Tag Archives: peer review

New “public health” panic: Ecig users practice freedom of association without proper supervision!

by Carl V Phillips

This is completely trivial compared to the vast amount of genuinely threatening anti-THR that is out there. But it is funny — too funny to pass up. This paper was recently published. It seems that The Journal of Public Health Policy is a bit hard to access (good news in itself, really) and I am certainly not going to pay for a download. But we have the abstract, and for papers like this the abstract is really all you can stand to read anyway. It begins: Continue reading


Complaints about conflict of interest are designed to maximize conflict of interest

by Carl V Phillips

A colleague who found himself the target of the “you have a conflict of interest!” bullshit game was invited to write his analysis of the nature of conflict of interest as it relates to e-cigarette research. He asked me for input and several points occurred to me. I am writing them up here, in an admittedly disorganized fashion, for possible use in that project. Continue reading

New Phillips-Burstyn-Carter working paper on the failure of peer review in public health

by Carl V Phillips

Our new working paper is available at EP-ology, “The limited value of journal peer review in public health: a case series of tobacco harm reduction articles”, Carl V Phillips, Igor Burstyn, and Brian L Carter (all of the authors are affiliated with CASAA, for those who may not know).


Background: A widespread belief holds that the journal peer-review process has magical powers to ensure that published claims are correct. While this misperception has limited consequences in many fields, in public health it results in consumer, clinical, and policy decisions being based on blind faith in the accuracy of published claims. At best, the review process is merely a couple of readers — perhaps, but not necessarily, highly expert — reading through a paper to ensure the research and presentation are reasonably sound. In reality, even this is often not accomplished.

Methods: We conducted reviews of 12 articles that focused on tobacco harm reduction published in a mainstream public health journal, BMC Public Health, consecutively during 2012-15. We each wrote a reviewer report of the manuscript version that was sent to the journal reviewers, as if we were writing a review for a journal. We then compared these to the reviews written by the journal reviewers. Additionally, we reviewed the changes made to the papers as a result of the journal reviews.

Results: Almost all the papers in the dataset suffered from major flaws, most of which could have been corrected, but none were corrected by the journal review process. The journal peer reviews were almost all inadequate and many contained no substantive comments. Those that contained substantive observations still did not identify most of the blatant major flaws that we noted. In the single case where a journal reviewer identified many of the major flaws, the comments were basically ignored by the authors and the paper was published with no substantive changes. Other than cosmetic improvements, the journal review process was about as likely to make the published version worse than the submitted manuscript, rather than better. Papers with no apparent value were published by the journal and the potential value of other studies was lost because serious flaws in the paper were ignored. Unreported conflict of interest was common among both authors and reviewers.

Conclusions: Faith in the journal peer-review process is misplaced. Even at best, the process cannot promise that a published claim is correct, but in reality it does not even ensure that patent major flaws are not present. In public health, the phrase “according to a peer-reviewed journal article” seems to mean little more than “I read this somewhere.”

It should be evident from the abstract that the primary study aim is not about THR. However, readers of this blog may be interested for several reasons. Most obviously, the case studies are based on articles about THR. But also, the idolatry of journal peer review is one of the more important causes of the persistence of anti-THR lies. Analyzing the reviews of the papers, not the papers themselves, was the purpose of the research, but that required assessing the papers en passant, which means that readers interested in that aspect will should find a fair bit of the content interesting (particularly delving into a few of the appendices).

Some of the material has already been covered here. The previous post was basically written as a footnote for the paper. The post about the terrible paper by Hughes (“Associations between e-cigarette access and smoking and drinking behaviours in teenagers”, by Karen Hughes, Mark A Bellis, Katherine A Hardcastle, Philip McHale, Andrew Bennett, Robin Ireland, and Kate Pike) was basically an excerpt from that research project. The extensive analysis of the Popova-Ling travesty was incorporated as part of the analysis in the paper.

There are few other papers in the analyzed case series that also fall solidly within the anti-THR lies category. There is this one (“Portrayal of electronic cigarettes on YouTube”, Chuan Luo, Xiaolong Zheng, Daniel Dajun Zeng, Scott Leischow) whose value lies entirely in it being unintentional comedy. Strangely, despite being a useless, silly, and badly conducted study, that was then written up as a political broadside that had nothing to do with the study results, it was probably only the 10th worst of the 12 papers in our case series.

Two of the papers were written to try to vilify snus. This one (“Snus user identity and addiction. A Swedish focus group study on adolescents”, Ingrid Edvardsson, Margareta Troein, Göran Ejlertsson, Lena Lendahls) is mostly just uninteresting in terms of what it claims. This one (“Predictors of smoking among Swedish adolescents” Junia Joffer, Gunilla Burell, Erik Bergström, Hans Stenlund, Linda Sjörs, Lars Jerdén) relates more closely to recurring themes from this blog. In particular, it makes the naive gateway claim that fails to distinguish between association and causation. This is particularly pathetic in this case because the paper is ostensibly about predictors and not causes.

