The Editor's Right To Be Provocative

There is a place in current medical literature for provocative clinical observations. In a recent commentary I noted that there are instances when the editor should be privileged to say to authors who report such observations, "Although the final draft of your report contains deficiencies, we agree with you that this information deserves further scrutiny. Therefore, we accept the paper for publication so that it may receive critical review from our entire readership. We ask only that the limitations of your study be clearly identified."¹ This defense of the occasional publication of observations (vs controlled trials) provoked the following comment from Thomas Preston, MD, "Despite knowledge of better scientific techniques and awareness that poorly controlled studies can be misleading, investigations and editors not only persist in publishing unsubstantiated research, but defend the practice with the rationalization that it will promote further research."² Since reported studies set medical standards,