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Journal standards.

Abstract

Despite its many imperfections, the peer review process is a firmly established quality control system for scientific literature. It gives readers some assurance that the work and views that are reported meet standards that are acceptable to a journal. Maureen Revington's editorial in a recent issue of the Australian Veterinary Journal (Revington2002) gives a good concise warts and all overview of the process and is well worth reading. I have some concerns about several articles in the December 2002 issue of the New Zealand Veterinary Journal (Volume 50, Number 6), devoted to the health and welfare of farmed deer, that relate to extensive citing of non-peer reviewed papers. I can understand the need for information to flow from researchers to the wider community but that need is already satisfied by publications such as the proceedings of the Deer Branch of the New Zealand Veterinary Association and Proceedings of the New Zealand Society of Animal Production. Non-peer reviewed papers have been cited in the Journal in the past but never to the extent displayed in this particular issue. It degrades the peer-review process and creates an added burden for reviewers who are forced to grapple with the uncertainties of the science in non-peer reviewed citations. One of my fears is that this process allows science from non peer reviewed articles to be legitimised by its inclusion in a peer reviewed journal and perhaps go on to be accepted as dogma. This is a real danger given the difficulties associated with tracing back to original citations and the increasing volume of scientific literature. It also affords opportunities for agencies to pick up questionable and doubtful science and tout it as support for their products or particular points of view. If deer researchers choose to publish most of their work in proceedings then so be it. However this approach, which seems to becoming increasingly prevalent in the deer sector, is questionable from an established science point of view. For my part, I am increasingly reluctant to spend time reading non-peer reviewed material, despite its appeal. At present there are two distinct baskets for scientific literature, one for non-reviewed articles and another for peer reviewed information. I would sincerely hope that we are not going to need another basket as a halfway house for issues that fall in between that classification.

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BibTeXRIS

R Jackson. 2003. Journal standards.. https://doi.org/10.1080/00480169.2003.36366

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Effectiveness of high-dose versus standard-dose influenza vaccines against hospitalisation according to frailty risk: a prespecified analysis of the randomised trial DANFLU-2.

BACKGROUND: Frailty is a major risk factor for influenza-related complications and can influence vaccine effectiveness. We aimed to assess the relative vaccine effectiveness (rVE) of high-dose (HD-IIV) versus standard-dose inactivated influenza vaccine (SD-IIV) in older adults aged 65 years or older according to frailty risk. METHODS: This study was a prespecified analysis of DANFLU-2, an open-label, individually randomised trial, conducted in Denmark during three consecutive influenza seasons (2022-23, 2023-24, and 2024-25). Adults aged 65 years or older were randomised (1:1) to the HD-IIV or SD-IIV group. The primary endpoint was hospitalisation for influenza or pneumonia. Frailty was defined according to the validated Hospital Frailty Risk Score (HFRS) based on ICD-10 codes within 10 years before randomisation. Participants were stratified into three HFRS categories, namely low (<5 points), intermediate (5-15 points), and high (>15 points) frailty risk. The rVE of HD-IIV versus SD-IIV against the primary endpoint was assessed across prespecified HFRS categories and treating HFRS as a continuous variable. Pearson's chi-square test was used to compare safety events across frailty risk groups and randomisation groups. FINDINGS: Among 332&#x2009;438 randomised participants (mean age 73&#xb7;7 years [SD 5&#xb7;8]; 161&#x2009;538 [48&#xb7;6%] were female), 276&#x2009;173 (83&#xb7;1%) had low frailty risk, 52&#x2009;395 (15&#xb7;8%) had intermediate frailty risk, and 3861 (1&#xb7;2%) had high frailty risk. The primary endpoint of hospitalisation for influenza or pneumonia occurred in 1424 (0&#xb7;5%) of 276&#x2009;173 participants with low frailty risk, 761 (1&#xb7;5%) of 52&#x2009;395 with intermediate frailty risk, and 163 (4&#xb7;2%) of 3861 with high frailty risk (relative risk [RR] for intermediate vs low frailty risk 2&#xb7;8 [95% CI 2&#xb7;6-3&#xb7;1]; RR for high vs low frailty risk 8&#xb7;2 [7&#xb7;0-9&#xb7;6]). HFRS as a continuous variable significantly modified the effect of HD-IIV versus SD-IIV against the primary endpoint with higher rVE estimates with increasing HFRS (pinteraction=0&#xb7;020). The rVE was 0&#xb7;2% (95% CI -10&#xb7;8 to 10&#xb7;2) among those with low frailty risk, 13&#xb7;1% (-0&#xb7;4 to 24&#xb7;8) among those with intermediate frailty risk, and 19&#xb7;9% (-10&#xb7;3 to 42&#xb7;1) among those with high frailty risk. No significant interaction was observed when HFRS was assessed according to the prespecified categorical frailty groups (pinteraction=0&#xb7;17). The proportion of participants with at least one serious adverse event increased across frailty risk groups (13&#x2009;366 [4&#xb7;8%] of 275&#x2009;795 for low frailty risk, 5475 [10&#xb7;5%] of 52&#x2009;315 for intermediate frailty risk, and 777 [20&#xb7;2%] of 3850 for high frailty risk; p<0&#xb7;0001), with similar proportions of serious adverse events in the HD-IIV and SD-IIV groups for each frailty risk group. INTERPRETATION: Among adults aged 65 years or older in Denmark, frailty risk might modify the effects of HD-IIV versus SD-IIV against hospitalisation for influenza or pneumonia, with higher rVE estimates with increasing frailty risk. These findings might support considering high-dose influenza vaccines for frail older adults. However, effect modification was not evident when frailty was assessed using prespecified categorical subgroups, and subgroup-specific estimates were imprecise, with 95% CIs crossing the null. These results should be considered exploratory, warranting further investigation. FUNDING: The DANFLU-2 trial was funded by Sanofi.

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