Comments on the working paper are welcome, either in the blog comments at EP-ology or via email.

Post publication peer-review: Correction to Burstyn (2014) and related matters

by Carl V Phillips and Igor Burstyn

[Igor Burstyn is an Associate Professor at Drexel University School of Public Health and a member of the CASAA Board of Directors. His research that is described here was sponsored by CASAA.]

Burstyn (2014), “Peering through the mist: systematic review of what the chemistry of contaminants in electronic cigarettes tells us about health risks”, BMC Public Health, is probably the most read scientific paper on e-cigarettes and among the most read in the history of tobacco harm reduction. It is often described as the most important paper on e-cigarettes, being the first to point out that there is ample existing evidence that the non-novel chemical exposures from vaping – which are used to concoct alarmist propaganda — are inconsequential. So imagine our surprise when, after well over 100,000 people had viewed the paper at the journal’s website and countless more via other means (the announcement of the publication of the working paper version remains the most read post on this blog), it went through journal peer-review, and each of us poured over many revisions, one astute reader caught a bright-line error in the results. It is recounted in the following text by IB: Continue reading

The failures of peer review do not begin with the journal – more on the Popova-Ling fiasco

by Brian L Carter

[Editor’s note: This is a guest post by CASAA advisor Brian Carter, who is working with me on research on peer review. He took the lead on part of the behind-the-scenes effort to get the Popova and Ling article retracted, an effort whose failure (and the irony of that failure) I covered in the previous post. –CVP]

Those of us who admire the elegance and clarity of thought contained in good scientific reasoning no doubt found Popova and Ling’s report of a study on warning labels severely lacking. The article is here and Carl V Phillips’s and Clive Bates’s devastating critiques of it are hereherehere, and in comments attached to the article at the journal here. People who manage to publish worthless junk out of sheer scientific ignorance are worrisome enough. But special condemnation is called for when people manage to combine their cluelessness with malicious intent. They use the language and trappings of science like a facade, all to support their decidedly unscientific personal policy goals.

At first, it’s difficult to understand how such an ill-conceived, poorly executed, and scientifically vacuous study could have ever been conducted, much less see the light of day in a respected journal like BMC Public Health. The journal peer review process, which we count on to at least identify utter junk science, was a colossal failure from start to finish, as documented here. However, this most basic failure was simply the last in a long line of peer review failures, aided by willful institutionalized ignorance and prejudice.

Beginning with the release of the article, we can work backwards, like crime scene investigators, to trace the various malicious acts back to the original fraud that formed the ideological genesis for this article. Popova and Ling note in the article that the National Cancer Institute (an organ of the National Institutes of Health), funded their study through a grant awarded to Pamela Ling. This means the very ideas behind the study, the background, the logic, the rationale for doing it, had to be blessed by an expert panel of scientific grant reviewers. These reviewers supposedly make their decisions on the basis of good scientific judgment. If you don’t make your case at this stage, you don’t get the money: Ling had to make a compelling argument for doing what she proposed, and she had to do it better than about 95% of the other applicants because there’s usually only enough money to dole out to the very highest scoring grant applications.

The National Institute of Health publishes information about every awarded grant on its Research Portfolio Online Reporting Tools (RePORT). One of the many pieces of information contained on this site is the applicant’s summary description of the proposed research. Ling’s is here.

Although we are not privy to the study details she proposed, this description clearly supports the thinking and methodology she used and subsequently published. The description is a checklist of the standard University of California San Francisco lies, evasions, and fallacies. Here are the lowlights:

 “Tobacco use is responsible for 35% of cancer deaths, and new smokeless tobacco marketing efforts threaten both to increase cancers caused by smokeless use . . .”

“new smokeless products are marketed as line extensions of major cigarette brands (Marlboro and Camel) to promote ‘dual use.’”

“These changes in smokeless tobacco marketing may blunt the effects of smokefree environments and the health benefits of smokers’ cutting down and quitting.”

“test new counter-marketing messages to block initiation of smokeless tobacco use among novices and the dual use of smokeless tobacco and cigarettes as an alternative to smoking cessation.”

“Findings will be relevant to guide development of policies on smokeless marketing and advertising.” 

That this grant was reviewed and given a top score tells us something about the review committee charged with evaluating its scientific rigor. I have sat on several grant review committees, and each grant has three (sometimes two) primary reviewers (just as journal articles do). With as many as 60-80 grants to review, each member is a primary reviewer on 3-4 grants and usually defers to the primary reviewers of the other grants when submitting a vote on quality score. In this way, the grant review system is embarrassingly similar to the journal review system. The only major difference is that with grant review there are 20 or so potential reviewers, and they all are supposed to be highly qualified to sit on the committee. Most have to have been awarded a grant themselves, be highly published and fairly well known in the field related to the RFA, and have the demonstrated expertise to evaluate the grants they are assigned. However, this academic record is obviously no guarantee committee members are blessed with deep critical thinking skills or untainted by strong political bias.

