Domhnall MacAuley: Storm clouds and research

Domhnall MacauleyOn an island off the west coast of Ireland, I picked up a discarded newspaper while sheltering in a bar. Browsing through, I came across an article about physical activity and depression. Based on a BMJ paper—a randomised controlled trial on promoting activity in depressed patients—it discussed the findings at length. A few days off far away from the daily editorial grind but, you can never escape.

The findings were a little unexpected. Much of the previous research suggested those who exercise are less depressed—but, that did not mean that advising patients about physical activity could improve depression. The news made international headlines and was picked up in the general media all over the world. The paper has been one of the most read and most commented upon in recent weeks and not without controversy. As I write there are 29 rapid responses on the BMJ website and the full paper accessed almost 24,000 times. The rapid responses vary from the critical to the incredulous—and the authors have responded. It is fascinating to see post publication peer review at work and it is certainly worth a look.

This is the story. I first heard preliminary work presented to a group of primary care researchers at a meeting in Canada in November. It was a short presentation but, in spite of some weaknesses, it was clearly an important piece of research….even if I, as a physical activity advocate, felt a little uncomfortable with the conclusion. It was good to see it submitted to the BMJ and I was part of the discussions at our editorial meeting. But, the story doesn’t end here. This paper, together with two others has been selected as a plenary lecture for next week’s WONCA Europe meeting in Vienna. It will be fascinating to see how the paper is presented after such extensive post publication peer review and intensive scrutiny.

Sheltering from the unexpected summer squalls on Sherkin Island, (and unaware of the media storm) I hadn’t expected to come across this paper in the “Irish Examiner.” But medical journal articles travel widely and quickly. It was a useful reminder of the importance of the editorial process and how the decisions we make in selecting papers for publication have widespread impact. This paper has travelled from its pre-submission form in Banff (Canada), via the editorial process and post publication peer review coordinated in London (UK),  to be presented as a major plenary lecture in Vienna (Austria) and has been, analysed, appraised, praised, and criticised across the world.

And, the newspaper report digested at length with a delicious bowl of seafood chowder among the seagulls and storm clouds of west Cork. The BMJ turns up everywhere.

Domhnall MacAuley is primary care editor, BMJ