The last decades saw remarkable change in the way healthcare professionals generate and consume medical knowledge. Information management technologies have evolved considerably, yet medical publications continue to use a referencing system that has changed very little since the turn of the 20th century. Research suggests that up to one in five referenced claims quotes the original text inaccurately. Many authors, perhaps inadvertently, contribute to this process by citing non-primary data and amplifying the errors of their predecessors. Erroneous claims are propagated, accumulate into false belief systems and generate inaccurate knowledge. Updating the referencing system to provide additional information to support each referenced claim (eg, the location of the referenced statement in the original text and the nature of that text) could, perhaps, address this cycle of inaccuracy. We believe such changes in the referencing system would prompt authors to rigorously verify referenced claims and provide readers with context to inform a critical evaluation of the text. We detail our proposal for changes in the notations used for referencing, as well as in the information provided within reference lists. We also discuss some barriers and solutions to the adoption of our proposal.
- medical journalism
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Contributors RB is a family physician; he is head of ’Plotkin' clinic in Clalit Health Services (CHS; Israel’s largest non-for-profit health provider), the secretary of the Israeli Society for Reduction of Overdiagnosis (ISROD) and a researcher at the Office of the Chief Physician at CHS and at the Sackler department of Medicine in the Tel Aviv University. MAS is an associate professor of Medicine at Beth Israel Deaconess Medical Center and at Harvard Medical School. YS is a family physician at CHS, a researcher at the Office of the Chief Physician at CHS and the Department of Noncommunicable Disease Epidemiology at the London School of Hygiene & Tropical Medicine. The article arose from discussion and observations of RB and YS regarding the difficulties and challenges of interpretation and application of current medical evidence. RB conceived the original concept. Literature search and drafting of the manuscript were performed by RB and YS. MAS contributed to the development of the idea. All authors participated in critically revising of the manuscript, approved it, and agree to be accountable for all its aspects. RB and YS are the guarantors of this article.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Patient consent for publication Not required.