Friday, July 09, 2004

Dr. Ostrovsky of EchoJournal and I have been sharing emails about medblog honesty. He emailed me a few days ago. After some pleasantries about my trauma ultrasound post he writes :
Also, here is something that's been bothering me for sometime. Bloggers have already started to put up medical case reports. I do it. You do it. But here is the problem. How do we know and how do people know that they can trust these case reports and research? One day some crazy medical blogger will put up some lies, and all medbloggers might end up with the spoiled reputation. In my opinion, we have to come up either with some type of code of conduct for medical blogs, or some kind of medical blogger "society". We need to protect our reputation, and we need to look trustworthy even in this early stage of blog evolution. Please let me know what you think. Do you think it is an issue that we even need to be worried about?
My reply:
Dr. Ostrovsky:
Your email brings up a good point, who do you trust?
I find it useful to divide the medical reporting in blogs in to two groups: commentary on published material and anecdotal reports.
Commentary on published material, be it in the peer-reviewed literature or in the lay press, is easy to evaluate as any blogger worth their salt will provide, or attempt to provide, a link to the source material. The blogger may editorialize their view about the story and commenters or other bloggers may take them to task. With the source material being linked it becomes an issue of "we report, you decide".
Anecdotal case reports are another case entirely. If I claim that I am cloning people in my garage or performing brain transplants, that doesn't come close to passing the smell test. Other cases are not so clear cut. Claims of "this treatment worked for me so everyone should do it" should be viewed with a jaundiced eye. Stories of patient interactions, such as the one I posted on 6/28, have to be taken in context with other postings. If you think that the blogger is an otherwise straight shooter, then posts such as that may be taken at face value. When discussing clinical scenarios and patients there is, and must be, some "filtering" of the facts to protect confidentiality. What about those of us who post using a pseudonym (including myself)? Can they be trusted?
As far as a "code of ethics" is concerned that would be a nice thing, but probably not practical. Who would write it? Who would enforce it? How? Strongly-worded censure posts? De-linking? My opinion is to let the readers be the guide. If someone puts a great deal of B.S. on their blog people will call them on it, and if it continues they will be ignored.
As with everything on the internet the watchword is: caveat emptor.

Discuss amongst yourselves.
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