Press releases Monday 1 February to Friday 5 February 2010

Please remember to credit the BMJas source when publicising an article and to tell your readers that they can read its full text on the journal's website (http://www.bmj.com).

(1) International relief efforts remain fragmented, warn doctors
(2) The Lancet should formally retract the Wakefield MMR study

(1) International relief efforts remain fragmented, warn doctors
(Feature: Appropriate response to humanitarian crises)
http://www.bmj.com/cgi/doi/10.1136/bmj.c562

Despite the frightening regularity of humanitarian disasters like the earthquake in Haiti, international responses remain fragmented and must be improved, argue a group of trauma surgeons on bmj.com today.

They warn that an uncoordinated push to get people and equipment into the affected zone as soon as possible can worsen the situation and reduce the effectiveness of relief efforts.

They also advise anyone thinking about volunteering to join an established group and obtain appropriate training to enable them to function in a disaster zone.

Many healthcare professionals from developed countries do not know what to do when faced with the horrors of a major humanitarian disaster, so proper preparation is key to providing prompt relief, write Dr Charles Krin and colleagues.

In the US, volunteers are required to undertake a National Incident Management System (NIMS) course so that they are aware of the likely systems and where they will fit in to the system. Other countries run similar programmes. Passports and immunisations also need to be kept up to date.

Medical volunteers should have a basic understanding of field and trauma medicine, be able to treat wounds and fractures with limited equipment and in non-sterile conditions, and know basic field sanitation and water purification techniques.

These measures will help avoid well intentioned but sometimes misguided help from uncoordinated and untrained people that can hamper relief efforts, say the authors.

Surely, we have learnt enough from the natural disasters of the last few decades to allow us to set priorities and offer a reasonably coordinated international relief effort the next time this happens, say the authors.

They call for international dialogue to explore ways to improve the response to these events.

"We have a perfect opportunity in Haiti to work towards true international cooperation," they conclude. "The Haitians will benefit from a long-term commitment to rebuilding, and the world medical community will benefit from the lessons learned when next we are called upon to provide disaster relief."

Contact:

Charles Krin, Retired Family and Emergency Physician, Salem, Missouri, USA
Email: Krin135@aol.com

Andrew Wakefield's now infamous MMR study should no longer be referred to as a "scientific" paper, and should be formally retracted by the Lancet, argues Professor Trisha Greenhalgh from University College London in this week's BMJ.

The story of the study, published by the Lancet on 28 February 1998, is well known, and led to the longest Fitness to Practise Panel hearing in the General Medical Council's history.

In a judgement published last week, the GMC declared that invasive clinical tests on children in the "Lancet 12" group were undertaken without proper ethics committee approval and without due regard to their clinical needs. Wakefield's presentation of the referrals as consecutive and routine was also deemed "dishonest," "irresponsible," and was found to have "resulted in a misleading description of the patient population in the Lancet paper."

Professor Greenhalgh points to the Committee on Publication Ethics guidelines (http://publicationethics.org/guidelines), which recommend that a journal should formally retract a paper if its findings are subsequently shown to be unreliable as a result of either misconduct or honest error or if the work turns out to have been conducted unethically.

She suggests that "the acceptance for publication of some very preliminary laboratory findings by one of the world's leading medical journals was, at the time that editorial decision was made, more a symptom than a cause of declining professional and public confidence in the MMR vaccine."

But, she adds, "once the article appeared with the Lancet kitemark - cautious accompanying editorial notwithstanding - the arguments were considered by many to be proven and the ghastly social drama of the demon vaccine took on a life of its own."

As such, she calls on the Lancet's editor, Dr Richard Horton, to state that this piece should no longer be referred to as a "scientific" paper.

Contact:

Professor Trisha Greenhalgh, Department of Primary Care and Population Sciences, University College London, UK
Email p.greenhalgh@pcps.ucl.ac.uk

Late note - For immediate release: Tuesday 2 February 2010: BMJ Editor responds to The Lancet retraction of the Wakefield MMR study

Dr Fiona Godlee, Editor of the BMJ welcomes the news that The Lancet has decided to retract the Wakefield MMR study. She says: "This will help to restore faith in this globally important vaccine and in the integrity of the scientific literature."

FOR ACCREDITED JOURNALISTS

For more information please contact:

Emma Dickinson
Tel: +44 (0)20 7383 6529
Email: edickinson@bma.org.uk

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and from:

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