Sunday 25 April 2010

Some influential papers from Medical Hypotheses

Some influential papers from the history of Medical Hypotheses

I believe that a journal editor should be ‘agnostic’ about the truth of the papers he publishes, since truth in science is not something that editors ought to guess, but should only be determined after publication by evaluation and testing within the wider scientific community.

There is, at present, no objective method of evaluating a journal's relative or unique influence either quantitatively or qualitatively. To do this would require a great investment of intelligence, time and resources.

After all, papers published in very high impact journals like Nature, Science and PNAS would - if rejected from one of these - almost-certainly have been published in another of these, or elsewhere in a specialist journal with similar impact; and if this had happened the same paper may well have had identical impact.

What is hard to get-at is the _distinctive_ contribution of a _specific_ journal. At present, the best avaiable method may be biographical: asking scientists their opinion about the importance of particular papers in particular journals:

However the crude influence of publications can sometimes be estimated using citation analysis – this looks at the number of times a paper has been listed in the reference section by other scientists.

Citations build-up over several years, so that citation analysis is more reliable for older papers. But citations tend to reward mainstream 'methodological' papers - it is hard to estimate the importance of 'ideas' papers such as hypotheses and theories, especially as scientists do not feel obliged to cite the sources of their ideas even if they can remember them (whereas, by contrast, scientists must cite the source of any empirical data on which their own research depends).

Bearing in mind these methods and caveats, I have compiled a short list of some of the papers from Medical Hypotheses which seem to have been most influential.

There were just two editors of Medical Hypotheses in its 35 year history

1975-2003 – David L Horrobin as Editor

In the early days of Medical Hypotheses many of the papers reflected the first Editor’s interest in nutritional topics; and Medical Hypotheses published many ideas that helped launch some of today’s mainstream ideas about diet, such as the benefits of supplementation with ‘omega’ fatty acids and antioxidants.

In 1985 AJ Verlangieri and others outlined the now widely-accepted idea that eating plenty of fruit and vegetables helps prevent heart disease in a widely quoted paper: “Fruit and vegetable consumption and cardiovascular mortality”.

Through the 1980s in Medical Hypotheses, freelance US scientist Mark F McCarty was publishing many of the early and influential papers about the importance of antioxidants in the diet, and their possible role in preventing disease. Over some three decades McCarty has published more papers in Medical Hypotheses than anyone else, and together these papers have been cited thousands of times in the scientific literature.

In 1987 the Medical Hypotheses founding editor David Horrobin published a frequently-referenced paper on the ‘omega-3’ type of essential fatty acid, which so many people now use as dietary supplements: “Low prevalences of coronary heart disease (CHD), psoriasis, asthma and rheumatoid arthritis in Eskimos: Are they caused by high dietary intake of eicosapentaenoic acid (EPA), a genetic variation of essential fatty acid (EFA) metabolism or a combination of both?”

In 1985, Clouston and Kerr published in Medical Hypotheses an influential paper called “Apoptosis, lymphocytotoxicity and the containment of viral infections”. This first described the now widely accepted idea that viruses may be fought by inducing suicide in virus-infected cells.

The most widely cited paper in Medical Hypotheses was published in 1991: The macrophage theory of depression by RS Smith. This is a key paper which argues that immune system chemicals may be a major cause of depression, and has been cited 242 times according to Google Scholar.

2004-2010 Bruce G Charlton as Editor

Here are some recent papers under my editorship which have already had an impact:

In 2005, Lola Cuddy and Jackie Duffin of Queens University Canada published an influential paper in Medical Hypotheses based on an elderly lady with several Alzheimer’s disease who still retained the ability to recognize music. They theorized that this might provide useful information on the nature of brain damage in Alzheimer’s, and suggested that dementia sufferers might benefit from a more musical environment. This paper was awarded the David Horrobin Prize for 2005 for the paper in Medical Hypotheses which best exemplified the intentions of the founding editor – the famous Cambridge transplant surgeon Sir Roy Calne was judge.

In “A tale of two cannabinoids” by E Russo & GW Guy from 2006, the authors presented the rationale for using a combination of marijuana products tetrahydrocannabinol (THC) and cannabidiol (CBD) as useful painkilling drugs and for the treatment of several other medical conditions. This idea has since been widely discussed in the scientific literature.

In 2005 Eric Altschuler published a letter in Medical Hypotheses outlining his idea that survivors of the 1918 flu epidemic might even now retain immunity to the old virus. A few 1918 flu survivors were found who still had antibodies, and cells from these people were cloned to create an antiserum that protected experimental mice against the flu virus. The work was eventually published in Nature and received wide coverage in the media.