Social Media and the Dissemination of Prepublication Data in Surgical Fields

Akhavan, Arya A.; Ndem, Idorenyin E.; Kalliainen, Loree K.

Embargos on the release of prepublication data have been in place in journals for 5 decades, but this practice has not been universally adopted by surgical journals. The "Ingelfinger rule," created in 1969 by the editor of the New England Journal of Medicine, was originally designed to The subsequent editor encouraged this rule specifically to discourage public disclosure of research results in a nonscientific forum before the peer-review process. 1 However, the value of prepublication data, and the harms and benefits it may pose, were widely discussed even before the public spread of social media. A key example is Mayo Clinic's 1997 prepublication release of data linking fenfluramine-phentermine ("fen-phen") to severe cardiac valvular disease. 18 The New England Journal of Medicine waived the Ingelfinger rule and allowed a large-scale public press conference releasing the prepublication data specifically due to the immediate implications for the health of patients taking fen-phen, 7 which ultimately proved correct after peer review and publication. Publication of the data only took 7 weeks, but in that time frame, clinical practices rapidly changed, and the drugs were widely deprescribed. Similar rapid and accurate changes in clinical practice occurred with the North American Symptomatic Carotid Endarterectomy Trial (NASCET) trials investigating carotid endarterectomy; prepublication data were disseminated at conferences, in medical alerts, and in newspapers, with rapid changes in practice throughout North America before peer-reviewed publication. 9 In counter, during the Severe Acute Respiratory Syndrome (SARS) epidemic, 93% of publications regarding SARS were not released until after the epidemic was over, preventing public health officials and government agencies from having the most accurate and expedient treatment recommendations. 10 For these specific cases, clearly, prerelease data served or would have served the target patient population well.