DDW 2006 - Perspective*|
During the past DDW three issues hit me particularly hard. First, many decisions by physicians in the United States are made not from the basis of evidence, but from fear of litigation. For example, although there is scant evidence that screening for Barrett's esophagus and surveying if found is beneficial, most physicians do so for fear of “missing” esophageal adenocarcinoma. As another example, consider the patients who attend an emergency room following head injury. Who among them is not the recipient of a CT scan or MRI scan?
Second, I found increasing evidence of “data dribbling”. This is the habit of dividing one's research into multiple abstracts rather than submitting one complete abstract. Is this done to maximize the chance of having at least one abstract accepted? Do abstracts really “count”? Regardless of the immediate cause, the over-arching responsibility must lie with the acceptance of so many abstracts by the participating organizations.
Third, and another result of very high acceptance rates of abstracts at DDW, is a general decline in quality of work presented. At one session I attended, each abstract had a major flaw, often related to inadequate consideration of sample size. While poor methodology and overblown conclusions may be a result of poor, or no, mentoring of young investigators, why must this work be accepted for such a major meeting?
The first of these issues will not be resolved until fear of litigation is no longer prevalent. The latter two will not be resolved until, and if, the participating organizations of DDW show some restraint. Bigger (the meeting) is not necessarily better.
This article was first published on GastroHep.com on 8 July 2006.