John R. Adler, Jr., MD, CEO & Editor-in-Chief Cureus.com;
Dorothy & TK Chan Professor, Emeritus, Stanford University
Q: CollabRx, and its “sister” not for profit organization “Cancer Commons”, are dedicated to rapid dissemination and implementation of the best evidence to improve cancer care. The National Academy of Medicine has called for the building of rapid learning communities. How can your company and journal “CUREUS” help facilitate these efforts?
A: CollabRx is dedicated to rapid dissemination and implementation of the best evidence to improve cancer care. But where does one find such evidence? Meanwhile, the National Academy of Medicine has called for the building of rapid learning communities. Yet what is the vehicle for such physician interaction? The answer to both of the above questions is peer-reviewed journals, which are the foundation for most scientific communication. Unfortunately the processes inherent to traditional medical journals undermine these very objectives, i.e. the “rapid” dissemination and “rapid” learning of critical knowledge. I would like to argue here that our reflexive reverence for conventional processes for curating peer reviewed knowledge can and is holding back better cancer treatment.
Modern medicine prides itself for being grounded in the scientific method, and looks to science as the only credible mechanism for improving cancer care. However, it is also important to remind our collective selves that the first step in the scientific method starts with observation, and in the case of cancer, much of this is clinical observation. Because most clinicians are ill equipped to take “bedside” observations and turn them into practical new cancer therapies, (a complex task often requiring lots of money and the backing of large organizations), it is essential that these “in-the-trenches” physicians be able to clearly communicate their discoveries to big cancer research institutions and Pharma. Traditionally this communication happened through peer-reviewed journals, whose review processes function as a safe guard against the publication and dissemination into the mainstream of fallacious science. I would like to suggest that something new, and better, might be afoot.
Burdened by their long legacies as vehicles for academic promotion and tenure, most journals subject observational clinical science to almost the same level of scientific, statistical and documentary scrutiny as that of very complex and socially highly consequential research. Yearning for the fame that comes with publishing big scientific studies, few such “luxury” journals (as nicknamed by Nobel Laureate Barry Schekman) truly value humble clinical observations, or “small science”, as I like to term it. This innate bias represents a hurdle to the documentation and dissemination of clinical science within oncology, and by virtue of such, it undermines the advancement of cancer care itself. Recognizing this impediment to scientific communication, Cureus, a new generation medical journal was created 4 years ago which seeks to blend the traditions of peer reviewed journalism with many contemporary tools that have recently emerged from within the consumer internet. By virtue of design, technology and philosophy, Cureus has sought to streamline the publication of small science without compromising scientific quality. It accomplishes this goal by combining accelerated prepublication peer review with a never-ending “exhaustive” post publication “crowd sourced” peer review, a process referred to as SIQ (Scholarly Impact Quotient) “scoring”. To further break down barriers to the documentation of innovative clinical science, Cureus service is free for both authors and readers, many of which find the increasingly cost of subscription or publishing fees prohibitive. Just maybe, future “cures” for cancer will be reported and authenticated in Cureus, thereby helping CollabRx and the National Library of Medicine to better live up to their own missions.
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