The Skeptical Sleuth

Applying a healthy dose of skepticism to new findings about health and psychology.

Authors, Don’t Call Us, We’ll Call You

Gaining privileged access to publishing in high impact journals.

Many journals with high rejection rates and high impact factors offer some authors privileged access to publishing in them. Chosen authors can publish with relaxed or no peer review but still claim the prestige and credibility of their work appearing in a high-impact journal with a high rejection rate. Often readers are left unaware that peer review and criteria for acceptance of a paper have been relaxed.

Privileged access publishing is just one of a number of challenges to the illusion that what appears in the "best" journals is the best evidence, a distillation of the highest quality available evidence in all its complexity, ambiguity, and contradiction. Other challenges include rampant confirmatory bias and implicit or explicit policies of discouraging publishing of null findings or failures to replicate existing findings.

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Privileged access is often political and tied to leadership in professional organizations or activity on committees or membership in informal cliques or old fashioned cronyism. The ability to award privileged access to publishing is one of the perks of being an editor, and control of that privilege can become the focus of a political struggle in some organizations.

Political influence and privileged access go both ways. Having privileged access gives an author political strength in organizations and scientific credibility disproportional to actual contribution to the field, as measured by conventional indices such as the H-index.

Yet, the contribution of privileged-access published articles to citations and an author's H-index should not be underestimated. Privileged-access published articles often become authoritative "must cite" throwaway citations ("Cancer is a highly distressing, often traumatic experience…"), particularly when associated with the recommendations of professional organizations. Some authors with few empirical papers make their careers with privileged access publishing. Others make the transition to privileged access  publishing after a few empirical papers, bolstered by political involvement in professional organizations.

With privileged access publishing, authors have the opportunity to define issues without having to accommodate alternative perspectives or criticism and can create the appearance of a contested empirical issue having been settled. It is no coincidence thaqt privileged access is granted precisely when there is controversy or troubling evidence threatening the position of the professional organization.

Professional organizations often exploit privileged access to announce practice guidelines or recommendations that are inconsistent with available evidence, but that nonetheless serve the organizations’ interest in legitimacy and in third-party payments for services. The gap between practice guidelines and available evidence is often commented elsewhere, but the gap is seldom fairly explored in privileged access articles.

The American Psychologist, one of the highest impact journals in psychology has regularly come under criticism for its privileged-access publishing. Notoriously, Martin Seligman, former president of APA put together a number of special issues with privileged access. One issue of five articles in May 2001 extolled the scientific status of positive psychology. Skeptics could not have their submissions considered. Naïve readers of American Psychologist might conclude that the claims of positive psychology were no longer controversial. Yet, in discussions at bars and informal gatherings at professional meetings, there were grumbling and complaints of the reviewers’ critiques and recommendations against publication having been ignored, authors having passages from their paper struck when they expressed alternative views, and of the issue being published without any critical commentary. But such expression of discontent is left at bars and informal conversations, marginalized by the seeming unanimity and consistency of message of the special issue.

In January 2011, American Psychologist again published a special issue under the editorship of Martin Seligman. Fourteen papers extolled the scientific status of the Comprehensive Soldier Fitness Program, his $117 million project designed to prevent posttraumatic stress disorder and build the character of American military serving in Afghanistan and Iraq. The program had come under intense criticism because it was funded with a no-bid contract, justified by the Department of Defense with claims that Martin Seligman had a strong scientific basis and that there were no competitive models of preventing post-traumatic stress disorder in need of consideration. The special issue offered flattering and uncritical endorsement of the Comprehensive Soldier Fitness Program, with many of the authors having undeclared financial interest associated with consulting or training or designing modules of the program. Subsequent evidence is that the Comprehensive Soldier Fitness Program has modest, if any effects on well-being and there is no evidence that the program prevents PTSD.

Critical commnetary published in American Psychologist about the special issue were limited to a few letters in the October 2011 issue and of course the editor of the special issue, Martin Seligman got the last word.

In April 2012, privileged access to Journal of Clinical Oncology allowed advocates of routine screening of cancer patients for psychological distress to declare that despite the lack of decisive evidence that screening improve patient outcomes, now was the time to put the question aside and promote widespread dissemination and implementation of screening.

The American Cancer Society journal CA: A Cancer Journal for Clinicians has the astonishing Journal Impact Factor (JIF) of 94.33 and the only articles concerning psychosocial aspects of cancer that can appear in it are privileged access. The impact factor reflects that the American Cancer Society publishes statistics in CA that are required citations for authoritative estimates of prevalence and other statistics as they vary by cancer site and this assures a high level of citation. Papers in CA discussing psychosocial issues tend to be cited infrequently, and so the JIF is utterly misleading in terms of predicting their rate of citation. But a publication in CA is sure to impress unknowing med school deans and administrators that a psychologist has published in a journal with one of the highest impact factors in the world!

Privileged access is only one of the many means by which political forces distort debates about evidence and select which conclusions are legitimized and which perspectives are marginalized. Because privileged access articles often escape rigorous peer review, the science is often flabby and grossly simplistic, and claims in privileged access articles can be extravagant.

Strategies for challenging inaccuracies and outright misrepresentations in privileged access articles are limited. Journals that grant privileged access also often restrict publishing of letters to the editor to only what authors indicate a willingness to respond. A refusal to respond is effective censorship, causing criticism to be barred from publishing. Even when letters are accepted, they often have severe restrictions on their length (often 400 - 600 words), are often published much later than the privileged access articles, fail to be indexed in ISI Web of science or other electronic bibliographic sources, or are limited to e-letters, not the paper editions of the Journal. It is notable that the webpages of the journals making the most use of privileged access articles do not link subsequent critiques with the original article, so that anyone in defining the critiques has to search for them separately.

Readers who are aware that particular journals grant privileged access can exercise a higher level of skepticism and be alert for propaganda. Eileen Gambrill and Amanda Reiman have provided a handy 32 item checklist and they have shown that with minimal training, readers can substantially increase their detection of propaganda. The checklist zeros in articles’ reliance on vague terms, and unsubstantiated assertions about conditions being underdiagnosed and undertreated, and particular interventions being exceptionally effective, all without adequate documentation.

Most privileged access publishing involves unsystematic reviews of the literature with cherry picking of research that supports particular positions. In some areas in which claims are considered important to the credibility of professional organizations, like psychoneuroimmunology, privileged-access publishing has allowed whole literatures to develop in which secondary sources cite other secondary sources.

Areas of research can thus go years without systematic review or meta-analysis, and yet have the illusion of a solid body of research. In these literatures, it is very difficult to determine on what original research, if any, claims are based. The lack of reference to specific findings is one clue, but often what is done is that the flawed conclusions of a particular study that has not been replicated, selectively gets cited again and again. To detect this, a reader has to have considerable familiarity with the literature.

One key criterion for detecting propaganda in a privileged-access publication is whether a supposed literature review is provided without indication of how the literature was searched or the evidence evaluated. The Assessment of Multiple Systematic Reviews (AMSTAR) checklist is a handy way of assessing this, and the credibility of most privileged access published reviews melts away with even a cursory examination. However, as with Gambrill and Reiman’s means of assessing propaganda, conclusions based on highly selective and distorted citings of a few unrepresentative papers, to the exclusion of other, better designed research excluded, can still escape detection. Readers beware, sleuths go to work checking references when you suspect that bad science has intruded into high impact journals via privileged-access publishing.

Jim Coyne, Ph.D., is a clinical health psychologist and Professor in the Department of Psychiatry at the University of Pennsylvania. more...

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