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J R Soc Med. 2006 October; 99(10): 485.
PMCID: PMC1592060

Response to ‘Lapses at the NEJM’

‘Lapses at the New England Journal of Medicine’ (August 2006 JRSM1) overlooks the most salient message of the recent Vioxx matter: authors must take responsibility for the integrity of their work. Integrity is not defined by what an author can get past an editor. It is the indisputable obligation of researchers to include all relevant data in manuscript submissions—especially in research involving drug safety.

The VIGOR authors, two of whom were Merck employees, withheld critical data on the cardiovascular toxicity of Merck's drug Vioxx. As soon as we learned that the authors knew of these data well before the article was published, we began preparing our Expression of Concern. By bringing this matter to public attention, we underscored its importance.

The tale Smith tells is riddled with distortions and unsubstantiated opinions. These inaccuracies seem designed to serve an agenda he already has put forth: that journals are information-laundering vehicles for industry, a cynical view that we do not share.

We stepped forward when we did, exposing ourselves to criticism, for the sake of open and honest discourse between authors and editors. Smith contends that medical journals have been damaged and the NEJM has been embarrassed. To the contrary, we are proud of our actions. We wanted to serve our readers by correcting the record and to affirm with authors the importance of accuracy and completeness. On the second point, we already have seen authors taking greater care to ensure the completeness of their submissions.

Journal editors can publish only those data that are submitted to them. Editors have no subpoena powers. While it is untenable to expect editors to root out data that researchers are intent on hiding, editors must defend their academic mission and hold authors accountable. That mission is based on fundamental principles of integrity, trust, and open communication between authors and editors.


Competing interests Dr Drazen is the Editor-in-Chief of the NEJM.


1. Smith R. Lapses at the New England Journal of Medicine. J R Soc Med 2006;99: 380-2 [PMC free article] [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press