Background There has been concern that medical journals do not provide adequate space for letters to the editor sections.1 We had the impression that rheumatology journals, similarly, were not giving due importance to letters, hence to the dissenting voice. To this end we decided to survey the changes in frequency of letters and the other types of publications in 3 widely read rheumatology journals within the last 25 years.
Methods Ann Rheum Dis, Arthritis Rheum and Rheumatology were hand searched at 11 time points within the last 25 years for the total number of letters and other manuscripts. The number of letters or other types of manuscripts were tabulated for each calendar year for the 3 journals combined, between 1985 and 2010. Supplements were excluded. For qualitative analysis of letter content, the frequency of rebuttal letters (letters with any degree of negative criticism of published manuscripts in the journals surveyed) was determined. Such rebuttal letters were further scored (1-3) according to their degree of criticism with 3 being the most critical. For this purpose, samples of rebuttal letters with separate degrees of criticism were initially discussed at a training session. The eLetters section of Ann Rheum Dis was also hand searched at 12 time points within the last 12 years for the number of letters and replies.
Results Figure 1 shows the number of letters and the other kinds of manuscripts for each calendar year. The mean ratio of letters to all manuscripts for the 11 time points was 0.18 (0.16–0.20, 95% CI). There was a significant change (p ≤ 0,0001) in the ratio of letters to the total number of manuscripts within the 11 time points and the latest ratio of 0.11 was definitely outside the 95% confidence intervals for all times given above. Meanwhile only 26% (range: 17%>33%) of all letters surveyed were rebuttals of published work. In turn, the 3rd degree rebuttal letters constituted 25% (range: 12%>39%) of all rebuttals. That is, only 6% of all letters were about serious criticism. In the eLetters section of Ann Rheum Dis, there were 224 letters, almost all of which were about moderate to serious criticism, but there were only 30 replies.
Conclusions The frequency of letters –the places of dissenting voice- in our leading rheumatology journals has decreased in the last 25 years. Furthermore only a minor fraction of these letters voice serious criticisms.
Christopher Baethge, Gabriele Seger. Our readers’ voice. Dtsch Arztebl Int. 2009;106(12):207-9
Disclosure of Interest None Declared