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Medical Journal of Australia editor responds to homebirth study concerns

Following yesterday’s Crikey and Croakey pieces on the homebirth study which has been hitting the headlines, I thought it only fair to ask the editor of the Medical Journal of Australia, Dr Martin Van Der Weyden, for comment.

I had raised concerns about the MJA (which is the Journal of the AMA) asking the AMA president, Dr Andrew Pesce, to do its editorial on the study, given the AMA’s opposition to homebirth and the heated politics of maternity services reform.

Below are the questions I put to him by email and in subsequent conversations, and his responses.

Q: I wrote that it was not helpful for the MJA to have chosen an editorialist with such a vested political interest at stake. Do you think this is a fair comment? Why did you choose the president of the AMA to comment?

A: Dr Pesce has a long track record of contributing to debate in the area, from before he was AMA president. We asked three obstetricians and a prominent statistician to review the article. He was one of the reviewers. We always ask one of the reviewers to write the editorial linked to the article. We always choose editorialists with an appropriate background. Futhermore, Dr Pesce identified in the Editorial that as competing interest: “I am President of the Australian Medical Association, which is opposed to home birth in Australia.” This whole area (of homebirth) needs debate. The current debate is informed by “somebody’s invading my patch”, that is what is behind the current criticisms. Maybe it’s the obstetricians, and maybe it’s the midwives. I am fulfilling my function of editor; to promote debate. The major finding of the study was statistically significant. If you want to critique the study, give me the data with an opposite finding. But I leave it to the authors to talk about their studies; otherwise I would be on the phone all day answering inquiries from journalists.

Q: Does the MJA or the AMA choose which journal articles will be press released? Did the AMA or the MJA draft the press release? Does the MJA check the press releases?

A: I select which articles from the MJA that the AMA media department might select to write press releases on. They send it to us and the authors for final approval. We check the press releases after they have been approved by the author.

Q: Should the press release have done more to acknowledge the uncertainties and complexities of the study and its findings?

A: That is not the purpose of the press release. The principal purpose of the press release is to draw the attention of the journalist to the article. The journalist reads the article, and have their own interpretations. The press release had contact numbers for the author. The press release is invariably cut to the bone by medical journalists. I don’t tell the Age or the SMH what to write, medical journalists write the articles. Journalists should read the article. I  sense this is a critique of the journalists. One of the better ones is Nick Miller at The Age.

Q: Does the AMA influence what you publish?

A: I have never been told by the AMA what to publish. I have complete editorial independence.

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  • 1
    AJ
    Posted January 21, 2010 at 5:05 pm | Permalink

    One thing that jumped out at me in the responses to these questions is that Dr Pesce was actually one of the peer reviewers of the article. Surely that constitutes a conflict of interest. For starters he is the President of the AMA and the AMA owns and publishes the Medical Journal of Australia. The AMA, with Dr Pesce as its key advocate, is knee-deep in a political campaign against homebirth. So in order to avoid any perception of bias the Journal should be going to a different expert to review this article (given that according to their website they have a panel of 3000 experts to review articles and Dr Pesce cannot be the only one who specialises in obstetrics). I am not saying that Dr Pesce is biased but an appearance of bias is as good as the real thing and generally to be avoided at all costs.

    The Journal’s website links to the World Association of Medical Editors Position Statement on “Conflict of Interest in Peer-Reviewed Medical Journals”:
    http://www.wame. org/conflict- of-interest- in-peer-reviewed -medical- journals

    Here are some sections of it I found pertinent:

    “However, it constitutes a problem when competing interests could unduly influence (or be reasonably seen to do so) one’s responsibilities in the publication process. If [conflict of interest] COI is not managed effectively, it can cause authors, reviewers, and editors to make decisions that, consciously or unconsciously, tend to serve their competing interests at the expense of their responsibilities in the publication process, thereby distorting the scientific enterprise. This consequence of COI is especially dangerous when it is not immediately apparent to others. In addition, the appearance of COI, even where none actually exists, can also erode trust in a journal by damaging its reputation and credibility. ”

    “A COI exists when a participant in the publication process is directly affiliated with an institution that on the face of it may have a position or an interest in a publication. …Professional or civic organizations may also have competing interests because of their special interests or advocacy positions.”

    “Reviewers should be asked if they have a COI with the content or authors of a manuscript. If they do, they should be removed from the review process. “

4 Trackbacks

  1. ...] This post was mentioned on Twitter by Ben Harris-Roxas HIA, Melissa Sweet. Melissa Sweet said: Aust Medical Journal editor raises interesting issues about peer review, press releases and gives one journo a plug: http://tiny.cc/hJ9NR [...

  2. ...] the rest here:  Medical Journal of Australia editor responds to homebirth study … Share and [...

  3. ...] is the original post: Medical Journal of Australia editor responds to homebirth study … Share and [...

  4. ...] press release and an accompanying editorial by the AMA president, Dr Andrew Pesce (see here, here and here, for example of the previous Croakey [...

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