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Context: Many journals provide peer reviewers with written instructions regarding review criteria, such as the originality of results, but little research has been done to investigate ways to improve or facilitate the peer review task., Objective: To assess the value that peer reviewers place on receipt of supplemental materials (eg, abstracts of related papers and preprints of related unpublished manuscripts)., Design: Questionnaire survey sent to all 733 peer reviewers recruited by the Journal of the National Cancer Institute to review 356 manuscripts consecutively sent out for review from February 24, 1997, through January 16, 1998. The inclusion of supplemental materials with manuscript review packages was optional., Main Outcome Measure: The peer reviewers' assessment of the actual or potential usefulness of supplemental materials on the performance of peer review., Results: A total of 481 (66%) of 733 questionnaires were returned. Of the 471 respondents' questionnaires that could be used, 217 (46%) indicated that they received abstracts, and 44 (10%) of 458 respondents indicated that they received preprints. Higher proportions of peer reviewers who received supplemental materials than those who had not received them felt that they were (or would be) useful to them when reviewing the manuscript (63% [95% confidence interval (CI), 57%-69%] vs 45% [95% CI, 38%-52%]; P<.001) and to the peer review process in general (80% [95% CI, 75%-85%] vs 64% [95% CI, 58%-70%]; P<.001)., Conclusion: The majority of respondents indicated that supplemental materials helped (or would have helped) them evaluate manuscripts and valued them more highly when they actually received them.

Context: Biomedical manuscripts undergo substantive change as a result of the peer review and editorial revision processes., Objective: To characterize quantitatively problems in manuscripts identified during peer review and changes made to address these problems., Design and Setting: Descriptive analysis of manuscripts submitted to and articles published by the Annals of Internal Medicine. A taxonomy of problems that occur in reporting clinical research was developed from analysis of changes made to 7 manuscripts between submission and publication (published October 15, 1996, and November 1, 1996). The taxonomy was used to characterize changes to 12 additional manuscripts (published January 15, 1997, to April 1, 1997)., Main Outcome Measure: Types of problems necessitating changes to manuscripts during peer review and revision., Results: Changes occurred because of 5 types of problems: too much information, too little information, inaccurate information, misplaced information, and structural problems. Changes most often occurred because information was missing or extraneous. The distribution of changes seemed to be influenced by the type of information involved (such as background or conclusions)., Conclusion: The proposed framework may be useful for characterizing quantitatively the effects of peer review and for comparing those effects across editors, journals, and specialties.

Context: Review articles are important sources of information to help guide decisions by clinicians, patients, and other decision makers. Ideally, reviews should include strategies to minimize bias and to maximize precision and be reported so explicitly that any interested reader would be able to replicate them., Objective: To compare the methodological and reporting aspects of systematic reviews and meta-analyses published by the Cochrane Collaboration with those published in paper-based journals indexed in MEDLINE., Data Sources: The Cochrane Library, issue 2 of 1995, and a search of MEDLINE restricted to 1995., Study Selection: All 36 completed reviews published in the Cochrane Database of Systematic Reviews and a randomly selected sample of 39 meta-analyses or systematic reviews published in journals indexed by MEDLINE in 1995., Data Extraction: Number of authors, trials, and patients; trial sources; inclusion and exclusion criteria; language restrictions; primary outcome; trial quality assessment; heterogeneity testing; and effect estimates. Updating by 1997 was evaluated., Results: Reviews found in MEDLINE included more authors (median, 3 vs 2; P<.001), more trials (median, 13.5 vs 5; P<.001), and more patients (median, 1280 vs 528; P<.001) than Cochrane reviews. More Cochrane reviews, however, included a description of the inclusion and exclusion criteria (35/36 vs 18/39; P<.001) and assessed trial quality (36/36 vs 12/39; P<.001). No Cochrane reviews had language restrictions (0/36 vs 7/39; P<.01). There were no differences in sources of trials, heterogeneity testing, or description of effect estimates. By June 1997, 18 of 36 Cochrane reviews had been updated vs 1 of 39 reviews listed in MEDLINE., Conclusions: Cochrane reviews appear to have greater methodological rigor and are more frequently updated than systematic reviews or meta-analyses published in paper-based journals.

Offers a news brief related to medicine from March 5, 1904. Report on a proposition that banking institutions disinfect all paper currency; Discussion of sanitation; Fight against tuberculosis and other infectious diseases.

JAMA has decided to publish a theme issue on infectious disease and immunology to help focus the attention of the medical community on novel research and to provide clinicians with new information on infectious diseases. Authors have been invited to submit papers and manuscripts on any topics pertaining to the biology, etiology, epidemiology, prevention, diagnosis or treatment of infectious diseases and immunological disorders.

The epidemic of intentional injury continues to be a leading cause of premature death in America. The ravages of violence are particularly devastating within the minority community. With this position paper from the Surgical Section of the National Medical Association (the country's oldest and largest organization of minority physicians), a group of trauma surgeons and surgical intensivists resolve to focus on underused violence prevention opportunities and to extend their spheres of influence beyond the walls of their institutions and emphasize violence prevention activities.

Paper patch myringoplasties are commonly performed in children at the time of ventilation tube removal, yet no series documenting their efficacy appears in the otolaryngology literature. Over an 18-month period at the Children's Hospital of Philadelphia (Pa), 163 ventilation tube removals were performed on 131 children aged 1 to 18 years. In 95 of these ears, a paper patch myringoplasty was performed after tube removal. No significant difference (87% vs 85%) in the overall healing rate at 6 months was shown between these two groups. An analysis of the variables potentially affecting outcome revealed that healing following simple tube removal was influenced by the frequency of tube placement and by tube size. Paper patch myringoplasty significantly improved outcome (93% vs 61%) in ears with more than three previous tube placements.

A conference paper about the physical and psychosocial complications of obese adolescents as illustrated by the case of a 14-year-old girl with a body mass index of 40, is presented. It assesses the effectiveness of pediatric obesity treatment and describes novel strategies to alter energy balance. It also explains the important role that parents should play on weight behaviors of their adolescents. In addition, it details behaviors that may promote successful long-term weight management.

ABSTRACT: We report two cases of recurrent episodes of hoarseness, cough, flushing, pruritus, and rash occurring within 30 minutes of topical exposure to carbonless copy paper. Provocative challenges revealed that alkylphenol novolac resin was the ingredient responsible. Video endoscopy of the larynx was performed and plasma histamine levels were obtained prior to and 30 minutes after cutaneous challenge of a patient with alkylphenol novolac resin. We documented marked laryngeal edema and a sixfold increase in plasma histamine levels after challenge. We conclude that topical exposure to carbonless copy paper may cause mast cell/basophil-medicated acute systemic and potentially live-threatening reactions in susceptible patients.

The editors of the Journal of the American Medical Association (JAMA) are calling for researchers and physicians to submit articles for the 1999 Global Theme Issue "Impact of New Technologies in Medicine." Technology in medicine contributes greatly to diagnosis and treatment, but presents moral, ethical, economic, and patient satisfaction issues which must be addressed.