The Lancet Airs Charges of Editorial Carelessness

Rivalry between two of the world's top medical journals broke into print this week when The Lancet of London ran a letter in its 15 February issue criticizing its competitor, The New England Journal of Medicine (NEJM) of Boston, Massachusetts, for lax editorial policies. The letter, signed by cardiologist Peter Wilmshurst of the Royal Shrewsbury Hospital in Shrewsbury, U.K., claims that NEJM has refused to investigate financial conflicts of interest among its authors. Wilmshurst also claims that NEJM's editorial selection process is biased in favor of local authors.

Wilmshurst's letter came in response to an editorial in the 7 September issue of The Lancet that discussed an alleged conflict of interest of NEJM authors. But he contends that problems at the Journal go much deeper. For example, Wilmshurst cites a 1988 case in which he alleges that an article by a British author was rejected in favor of a later submission on the same topic by a group of Harvard researchers. Worse, Wilmshurst suggests, one of the Harvard authors had previously reviewed the British article for NEJM, criticized it, and then was commissioned by NEJM to write a different version. Wilmshurst also claims that four out of five authors of a 1978 NEJM article on the heart drug amrinone had received support from the drug's manufacturer without revealing this fact. He suggested that NEJM should appoint an ombudsman, as The Lancet has done, to "get to the truth of these cases."

Wilmshurst's attack on NEJM appears as an independent comment in The Lancet's letters section. But The Lancet gave it prominence by including it in a list of items highlighted for the media released on 13 February. It appeared under the heading, "Doubts about Editorial Integrity of New England Journal of Medicine." The Lancet seems ready to keep the criticism coming, too: Deputy Editor David Sharp confirms that the journal will soon be publishing a longer article by Wilmshurst on the "general topic" of conflicts in medical publishing.

NEJM's current editor, Jerome Kassirer, declined to comment. But Arnold Relman, NEJM's editor when the articles in question appeared, firmly rejected Wilmshurst's allegations. Referring to Wilmshurst, Relman said: "Sometimes rejected would-be authors take a rather unkind view of the editors who have made negative decisions on their manuscripts. I categorically deny Dr. Wilmshurst's implication of editorial improprieties. Most of the events he talks about are old and buried and not usefully rehashed now. But Wilmshurst is simply wrong in most of his accusations."