Medical Hypotheses
Encyclopedia
Medical Hypotheses is a medical journal published by Elsevier
Elsevier
Elsevier is a publishing company which publishes medical and scientific literature. It is a part of the Reed Elsevier group. Based in Amsterdam, the company has operations in the United Kingdom, USA and elsewhere....

. It was originally intended as a forum for unconventional ideas without the traditional filter of scientific peer review
Peer review
Peer review is a process of self-regulation by a profession or a process of evaluation involving qualified individuals within the relevant field. Peer review methods are employed to maintain standards, improve performance and provide credibility...

, "so long as (the ideas) are coherent and clearly expressed" in order to "foster the diversity and debate upon which the scientific process thrives." Medical Hypotheses was the only Elsevier journal that did not send submitted papers to other scientists for review. Articles were chosen instead by the journal's editor-in-chief based on whether he considered the submitted work interesting and important. The journal's policy placed full responsibility for the integrity, precision and accuracy of publications on the authors, rather than peer reviewers or the editor.

The journal's lack of peer review and publication of ideas that are considered clear pseudoscience
Pseudoscience
Pseudoscience is a claim, belief, or practice which is presented as scientific, but which does not adhere to a valid scientific method, lacks supporting evidence or plausibility, cannot be reliably tested, or otherwise lacks scientific status...

, particularly AIDS denialism, attracted considerable criticism, including calls to remove it from PubMed
PubMed
PubMed is a free database accessing primarily the MEDLINE database of references and abstracts on life sciences and biomedical topics. The United States National Library of Medicine at the National Institutes of Health maintains the database as part of the Entrez information retrieval system...

, the prestigious United States National Library of Medicine
United States National Library of Medicine
The United States National Library of Medicine , operated by the United States federal government, is the world's largest medical library. Located in Bethesda, Maryland, the NLM is a division of the National Institutes of Health...

 online journal database. Following the AIDS papers controversy, Elsevier forced a change in the journal's leadership. In June 2010, Elsevier announced that "Submitted manuscripts will be reviewed by the Editor and external reviewers to ensure their scientific merit", suggesting that peer review is now in place.

Founding and editorship

Medical Hypotheses was founded in 1975 by physiologist David Horrobin
David Horrobin
David Frederick Horrobin was an entrepreneur, medical researcher, author and editor. He is best known as the founder of the biotechnology company Scotia Holdings and as a promoter of evening primrose oil as a medical treatment, Horrobin was founder and editor of the journals Medical Hypotheses and...

, who was the editor-in-chief of the journal until his death in 2003 as well as the head of the Schizophrenia Association in Britain. Horrobin was a controversial figure, a scientist and entrepreneur best known for his promotion of evening primrose oil
Oenothera
Oenothera is a Genus of about 125 species of annual, biennial and perennial herbaceous flowering plants, native to North and South America. It is the type genus of the family Onagraceae, the Evening Primrose Family. Common names include evening-primrose, suncups, and sundrops.The species vary in...

 as a treatment for diseases, leading the British Medical Journal
BMJ
BMJ is a partially open-access peer-reviewed medical journal. Originally called the British Medical Journal, the title was officially shortened to BMJ in 1988. The journal is published by the BMJ Group, a wholly owned subsidiary of the British Medical Association...

(BMJ) to predict that he "may prove to be the greatest snake oil salesman of his age." Horrobin wrote in his inaugural editorial for Medical Hypotheses: "The history of science has repeatedly shown that when hypotheses are proposed it is impossible to predict which will turn out to be revolutionary and which ridiculous. The only safe approach is to let all see the light and to let all be discussed, experimented upon, vindicated or destroyed. I hope the journal will provide a new battlefield open to all on which ideas can be tested and put through the fire." In its first edition, Medical Hypotheses published articles from its editorial review board member, virologist Frank Macfarlane Burnet
Frank Macfarlane Burnet
Sir Frank Macfarlane Burnet, , usually known as Macfarlane or Mac Burnet, was an Australian virologist best known for his contributions to immunology....

, in vitro fertilization
In vitro fertilisation
In vitro fertilisation is a process by which egg cells are fertilised by sperm outside the body: in vitro. IVF is a major treatment in infertility when other methods of assisted reproductive technology have failed...

 pioneer Ian Johnston, Gerald Kolodny of Beth Israel Medical Center, and Tom Tenforde, later chief scientist of the United States Department of Energy
United States Department of Energy
The United States Department of Energy is a Cabinet-level department of the United States government concerned with the United States' policies regarding energy and safety in handling nuclear material...

