When deciding what research to publish and how to evaluate it, medical journals have a heavy responsibility—and it shows when things go wrong. For example, in 1998, the Lancet published an article erroneously linking autism to the MMR (measles, mumps, and rubella) vaccine. They recalled paperbut the genie was out of the bottle: the ensuing health scare reverberates to this day.
British-born physician and editor Drummond Rennie, who has died aged 89, was a towering figure in American medical journals who was committed to combating inaccuracies in scientific publishing and raising standards. A cartoon in the British Medical Journal in 2001 depicted him as a biblical prophet, beckoning his fellow medical editors to the “promised land” of rigorous scientific reporting. He was associate editor of two of the most influential medical journals in the world: the New England Journal of Medicine (NEJM) from 1977 to 1981; and Journal of the American Medical Association (JAMA) from 1983 to 2013.
When Rennie started working at NEJM, the journal had just published a paper about patients with schizophrenia who had low levels of the enzyme monoamine oxidase. He was dismayed to see that the same study in a different journal came to a different conclusion, stating that enzyme levels were normal. The more Rennie studied, the more he found: the medical literature seemed to be riddled with anomalies, errors and shortcomings. In 1986, he concluded: “There are hardly any obstacles to eventual publication. No study seems to have been too disjointed, no hypothesis has been too trivial, no literature citation has been too biased or too self-interested, no design has been too flawed, no methodology has been too clumsy, no presentation of results has been too imprecise, too unclear or too contradictory, no analysis would be too self-serving, no argument too circular, no conclusion too flawed. trifling or too unjustifiable, and no grammar or syntax is too offensive for the article to be published.”
Peer review is at the core of the journal's publishing process. When deciding to publish a scientific article, the journal editor sends it to experts for evaluation. Rennie was concerned about the emergence of bias. For example, did reviewers view papers written by scientists they knew more favorably? He was also concerned that peer review was simply not doing its job: it was supposed to filter out errors, but he found many problems in printed articles.
Wanting to bring a scientific approach to the entire medical journal publishing process, Rennie launched the International Congress on Peer Review and Scientific Publishing in 1989. Held every four years, the forum is a forum for journal editors and researchers to raise standards and “enhance the quality and integrity of science.” Rennie was its director and then director emeritus for the rest of his life.
As codes of practice for research evaluation emerged, in 1994 JAMA published guidelines for reporting randomized controlled trials with a structured checklist to standardize the presentation of information. This led to a set of rules called the Consolidated Standards of Reporting Research (Consort) to which medical journals could subscribe. Rennie also lobbied for all trials to be registered when they began and for records to be kept of their results. This was done to combat the practice of unsuccessful trials disappearing without a trace, so doctors had no idea about drugs or treatments that didn't work. In 2000, the US government introduced the Clinicaltrials.gov registry, requiring researchers to register their studies.
A special place in hell, according to Rennie, was reserved for people who deliberately manipulated scientific data. In 1994, a whistleblower nicknamed “Mr. Butts” from the Brown and Williamson tobacco corporation sent 4,000 pages of company reports, letters and notes to a University of California doctor. The newspapers were picked up by JAMA, and in an editorial, Rennie harshly criticized the company, describing how they did it. planned to suppress scientific evidence by hiding research that nicotine is addictive.. He served on the US government's Research Integrity Commission and in 1995 helped tighten rules regarding scientific misconduct.
As well as raising standards, Rennie wanted to improve how frontline doctors use research findings. He founded the Evidence-Based Medicine Working Group at JAMA, which published a series of 32 articles in the journal between 1993 and 2000. Called the User's Guide to the Medical Literature—and later compiled into a book of the same name—they brought evidence-based medicine into the mainstream by teaching physicians to critically evaluate the medical literature and integrate the best evidence into their practice.
Rennie was born near Leeds, one of three children of John, a British cardiologist, and Isabella (née Wiese), a Danish-American doctor. He was educated at Winchester College and then studied medicine at Cambridge University. After training at Guy's and Royal Brompton hospitals in London, he specialized in nephrology (kidney treatment). Taking advantage of his dual citizenship, he moved to the United States in 1967 to work for nephrologist Robert “Gugu” Kark at St. Luke's Presbyterian Hospital in Chicago.
In London, Rennie met Sylvia Nussio, whom he married in 1958. While visiting her family in Switzerland, he was initially frightened by the altitude in the Alps. This quickly changed and he developed a lifelong passion for mountaineering, which he was able to combine with work, joining expeditions around the world to provide medical care and also study the effects of high altitude on the body. In 1970, he led the American medical relief effort in the highlands of Peru after an earthquake.
Publishing articles on mountain medicine and nephrology in the Lancet and JAMA introduced Rennie to the world of medical journals, and he was curious to learn more. In 1977, he left nephrology and became an associate editor of NEJM. He was content to remain an associate editor both there and at JAMA, since the “top job” came with pressures he didn't care about, such as keeping management and advertisers on side.
However, he combined his editorial work with teaching at universities: at NEJM he was a professor of medicine at Rush Medical College in Chicago, and when he moved to California to work at JAMA, he became an associate professor of medicine at the University of California.
In 1984, his marriage ended in divorce. In 1992, he married Deborah Peltzman, a data scientist. The couple loved the outdoors, and after he retired, they moved with their St. Bernard dog to a “house in the woods” in Oregon, where he could hike, read and appreciate nature.
Rennie is survived by Deborah, two children, Caroline and Nicholas, from his first marriage, and two granddaughters. His sisters, Jane and Isabel, preceded him in death.
