Unjustifi Ed Restrictions on Letters to the Editor Editors' Reply Box 1. " Editors Should Promote Self-correction in Science and Participate in Efforts to Improve the Practice of Scientifi C Investigation By

Douglas G. Altman Editors of medical journals accept that published research should be open to comment and correction in published correspondence ([1]; Box 1). “Post-publication peer review” enables comments on, clarifi cations of, and corrections to published research. All journals should have a correspondence page for this purpose. I previously criticised the effective “statute of limitations” in several leading general medical journals “whereby authors of papers are immune to disclosure of methodological weaknesses once some arbitrary (short) period has elapsed” [2]. Such a time limit discourages post-publication peer review, with potential correspondents deterred by the short and unambiguous deadline. I suggested that journals with such a policy should reconsider. The word limit on that article precluded additional adverse comments on journals’ word limits for letters, although they were presented in Table 2 of that article [2]. Subsequently, three of the six journals did revise their instructions [3–5], but each imposed tougher restrictions on letters, reducing either the maximum time limit, the maximum length, or both. The strictest current requirements are a two-week limit by The Lancet and a 175-word limit by the New England Journal of Medicine. Editors are seemingly falling over themselves to speed up and shorten letters, but this behaviour is inappropriate for a scientifi c journal. The key characteristic of science is not its infallibility, a quality it clearly does not and cannot have, but its self-correcting ability. The decision by medical editors to stifl e debate is misguided [2,6]. A time limit, especially a very short one, signals that speed is more important than content, that convenience takes precedence over science. While it is reasonable to encourage early comments, there should be no time limit on comments aimed at clarifying or criticising study methodology. Likewise, it will often be impossible to explain the subtleties of methodological problems in 400 words, and impossible in only 175. Additional restrictions on the number of authors and references are also questionable. I am disappointed that PLoS Medicine has imposed a time limit of four weeks on correspondence. As explained above, I believe that such a limit is mistaken. The word limit of 750 words is generous by comparison to established general medical journals, but even this should be open to fl exibility should the circumstances merit it. In this world of Web-based journals and Web pages for print journals there is no real cost to permitting longer and later letters on the web while keeping the print version timely and terse.

[1]  Kenneth Lange,et al.  In the Garden of Branching Processes , 2004, SIAM Rev..

[2]  B. Schwartländer,et al.  The HIV/AIDS epidemic in eastern Europe: recent patterns and trends and their implications for policy-making. , 1999, AIDS.

[3]  N. Sewankambo,et al.  The incidence of HIV-1 associated with injections and transfusions in a prospective cohort, Rakai, Uganda , 2004, AIDS.

[4]  S. Gregson,et al.  Informal confidential voting interview methods and temporal changes in reported sexual risk behaviour for HIV transmission in sub-Saharan Africa , 2004, Sexually Transmitted Infections.

[5]  D. Kendall On the Generalized "Birth-and-Death" Process , 1948 .

[6]  Stuart Brody,et al.  Let it be sexual: how health care transmission of AIDS in Africa was ignored , 2003, International journal of STD & AIDS.

[7]  L. Simonsen,et al.  Unsafe injections in the developing world and transmission of bloodborne pathogens: a review. , 1999, Bulletin of the World Health Organization.

[8]  J. Potterat,et al.  Establishing valid AIDS monitoring and research in countries with generalized epidemics , 2004, International journal of STD & AIDS.

[9]  S. Brody Declining HIV rates in Uganda: due to cleaner needles, not abstinence or condoms , 2004, International journal of STD & AIDS.

[10]  J. McCormick,et al.  The relationship between therapeutic injections and high prevalence of hepatitis C infection in Hafizabad, Pakistan , 1997, Epidemiology and Infection.

[11]  J. T. Boerma,et al.  Monitoring sexual behaviour in general populations: a synthesis of lessons of the past decade , 2004, Sexually Transmitted Infections.

[12]  J. Potterat,et al.  HIV epidemicity in context of STI declines: a telling discordance , 2002, Sexually transmitted infections.

[13]  R. Anderson,et al.  For Personal Use. Only Reproduce with Permission from the Lancet Publishing Group , 2022 .

[14]  Jean-François Guégan,et al.  Climate Drives the Meningitis Epidemics Onset in West Africa , 2005, PLoS medicine.

[15]  J. Potterat,et al.  HIV Epidemiology in Africa: Weak Variables and Tendentiousness Generate Wobbly Conclusions , 2005, PLoS medicine.

[16]  Y. Hutin,et al.  The global burden of disease attributable to contaminated injections given in health care settings , 2004, International journal of STD & AIDS.

[17]  J. Potterat,et al.  Still not understanding the uneven spread of HIV within Africa. , 2004, Sexually transmitted diseases.

[18]  D. Brewer,et al.  Mounting anomalies in the epidemiology of HIV in Africa: cry the beloved paradigm , 2003, International journal of STD & AIDS.