Trial By Error: My Follow-Up Letter to the British Journal of General Practice

By David Tuller, DrPH

Two weeks ago, I exchanged e-mails with Professor Roger Jones, editor of the British Journal of General Practice. I asked him to correct a false statement in an editorial about the cost of so-called medically unexplained symptoms to the National Health Service.

In response, he invited me to send in “one or two short sentences” that the journal would consider publishing. I declined this invitation and suggested it was his and the authors’ job to fix their own mistakes. I haven’t heard back.

Although the journal published the editorial two years ago, Professor Jones rightly pointed out in his e-mail to me that the data being mis-cited were ten years old. He appeared to suggest it was therefore a waste of time to bother correcting them–although I must have been mistaken because no editor of a prominent medical journal would make such a ridiculous suggestion.

But perhaps Professor Jones has more pressing matters on his mind than dealing with dated data. As it turns out, he is a current candidate for president of the Royal College of General Practitioners.

Hey, and voting takes place this month! Here is some information about what this position entails: The RCGP President is the ceremonial head of the College, but without executive powers, whereas our Chair…leads on strategic direction and policy at the organisation.

I guess being RCGP president is like being the queen. Maybe you get to tilt your head and wave politely at affairs of state. I wish Professor Jones the best of luck in his electoral campaign!

In any event, I sent him the following on Sunday. I cc-d those I had previously cc-d–three members of Parliament, four doctors involved in the NICE guidance development process, the lead author of the cited paper, the lead author of the journal editorial.


Dear Professor Jones,

I have not heard back from you about when you and/or Professor Chew-Graham intend to correct the claim that medically unexplained symptoms (MUS) among the working-age population in England account for 11% of all National Health Service expenditures. As I documented, this statement–from a 2017 editorial published in the British Journal of General Practice–is a misrepresentation of a 2010 study by Bermingham et al. That study reported that the NHS costs associated with treating working-age people in England identified as having MUS accounted for about 10% of all expenditures on that age group–a very different statistic than the one quoted by Professor Chew-Graham and her co-authors in their editorial.

As you know, I declined your invitation to send in one or two short sentences to be considered for publication. Publishing a letter from me would be appropriate if there were a point of dispute. There is no dispute here. The figure cited in the British Journal of General Practice is wrong. It does not conform to what was reported in the referenced article, and it needs to be corrected.

It is the responsibility of editors and authors to correct their own errors. According to its website, the British Journal of General Practice is a member of the Committee on Publication Ethics and “subscribes to the principles and guidelines” of the International Committee of Medical Journal Editors. Failure to safeguard the accuracy of the medical literature surely violates the principles and guidelines of both of these organizations. Do I really need to cite specific phrases from authoritative publishing ethics codes to make this point?

So I am asking again: When do you and/or Professor Chew-Graham plan to replace the misquotation of Bermingham et al in the 2017 editorial with an accurate description of the study€™s findings? Or do you plan to leave this mistake uncorrected and ensure that future readers of the British Journal of General Practice will be misinformed about a major public health policy issue?


David Tuller, DrPH
Senior Fellow in Public Health and Journalism
Center for Global Public Health
School of Public Health
University of California, Berkeley

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