderable, but you can't ever forget about them, because doing so allows you to forget you're ordering a substandard test, that you're lulled into thinking is the "best." "Best available test" doesn't equal "best" test.

I’d pay good money to stream that lecture

 

[Dusn]

This didn't start with COVID and isn't limited to one EM journal. It's been obvious and well documented for a long time that most medical research is false. Is this a new discovery for you?

I’m well aware that some studies are fabricated; other studies are repeated 40 times and, because of publication bias, the one study with the positive result gets submitted and published and the 39 negative studies are never seen, etc. Even some device manufacturers will repeat a study if they get a bad result and just submit the study with the “better” result to the FDA for approval and not mention the negative studies.

This is different because of the blatant stupidity of it. A rhegmatogenous retinal detachment is a purely mechanical process due to tears or holes in the retina. It would be like attributing a broken bone to a vaccine. It doesn’t even make sense.

In addition this RD has scar tissue (pvr) that makes it likely that it began prior to the vaccines 3 days ago.

Also, they’re doing a huge disservice to the millions of people working to get the county vaccinated in the middle of a pandemic. Prior to publishing anti-vax click-bait, you think they could have just sent an email to a couple of retinal specialists and just asked them if blaming this single case-report RD on the vaccine even makes sense?

 

[Birdstrike]

Also, they’re doing a huge disservice to the millions of people working to get the county vaccinated in the middle of a pandemic. Prior to publishing anti-vax click-bait, you think they could have just sent an email to a couple of retinal specialists and just asked them if blaming this single case-report RD on the vaccine even makes sense?

I agree with what you're saying here. I was just surprised, that anyone was surprised, that junk research is the rule rather than the exception. The bias may change depending on the way the wind blows, but the overall unreliability of what our profession publishes, doesn't.

 

[Birdstrike]

I’d pay good money to stream that lecture

Honestly, I think I would too, at this point. That's one I wish I could go back and listen to again, with weathered ears.

 

[Dred Pirate]

couple of points
1. I am one of those unpaid laborers for a journal - and I recently suggested rejection of a stupid study comparing cisatracuronium use in covid vs non-covid pts - it was just a stupid study - never gave a rationale, didnt list methos, etc. just a classic case of everyone throwing "covid" on a study and thinking it will get published.

2. lately I have seen some really weak studies get published in reasonable journals. One was a study on the time it took to deliver narcan via drone - sounds interesting- but all they did was have a guy take a phone call in a office building, then fly a drone to the parking lot based on directions and record the time - ya because the OD always happens in the parking lot outside of the 911 center - what does this study even tell us??

 

[wholeheartedly]

couple of points
1. I am one of those unpaid laborers for a journal - and I recently suggested rejection of a stupid study comparing cisatracuronium use in covid vs non-covid pts - it was just a stupid study - never gave a rationale, didnt list methos, etc. just a classic case of everyone throwing "covid" on a study and thinking it will get published.

2. lately I have seen some really weak studies get published in reasonable journals. One was a study on the time it took to deliver narcan via drone - sounds interesting- but all they did was have a guy take a phone call in a office building, then fly a drone to the parking lot based on directions and record the time - ya because the OD always happens in the parking lot outside of the 911 center - what does this study even tell us??

sounds like a ”pilot” study



(sorry, terrible, i had to)

 

[wholeheartedly]

speaking of journal WTF.

Juul Bought Out Medical Journal for $51K

E-cig maker sponsored nearly a dozen studies, took over journal as it awaits FDA ruling

www.medpagetoday.com

 

[Birdstrike]

speaking of journal WTF.

Juul Bought Out Medical Journal for $51K

E-cig maker sponsored nearly a dozen studies, took over journal as it awaits FDA ruling

www.medpagetoday.com

A vaping company bought out a medical health journal. How come this doesn't surprise me very much?

I'd like to know how many other journals are owned, funded or bribed by entities with ulterior motives, that we're not aware of.

 

[aafisahar]

A vaping company bought out a medical health journal. How come this doesn't surprise me very much?

I'd like to know how many other journals are owned, funded or bribed by entities with ulterior motives, that we're not aware of.

Been going on for 50 years. Oil/gas companies have done it to reduce the impact of pollution in health. Tobacco companies did it to disprove cigarettes were harmful for you. A bought expert is a terribly effective weapon.

 

[Birdstrike]

Been going on for 50 years. Oil/gas companies have done it to reduce the impact of pollution in health. Tobacco companies did it to disprove cigarettes were harmful for you. A bought expert is a terribly effective weapon.

True, except I’d say it’s probably going on as long as humans have been human.

 

[Mount Asclepius]

This is why I think medicine is no longer trusted by society as empirically as it once was. People used to take physician’s advice blindly stating, “Well you’re the doctor.” Now everyone is on google and skeptical of their emergency physician with whom they don’t have an established relationship. I don’t completely blame them when their doc might increasingly be from a CMG program that trained them to bill highly and not necessarily practice good medicine. The new ‘standard of care’ which might also become based off of studies funded by tobacco companies. Forgive me for no longer trusting science when it has been bought and paid for by corporate greed.

 

[BoardingDoc]

This is why I think medicine is no longer trusted by society as empirically as it once was. People used to take physician’s advice blindly stating, “Well you’re the doctor.” Now everyone is on google and skeptical of their emergency physician with whom they don’t have an established relationship. I don’t completely blame them when their doc might increasingly be from a CMG program that trained them to bill highly and not necessarily practice good medicine. The new ‘standard of care’ which might also become based off of studies funded by tobacco companies. Forgive me for no longer trusting science when it has been bought and paid for by corporate greed.

I hope that what you mean is that you no longer blindly trust science. Looking at studies with a skeptical eye is certainly good practice. Blindly rejecting widely accepted science is something best left to chiropractors, homeopaths, Jenny McJennyson, etc.

 

[Mount Asclepius]

I hope that what you mean is that you no longer blindly trust science. Looking at studies with a skeptical eye is certainly good practice. Blindly rejecting widely accepted science is something best left to chiropractors, homeopaths, Jenny McJennyson, etc.

I don't really blindly trust anything. I'd define what I mean more so that I have become increasingly skeptical of medicine. I also see it just as much as an art as a science, where as when I started I saw it as almost purely science.

As a corollary, the NNT in most of medicine is higher than we think. I think that is why it's harder to prove interventions work. On the other hand, simple weight loss is harder for many people, but I'd argue has a significantly lower NNT to impact disease.

Why Most Published Research Findings Are False

 

[aafisahar]

This is why I think medicine is no longer trusted by society as empirically as it once was. People used to take physician’s advice blindly stating, “Well you’re the doctor.” Now everyone is on google and skeptical of their emergency physician with whom they don’t have an established relationship. I don’t completely blame them when their doc might increasingly be from a CMG program that trained them to bill highly and not necessarily practice good medicine. The new ‘standard of care’ which might also become based off of studies funded by tobacco companies. Forgive me for no longer trusting science when it has been bought and paid for by corporate greed.

The widespread availability of salaries and knowledge that it's fee for service has eroded trust in our system. Patients know we are making money off them when they are most vulnerable. That, coupled with the fact that patients pay exorbitant amounts for seemingly minor things, makes them feel exploited. Every week on NPR or reddit, you'll find stories on how patients are paying 1k a month for insulin, or that getting stitches in the ED was 2500 or how they were treated for a heart attack and now on the hook for 75,000.