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We thrive on feedback at the BMJ, and boy do we get a lot of it—some invited, some not, much of it in the form of friendly criticism (we like that), some of it rude (that can be ok too), most of it replied to (I hope), much of it posted on bmj.com, all of it useful in one way or another.
Recently we inadvertently hit on a rich source of accidental feedback, from authors in the first flush of rejection. As advised by the International Committee of Medical Journal Editors, we send emails to all authors on a paper so they know what's going on and no one is listed as an author without knowing about it (this does happen). Stung by our rejection email, some authors hit “reply all” and let fly their invective. “Miserable gits,” wrote one author to his colleagues. “Pearls before swine,” wrote another.
We've done what we can to close this accidental feedback loop (with some reluctance I admit) by warning authors not to hit “reply all” unless they want to share their disappointment and disparagement with us—but not before receiving important accidental feedback from one of our advisers (our rejection letters know no bounds). “Drats!” she wrote. and “I did not realise that NICE pays the BMJ to get things in.” Blimey, nor did we, but I'm glad to have found out that some people might think this. Our friend had been at an international meeting at which someone criticised the BMJ for publishing NICE guidelines, saying it was a commercial arrangement with no peer review.
So just in case you thought we did, we don't take money from NICE, or from anyone whose work we publish. Feedback (there we go again) from readers indicated that summaries of guidelines would be helpful. Clinicians don't read guidelines—and who can blame them, faced with hundreds of pages and unsearchable pdfs. So we approached NICE about summarising some of their new guidelines as soon as possible after they are published. Perhaps we should. This is an experiment, like so much of journal editing. If readers like these summaries, we'll do the same with evidence based guidelines from other national bodies. We are already in discussion with several.
The fact that we publish the summaries doesn't mean we endorse the guidelines, but we agree with the process behind them. We've published criticism of NICE in many forms, but regular readers will not have missed the fact that we are broadly in favour of NICE. We think it is A Good Thing, of national and international importance, and deserving of support. This week, support comes from several quarters. Alan Watson (doi: 10.1136/bmj.39309.423542.80) gives his take on the NICE guideline on urinary tract infection in children (doi: 10.1136/bmj.39286.700891.AD), John Appleby and colleagues ask why NICE should be required to set and defend an NHS-wide cost effectiveness threshold—they propose an independent threshold committee like the UK's Monetary Policy Committee (doi: 10.1136/bmj.39308.560069.BE), and in the wake of its criticism of NICE's Aricept decision, Iain Chalmers challenges the Alzheimer's Society to come clean about its links with the drug industry (doi: 10.1136/bmj.39309.704016.BD).