No joke: CMAJ editorial policy changed after spoof articles taken seriously

"Acquired growth hormone deficiency and hypogonadotropic hypogonadism in a subject with repeated head trauma, or Tintin goes to the neurologist"
(CMAJ, December 7, 2004)

"The impact of hissy fits in primary care"
(CMAJ, December, 1998)

"Bubble bubble, abdominal trouble: a new test to chew on"
(CMAJ, December 14, 1999)

"The efficacy of stethoscope placement when not in use: traditional versus 'cool'" (CMAJ, December 12, 2000)

If you didn't realize those four articles were spoofs, then you're not alone -- although that doesn't absolve you of the guilt you should feel for being so oblivious. Those four Canadian Medical Association Journal (CMAJ) spoofs have all been cited in serious medical research articles in reputable journals, writes Nova Scotian physician Christopher Naugler in the latest issue of the CMAJ.

"For the past decade CMAJ has published a series of articles inspired by the holiday season in a section called the Holiday Review. Some of these articles consist of quirky questions addressed with real data whereas others are, in the words of CMAJ's editors, "evidence-free exaggeration and premeditated preposterousness." Although these articles are a welcome holiday diversion for many physicians, confusion has sometimes arisen because these articles are indexed in MEDLINE as if they were real research articles.

"To see if these articles have been mistaken for evidence-based articles, I searched Google Scholar for citations of Holiday Review articles published in 1999–2006 and then reviewed these citations... If CMAJ's Holiday Review articles are to continue being indexed in MEDLINE, perhaps it would be prudent to insert a note at the end of each evidence-free abstract stating that the article is for entertainment purposes only and is not a real study."

Dr Naugler's letter prompted a response from deputy editor Barbara Sibbald, who has promised a change in the journal's policy. "In the future," she writes, "we will include a disclaimer in the titles of our Holiday Review science articles."

This situation makes one wonder what's more ridiculous: researchers who can't tell a spoof from the real thing, doctors studying the frequency of that phenomenon, or editors expressing grave concern about that frequency. Unless, of course, we've all been duped and this latest exchange of letters between Dr Naugler and Ms Sibbald is itself a spoof -- a late April Fool's joke. Somehow, however, I doubt it.

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