Without question, there is or should be a place in current medical literature for provocative clinical observations. Without reports of new observations and ideas, medical journals would be reduced to repositories for case reports and medical statistics. The question is not whether to report new observations and ideas, but how to do so without premature assumption of false conclusions with regard to those observations.
I do not object whatsoever to reports of observations or ideas and, in fact, agree that medical journals have an obligation to encourage such reports. What I believe is improper is the reporting of results and conclusions that have important clinical implications, but that are based on improper and scientifically invalid methodology. It is the relative absence of scientific thought in medicine that leads to confusion between an idea (hypothesis) and validation of the clinical application of that hypothesis.1 The problem resides in appropriate validation