The Australian Journal of General Practice inappropriately retracts two ACCO publications on melanoma commissioned by the journal's Editor in Chief.
The AJGP relied on the following "independent" review to justify retracting our two manuscripts. This is the review in full, word for word:
"I have had a brief look over the material. I have not read all the articles in full. The lead author, Dixon, is an osteopath which is a small concern. I have not heard of the Australasian College of Cutaneous Oncology. The problem you have is that it is already published. One solution would be to publish the
letter from Prof Thompson and his co-authors and the response by Dixon and argue that vigorous debate exploring different perspectives is good for science."
This review raises many more questions than it answers:
- How could this be a review by anyone responsible?
- Who could have written this?
- How could a reviewer not even bother to read the manuscripts, yet submit a review on them?
- How could any journal accept such a review let alone act on it? In this case the journal took the most drastic of all actions based on the drivel in this review.
- Why does the reviewer determine that the lead author is an osteopath? Indeed this is false. All but one of the authors are registered medical practitioners. Two authors have PhDs, including the lead author. The only author that is not a medical practitioner is a community occupational therapist who contributed the section on occupational aspects of melanoma prevention. None of the authors are osteopaths.
- Even if it were true that an author was an osteopath, why would this matter? A review is required to be about the content of the manuscript, not who may or may not have written it. This reviewer seems to think a review of a manuscript should be about the apparent eminence or otherwise of the authors.
- Why does the reviewer afford Prof. Thompson his title, but not afford titles to the manuscript authors?
- Even though the reviewer does not recommend retraction, but scientific debate, why did the AJGP falsely claim the reviewer determined that retraction was the only option?
- How can a review designed to determine the accuracy or otherwise of the material content in a manuscript make no mention at all of any content?
- A review of this type constitutes research misconduct. Why did he AJGP not immediately reject the review and commence proceedings of research misconduct against the reviewer?
- Why did the AJGP claim that serious major errors were found in the manuscript by reviewers even though not a single error was identified?
TWO OTHER REVIEWS OF OUR MANUSCRIPTS
AJGP organised two other "independent" reviews of our manuscripts. One suggested retraction of one of our two manuscripts. The other did not suggest retraction of either manuscript. None of the reviews identified any fault in either manuscripts.
Rather, both reviews focused on the apparent eminence of the letter from Prof Thompson and co-authors and the apparent lack of eminence of our team. They commented on our CVs and how apparently lacking they were. One reviewer argued that the expert opinion of Prof. Thompson should somehow trump the cited evidence based medicine that we published.
One reviewer commented that our team has never undertaken a drug trial and hence has no understanding of such trials. - That might be the case if you totally disregarded the drug trials that we have designed, had approved, implemented, completed and published in major peer reviewed journals.
12. If our team were so inadequate, lacking the expertise and experience suggested, why did the AJGP Editor in Chief request that our team write the articles in the first place?
Both these reviewers made the comment that our team were not competent to write articles of this type, because none of us have any day to day experience managing melanoma. - This despite the fact that three of our authors each have over 20 years experience managing melanoma on a day to day basis.
13. Why did the AJGP accept let alone act on such an argument?
14. Does fact checking play no part in AJGP processes?
The best quality independent medical reviews are often written by those that have no expertise in the area. Their expertise is in reviewing evidence in the literature and synthesizing its value and quality. They may seek some contextual advice from those with clinical experience, but this does not influence the reports.
The Cochrane Database System Review Collaboration is such an organization. The expertise needed is in evidence based medicine. Our team also includes evidence based medicine experts with little or no personal experience managing melanoma.
The AJGP and many major journals accept and publish manuscripts from juniors, including medical students and residents. The articles are published based on the merit of the content. The AJGP also accepts articles written to advise GPs how their practice can be improved by people who have never worked in General Practice.
15. Why does the AJGP feel that these principles no longer apply regarding our manuscripts?
1 in 6 is portayed as 6 in 6 by RACGP
In total there were three reviews of two manuscripts. One reviewer recommended retraction of one manuscript, without identifying a single fault. Yet the AJGP falsely claimed that all three reviewers insisted on retraction of both manuscripts. Somehow a 1 in 6 recommendation was turned into a 6 in 6 determination by the AJGP.
