Surfing versus science

When we are such busy health professionals, why should we bother plowing through scientific journals like this one? There is an explosion of information out there. The Internet promises to expand and update our store of knowledge: that which was previously unpublished due to lack of space is now available on a computer screen in seconds. Increasingly, there is pressure on scientific journals to change from the peer review process and march into quick publication of data. Worldwide, the lay press is increasingly interested in publishing articles about science. Furthermore, non-health professionals may expand their knowledge base through on-line discussions. Some of these Internet sites are becoming testimonials for therapy. Parents, desperate for the latest treatment, jump on the Internet bandwagon and next thing you know they are headed to another city, for another opinion, in search of another therapy; a magnet here or there, that will make a difference for their child. To complement this, naive or even unscrupulous professionals fan the eagerness and enthusiasm for these new medical interventions: like Californian surfers, they ride on each new wave of treatment until it crashes, leaving the patient and their family disillusioned, disappointed, and poorer. How do we as professionals counter these untested trends? We ask for the academic rigor offered in scientific journals like Developmental Medicine & Child Neurology. While this proliferation of user-friendly information is often welcomed, particularly by those not working in the health sector, the arrival of the red journal each month certainly gives the health professional a break from the barrage of non-science out there. This journal is not a how-to manual and it is not science fiction: all articles are peer reviewed and collectively speak to us, as clinicians, in scientific language regarding the multiple problems experienced by our clinical children. It is truly interdisciplinary: just looking at the index for the journal provides an insight into some of the many areas that impact upon our patients and our cross disciplines. For instance, if a parent says that their child with delayed motor milestones, especially walking, is also having problems with learning language, we will know, from picking up this edition of the journal, that the statistics show the child would benefit from an MRI1. The lead article this month discusses Tourette syndrome and identifies the international perspective on it. The authors have established a multisite international database of 3500 people with the syndrome2. Such extensive research allows the reader a much more comprehensive understanding of this relatively common neurological problem. Freeman et al.’s in-depth approach is partly attributable to ever-improving science: research tools are better and, paradoxically, computers— the basis of the Internet— are enabling multicentered projects to be undertaken. More sophisticated education throughout the world is allowing more scientific studies; those that are double blind, placebo controlled, and prospective are especially helpful. Treatment based on hearsay and tradition has often been overturned or supported as a result of science. This is certainly true in the field of orthopaedics and, I suspect, also in such areas as developmental medicine, where improved diagnostics enable earlier detection and treatment of subtle but often disturbing problems. Indeed, a rigorous analytical approach to treatment has been recommended in the journal3,4. Medical myths which can multiply like an Internet virus are proved or disproved in this journal. Through the accumulation of the red journals over the years, many more pieces of the puzzle of developmental medicine have been put in place. The challenge to stay ahead in medical science is met by this journal, so keep reading.