In 2012’s first edition, the Ulster Medical Journal review paper considers a vital question: what precisely is the difference between a discrepancy and an error? This review has been written by a formidable quartet. Three of the authors (AB, RO‘L, PMcC) have been Deans of the Faculty of Radiologists, Royal College of Surgeons in Ireland. The fourth (RMacD) is almost certain to follow suit, should he so elect.
The review paper is written from the perspective of a radiologist, but that‘s just geography. Is there a difference between discrepancy and error, and does that difference matter?
The authors attest that one test of discrepancy is that in retrospect the same, original, conclusion would be reached with the same tools. With an error, that isn‘t the case. In fact, it is practically a sine qua non that in the case of error, a diametrically different conclusion would be reached in retrospect.
Let me be clear here. This review is not an apology for the intellectually infirm, professionally questionable, or ethically bankrupt medical practitioner. However, a distinction must be made between that which might be reasonably avoided, that which cannot be - and as Reinhold Niebuhr wrote, ‘the wisdom to know the difference’. Treating a discrepancy by victimising those implicated would seem a less logical option than using, for example, Root Cause Analysis to ascertain what actually happened and why; and whether it had been an unavoidable or potentially preventable event. Errors too, sadly, must continue to be a facet of our life, for as long as we remain human. Making a distinction between the two is in everyone‘s interests. I would urge you all to read our latest review.
HOUSE RULES
It is perhaps worth reiterating that there are two constituencies for our Journal. The first is the printed page, with around 800 copies, distributed locally and to the many libraries and academic institutions that subscribe to us. The second is the ethereal world of the internet and PubMedCentral, the US National Institutes of Health digital archive of biomedical and life sciences journal literature. My gifted predecessor, Patrick Morrison, worked tirelessly to get us onto PubMedCentral, and this presents the editorial board with a challenge as well as an opportunity.
While a local audience might be gracious about the merits of an undistinguished case report (and lets face it, that‘s how we all started), a browsing international academic, searching for specific MeSH terms might not. Equally unimpressed is the senior colleague whose name might have been unilaterally inserted on an article for all to see. This is particularly an issue when that colleague‘s peers might bring it to his attention as an example of the true calibre of his work. At that stage, the nurturing local aspect is left far behind.
Consequently, your editor will assume that everything published within these pages is visible everywhere - shouting at the world, if you will. So, in 2012 the journal will modify its instructions for authors. There will be a single electronic submission route. Each paper will have a guarantor, typically a senior author, who will assume responsibility for all aspects of the paper. Each author will be required to indicate his or her justification for authorial inclusion, and this will be by completion of an ‘Author Role, Originality, and Conflict of Interest Form’. The authors must also indicate whether ethical approval was considered necessary, and if so, when it was granted. Finally, the editorial team will assume that when revised versions of accepted papers are returned by the corresponding author, the revised version will have been agreed by all of its authors.
By definition, this process will be an evolving one, and I would envisage that the revised format will be fully functional by the end of 2012. I would also sincerely hope that these modifications are not too onerous. The revised instructions for authors will soon be available both in paper format within the journal, and also on the Ulster Medical Society website.
SOCIAL NETWORKING
I am delighted to report that our foray into social networking is proving to be a remarkable success. Please follow us on FaceBook (type ‘facebook’ into your internet browser, and then ‘Ulster Medical Journal’ in the search pane). Similarly for Twitter, follow us by typing in ‘@UMJ_Belfast’.
ACKNOWLEDGEMENT FOR REVIEWERS
I am pleased to inform you all that the Journal will begin the process of acknowledging the debt to our many reviewers by issuing them with CME credits, hosted by the Ulster Medical Society. Finally, on behalf of the editorial board, may I wish you all a peaceful and fulfilling 2012. Oh yes, and do keep sending me your good papers