16. Why did the AJGP and the RACGP make such misleading remarks about what the three independent reviewers determined, let alone act on them?
Our team rebutted each and every point made by Prof. Thompson et. al in their letter of concern. Our full rebuttal can be found here.
Part 3 Melanoma update manuscript
The Editor in Chief of the AJGP later invited us to contribute a third and final melanoma manuscript. We did so in 2019. We are yet to hear any outcome from independent blinded reviewers regarding this submission, if indeed any such reviews were organised. As far as we can tell, this submission was invited, submitted, but never processed. We are staggered at the unprofessional and unethical approach by the journal in this regard. Manuscript 3 involved a substantial workload by our team to ensure it was thoroughly evidence based and accurate. If the AJGP did submit manuscript 3 to independent reviewers, we would like to see such reviews.
Shame on the Royal Australian College of General Practitioners and AJGP for even accepting let alone acting on these reviews.
It says very little for the standards of that RACGP and their journal the AJGP.
COVID-19 - ACCO suspends programs for 2020
- All ACCO programs including workshops scheduled for April and July 2020 have been postponed until 2021.
- The Essentials workshop will now take place on Saturday 24 and Sunday 25 April 2021
- The Dermoscopy workshop will now take place on Sunday 25 and Monday 26 April 2021
- The Combined Essentials and Dermoscopy workshops can be completed back to back on April 24 / 25 / 26 2021
- The Flap and Graft workshop will now take place over the five days: June 11-15th 2021 (including Queens Birthday weekend)
- The Face and Ear Reconstruction workshop will now take place 30 October to 1 November 2021
- The 1-Day Dermatopathology workshop will now take place Tuesday 2 November 2021.
ACCO will provide full refunds to all registrants who were hoping to attend our workshops in 2020.
You may also choose to defer your course fee to 2021.
For more information, please contact us at [email protected]
COVID - 19 Do I need to alter my skin cancer management?
As of May 20, 2020, ACCO recommends:
- Limit skin cancer checks to patients with a past history of skin cancer or marked actinic damage.
- Using gloves and hand washing is essential before and after each skin check.
- Polarised dermoscopy allows no contact between patient and instrument. This can be an advantage in these situations.
- Delay procedures to manage minor lesions and indolent skin cancers including SCC in situ and superficial BCCs.
- Surgery for wide local excision of melanoma, invasive SCC, or other BCCs should not be delayed on this basis alone.
- Consider reception triaging patients need for skin checks. Low risk patients can be asked to book at a later date.
- Any patient unwell with upper respiratory symptoms and / or fever should have a skin check deferred and should be advised to contact their local GP for advice on COVID testing, as guidelines vary between states.
ACCO understands that COVID 19 has affected all our programs in 2020. The impact in 2021 is unknown. At this stage, We plan to run all events as per normal. If COVID interferes, all registrants will receive a full refund of any registrations paid.
Your ACCO academic team continue to publish research in skin cancer.
Recent publications from the ACCO team are as follows :
- Nirenberg A, Steinman H, Dixon J, et al. Merkel cell carcinoma update: the case for two tumours. J Eur Acad Dermatol Venereol 2020:34:1425-1431
- Nirenberg A, Steinman H, Dixon A, Melanoma Extravascular Migratory Metastasis: An Important Underrecognized Phenomenon. J Eur Acad Dermatol Venereol 2020
- Nirenberg A, Steinman H, Dixon J, et al. Merkel cell carcinoma update: the case for two tumours. J Eur Acad Dermatol Venereol 2019.
- Dixon AJ, Dixon ZL, Anderson S, et al. Management of invasive melanoma. Aust J Gen Pract 2019;48:368-372.
- Dixon AJ, Anderson S, Dixon JB, et al. Cutaneous melanoma: Latest developments. Aust J Gen Pract 2019;48:348-353.