Medical publishing has exploded in the past decade. There are thousands of scientific journals in print and online, but not all journals are held to the same standard. Researchers have a pressure to publish; driven by a desire for promotions, grant funding, and other personal incentives. Publishing companies have responded to this pressure by establishing new journals, some of which charge a fee to publish your research. There have been several high-profile cases of research and publication fraud. The research you read should come from a reputable journal that uses the peer-review process for publication.
Here is how the peer review process works. When someone submits their manuscript (e.g. research, case report, review article, photo, etc.) to a journal, the editor determines if it is suitable for the journal and then forwards it to 3-5 reviewers who have established expertise in that subject. The reviewers will grade the manuscript on design and methods, and study the results to judge that the authors are coming to the appropriate conclusion from their data. This process is a prerequisite to ensure reliability and accuracy.
Articles follow a generally accepted format starting with the title and list of authors. Although all authors are expected to have contributed to the manuscript, the first author is usually the lead researcher, and the last author is the senior researcher. Most articles will provide an abstract or summary of the manuscript; this can be helpful if you are reviewing many articles for a particular question. The introduction provides a background for the research, summarizing what has been done in the area and what questions are left unanswered in the field. Here, the authors will state their objectives. Next, the methods section describes the details of what the authors did and how they did it. Pay attention to what the researchers are measuring, how accurate the measurement is, and how many measurements are taken. Statistical interpretation of these measurements is complex, but in general, the bigger the study group, the better (more significant) the results. Lastly, the discussion section should conceptualize the results into the practical, real world setting. Remember that it is very difficult, nigh impossible, to prove causation. Any positive or negative results from a study should be judged as an association. As they say, falling leaves do not cause winter! Finally, the authors should describe the weaknesses and limitations of the study. A responsibly published manuscript should warn its readers of these limitations before drawing any conclusions.
There is a sea of published research to sort through when searching for an answer to a specific question. Consider the journal you read, its reputation, and what medical specialty it is affiliated with. Look at the authors and see what else they have published on the subject. Check to see what conflicts of interest they may have with the subject. Finally, if you’re stuck for an answer, Ask A Toxicologist!
Mark Neavyn, MD