e-patients.net is a blog published by the Society for Participatory Medicine, a 501(c)3 public charity devoted to promoting the concept of participatory medicine by and among patients, caregivers and their medical teams.  Receive RSS feeds and learn more about the Journal of Participatory Medicine or epatients.net contributors.  Today’s blog post was contributed by Dave deBronkart, also known as “e-patient Dave”.

There’s an extraordinary new article in The Atlantic, “Lies, Damned Lies, and Medical Science.”  It echoes the excellent article in our Journal of Participatory Medicine (JoPM) one year ago this week, by Richard W. Smith, 25 year editor of the British Medical Journal: In Search Of an Optimal Peer Review System.

JoPM, Oct 21, 2009: “…most of what appears in peer-reviewed journals is scientifically weak.”

Atlantic, Oct. 16, 2010: “Much of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong.”

JoPM, 2009: “Yet peer review remains sacred, worshiped by scientists and central to the processes of science — awarding grants, publishing, and dishing out prizes.”

Atlantic, 2010: “So why are doctors—to a striking extent—still drawing upon misinformation in their everyday practice?”

Dr. Marcia Angell said something just as damning in December 2008 in the New York Review of Books: “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines.  I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.”  (Our post on Angell is here.)

What’s an e-patient to do?  How are patients supposed to research if, as all three authorities say, much of what they read is scientifically weak?

More problematic, what’s an e-patient to do when doctors commonly insult them, saying “You don’t know how to research – stick to peer reviewed journals”?  You know what reaction patients get when they question those journals?  Commonly, doctors’ eyes roll.  Both are reasons why we’ve covered this subject forever.

I haven’t read the full Atlantic article yet, but today it was the buzz of Twitter.   I’ve asked for a post by Peter Frishauf, who authored a great commentary on Smith’s article last year: Reputation Systems: A New Vision for Publishing and Peer Review.  Stay tuned.