Clearly, the primary reviewers for Ling’s grant were fellow travelers able to ignore (or, through confirmatory bias, simply not see) the clear evidence that smokeless tobacco use has trivial cancer risk, if any, a well researched scientific finding that makes the entire premise of the grant specious. None of the other 15-20 committee members (who have access to all grants under review, and usually have read the summary descriptions) apparently had any serious objections either. Any one of them could have raised the point of smokeless tobacco’s trivial risks and demanded a debate on the topic, a discussion that could have significantly lowered Ling’s score. So Ling’s grant sailed to the top of the score list in much the same way it sailed onto the pages of BMC Public Health.

How does a grant review committee so ignorant of smokeless tobacco pass muster on Ling’s grant? For this clue we have to dig a little further. In the “details” section of Ling’s RePORT page we discover she had submitted her grant under a specific Request For Applications (RFA). The NIH frequently publicizes RFAs when it wants some narrowly focused research applications to address a particular topic area–in this case, an RFA titled, “Measures and Determinants of Smokeless Tobacco Use, Prevention, and Cessation.” The RFA is a special invitation to submit a grant tailored to it. Full text here: http://grants.nih.gov/grants/guide/rfa-files/RFA-CA-08-024.html.

Most of the RFA contains instructions on how to apply, but the most important piece of information is listed in the executive summary under “purpose.” This text describes what the issuers of the RFA want in an application and helps explain the rubber stamp of the review committee.

“The overall goal is to develop an evidence base to inform smokeless tobacco control efforts, and to develop effective ways to limit the spread and promote cessation of smokeless tobacco use.”

There you have it. From the very beginning the federal government, in the form of the National Cancer Institute, deliberately solicited applications for the express purpose of figuring out how to “limit the spread” of smokeless tobacco, especially for smokers who might fall into the fictitious trap of dual use in an attempt to switch. They formed a review committee that would stick to the flawed central premise of the RFA. The premise was right in Popova and Ling’s wheelhouse, and they naturally proposed an experiment going further than merely misleading smokeless tobacco users with false labeling, but adding some graphic and disturbing images to boot. You can fault Popova and Ling’s ignorance of good scientific practice, and their shameless attempt to use their wreck of a study in a shabby attempt to influence FDA policy. But you can’t accuse them of failing to deliver exactly what the government wanted.

Peer review – are they really even trying anymore?

by Carl V Phillips

As part of our research on journal peer review in public health — the practice and interpretation of which is a dire threat to THR and other policies based on good science — my colleagues and I found ourselves contemplating this report at Retraction Watch from March, about BioMed Central (BMC) retracting 43 published articles for improprieties in the peer review process. We were bitterly reminded of BMC’s lack of retraction for the travesty of an article by Lucy Popova and Pamela M Ling in BMC Public Health. Those authors claimed that they had demonstrated that harsher warning labels about smokeless tobacco and e-cigarettes were warranted, when actually their results — such as they were — supported the opposite conclusion. You may recall from my previous posts that the Popova-Ling paper was excoriated as unethical, utterly useless, and misleading by me, Brian Carter, Clive Bates, and others. The journal considered retracting it after our complaints, but ultimately decided that was all fine by them. Continue reading

TPSAC meeting on Swedish Match MRTP application: is there a scientist in the house?

by Carl V Phillips

The FDA just concluded the meeting of their Tobacco Product Scientific Advisory Committee (TPSAC) to review the MRTP application by Swedish Match to change the incorrect warning labels on their smokeless tobacco products. They applied for removal of the warnings that say that the products cause diseases that they do not actually seem to cause (meaning: to a measurable degree, of course) and to replace them with a warning statement that says while no tobacco product is safe, these are substantially lower risk than smoking. (Background on that here, here, and here.) In other words, they were asking to be able to state something that is beyond doubt and not be forced to make claims that are not supported by the science.

So how do you think this extremely reasonable and clearly valid supplication to the FDA went? Continue reading

A real peer review of Hughes et al paper on teenage use of ecigs

by Carl V Phillips

As I alluded to in the previous post, I am working on a project to review the quality of peer review of papers in the THR space. The first step in that is to write a review of the original submission to the journal. It will then be compared to what the journal’s reviewers actually wrote. It just so happens that a paper that came out today and that is currently dominating the chattering on the topic — “Associations between e-cigarette access and smoking and drinking behaviours in teenagers”, by Karen Hughes, Mark A Bellis, Katherine A Hardcastle, Philip McHale, Andrew Bennett, Robin Ireland, and Kate Pike — happens to fit the criteria for inclusion in our study. So I went ahead and wrote my review of it so I could share it before everyone moves on to a new shiny object du jour. Continue reading