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On-line version ISSN 1980-5497
Rev. bras. epidemiol. vol.11 no.4 São Paulo Dec. 2008
LETTER TO THE EDITOR CARTA AO EDITOR
Departamento de Medicina Preventiva - Faculdade de Medicina da Universidade de São Paulo Av. Dr. Arnaldo 455 São Paulo - SP CEP: 01246-903
Dear Editors, although not regarding material published in the Revista Brasileira de Epidemiologia, I submit this letter reporting what happened with correspondence (reproduced below) submitted, on January 29, 2008 for publication in the New England Journal of Medicine, about a paper published by the NEJM.
"To the Editor: In their report on outcomes in athletes, Pelliccia et al. (Jan. 10 issue)(1) described their study as a matched case-control study. In fact, it was a cohort study designed to evaluate long-term clinical outcomes in young athletes presenting marked electrocardiogram (ECG) repolarization abnormalities. The authors compared athletes presenting such abnormalities with those presenting normal ECGs.
As shown in Figure 2 of the paper, among the athletes presenting marked ECG repolarization abnormalities, those who were followed for only 1 year were included. Why, then, did the authors exclude those with normal ECGs who were monitored for less than 3 years? In Discussion, there is no mention of any limitations of the study. At the very least, the authors should have addressed the potential selection bias, as well commenting on the generalizability of the results."
On February 26 I received the following message from the Deputy Editor: Thank you very much for your letter to the editor regarding the paper by Pelliccia et al. (Outcomes in Athletes with Marked ECG Repolarization Abnormalities. N Engl J Med 2008; 358: 152-61). The error you have identified was introduced during the editorial process, and we will publish a correction in an upcoming issue of the Journal.
On February 28 I asked whether they would publish my letter with a correction. On February 29 the Manager of Editorial Administration answered that she regretted to inform that my letter was not selected for publication, and a formal correction notice would be published in a forthcoming issue of the Journal, in the Corrections section.
On March 7 I sent the following message: I think my letter should be published. It is very unlikely that the error I have identified was introduced during the editorial process. In fact, I cannot believe that the study design description was changed from cohort to a matched case-control study during an editorial process in the NEJM. Furthermore, in the letter I have pointed out other problems in the paper: "In Discussion, there is no mention of any limitations of the study. At the very least, the authors should have addressed the potential selection bias, as well commenting on the generalizability of the results."
So far (October 23), no correction of the paper has been published. Furthermore, in the current NEJM issue (October 23), there is a correction of a paper published on the 10th of July. In my view, the Journal does not want to admit that a paper with the deficiencies pointed out in my letter had been accepted for publication. It is important that such a journal behavior be known by readers and authors.