NEJM Owes Patients Responsible Journalism Says Lyme Disease Association
Jackson, NJ, October 4, 2007-The New England Journal of Medicine (NEJM) published an article October 3 titled A Clinical Appraisal of "Chronic Lyme Disease." Eleven of its authors also served on the IDSA Lyme Disease Guidelines panel which is under investigation by the Connecticut Attorney General for the development of those Guidelines.
Although the article mentions the investigation, nowhere does it disclose that these authors are under investigation. What sanctions does a journal of the stature of NEJM impose on authors who do not fully disclose?
In an unscholarly tone uncharacteristic of NEJM, the article concludes there is no chronic Lyme disease, and patients should not receive treatment. It tells doctors how to deliver that message to patients. It implicates Lyme disease groups established by "laypeople" as being part of the problem rather than part of the solution. Yet the article offers no solutions as to how to identify what these patients do have or what can be done while this issue is resolved. Worse, the article precludes the exercise of clinical judgment, which physicians usually rely on in areas of uncertainty.
NEJM is used by physicians worldwide, but this article provides an appendix of author-selected science that physicians use to deny patients diagnosis and treatment and excludes the science in opposition. A balanced peer review process that included divergent viewpoints would have prevented this. No one benefits from foreclosing debate on open scientific issues. The problem in Lyme disease is not the patients or their treating physicians, but the suppression of divergent viewpoints. Without open public debate, critical questions never reach the research agendas. What responsibility does the NEJM have to provide "the whole truth" to its readers?
NEJM has done a disservice to patients who are sick with Lyme disease and who now will be unable to get a diagnosis and treatment. Isn't it time that responsible, rational people stop recycling the same rhetoric from the same people and instead choose to sit at the table together to find out why tens of thousands of people are left to suffer without diagnosis and without treatment?
Patricia V. Smith
President, Lyme Disease Association