The same blog that I highlighted below had a commentary about how clinicians almost never publish pre-prints of their work. This is in contrast to other fields, most notably Astronomy, where pre-prints are the norm. If clinicians are reluctant, the Ingelfinger rule may be to blame.

The Ingelfinger rule refers to a policy of the New England Journal of Medicine and many other medical journals, elucidated most clearly by a 1969 editorial by Franz Ingelfinger and re-iterated by a 1991 editorial by Marcia Angell and Jerome Kassirer. The Ingelfinger rule states that a manuscript cannot be considered for publication if it has appeared in print somewhere else. This policy includes public discussion of the results at a press conference. The journals themselves will often send out press releases about important publications, but those press releases are subject to a news embargo, which requests that no information about the journal article should appear in the news media prior to the article appearing in the journal itself.

The policy is intended to assure that any results published in the journal represent original research. There are a lot of problems with duplicate publication. The policy also is intended to discourage “science by press conference.” The Angell and Kassirer editorial mention several therapies being promoted for treatments of AIDS that were announced at press conferences and were later found to have no firm basis.

The Ingelfinger rule has a lot of critics, and there are counter examples in a book, “And the Band Played On, ” by Randy Shilts. He notes a time when an important medical finding about AIDS was not publicized immediately because of the Ingelfinger rule.

“There was a doctor from New York University who had written an extensive study on the apparent infection of the central nervous system, but he refused to tell the reporter from the American Medical Association journal about his work because he had submitted his paper to a neurological journal where it had been accepted for publication. The neurological journal might throw out the story if he publicly discussed his findings with the press, and that would hurt the doctor’s career in the publish-or-perish world of academic medicine. It was science as usual, and the Journal of the American Medical Association would just have to wait until the research was published in six months.”

There are other examples in the book as well. It’s a difficult and dangerous trade-off, but I think the research world would be better if clinical researchers adopted the pre-print model that Astronomers have been using for quite some time.