.

After Horrobin's death Bruce G. Charlton, a professor of evolutionary psychology at the University of Newcastle upon Tyne and theoretical medicine at the University of Buckingham
University of Buckingham
The University of Buckingham is an independent, non-sectarian, research and teaching university located in Buckingham, Buckinghamshire, England, on the banks of the River Great Ouse. It was originally founded as Buckingham University College in the 1970s and received its Royal Charter from the...

, became the editor, making publication decisions with the informal assistance of an advisory board. Notable members of the board included behavioral neurologist António Damásio
Antonio Damasio
Antonio Damasio is David Dornsife Professor of Neuroscience at the University of Southern California, where he heads USC's Brain and Creativity Institute and Adjunct Professor at the Salk Institute. Prior to taking up his posts at USC, in 2005, Damasio was M.W...

, cognitive neuroscientist Vilayanur S. Ramachandran
Vilayanur S. Ramachandran
Vilayanur Subramanian "Rama" Ramachandran, born 1951, is a neuroscientist known for his work in the fields of behavioral neurology and visual psychophysics...

, surgical pioneer Roy Calne, psychiatrist David Healy
David Healy (psychiatrist)
David Healy is an Irish psychiatrist who is currently a professor in Psychological Medicine at Cardiff University School of Medicine, Wales. He is also the director of North Wales School of Psychological Medicine. He became the centre of controversy concerning the influence of the pharmaceutical...

, philosopher David Pearce
David Pearce (philosopher)
David Pearce is a British utilitarian thinker. He believes and promotes the idea that there exists a strong ethical imperative for humans to work towards the abolition of suffering in all sentient life. His book-length internet manifesto The Hedonistic Imperative details how he believes the...

, and the Nobel laureate Arvid Carlsson
Arvid Carlsson
Arvid Carlsson is a Swedish scientist who is best known for his work with the neurotransmitter dopamine and its effects in Parkinson's disease...

. Founding board members included Nobel Prize-winning chemist Linus Pauling
Linus Pauling
Linus Carl Pauling was an American chemist, biochemist, peace activist, author, and educator. He was one of the most influential chemists in history and ranks among the most important scientists of the 20th century...

, virologist Frank Macfarlane Burnet
Frank Macfarlane Burnet
Sir Frank Macfarlane Burnet, , usually known as Macfarlane or Mac Burnet, was an Australian virologist best known for his contributions to immunology....

, neurophysiologist John Eccles, physiologist Arthur Guyton
Arthur Guyton
Arthur Clifton Guyton was an American physiologist. He was born in Oxford, Mississippi, to Dr. Billy S. Guyton, a highly respected eye, ear, nose, and throat specialist, who later became Dean of the University of Mississippi Medical School, and Kate Smallwood Guyton, a mathematics and physics...

, and philosopher Karl Popper
Karl Popper
Sir Karl Raimund Popper, CH FRS FBA was an Austro-British philosopher and a professor at the London School of Economics...

. Mehar Manku became the editor of Medical Hypotheses after Charlton was fired in 2010.

Medical Hypotheses was initially published by Eden Press. Elsevier
Elsevier
Elsevier is a publishing company which publishes medical and scientific literature. It is a part of the Reed Elsevier group. Based in Amsterdam, the company has operations in the United Kingdom, USA and elsewhere....

 has been its publisher since 2002.

Abstracting and indexing

The journal is abstracted and indexed in the Science Citation Index
Science Citation Index
The Science Citation Index is a citation index originally produced by the Institute for Scientific Information and created by Eugene Garfield in 1960, which is now owned by Thomson Reuters. The larger version covers more than 6,500 notable and significant journals, across 150 disciplines, from ...

, Index Medicus
Index medicus
Index Medicus is a comprehensive index of medical scientific journal articles, published since 1879. It was initiated by John Shaw Billings, head of the Library of the Surgeon General's Office, United States Army...

/Medline
MEDLINE
MEDLINE is a bibliographic database of life sciences and biomedical information. It includes bibliographic information for articles from academic journals covering medicine, nursing, pharmacy, dentistry, veterinary medicine, and health care...

, BIOSIS
BIOSIS Previews
BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Thomson Reuters Web of Knowledge suite. Content that was originally integrated from the BIOSIS company before the merger in 2004 is now part of the Web of Knowledge...

, Chemical Abstracts
Chemical Abstracts Service
Chemical Abstracts is a periodical index that provides summaries and indexes of disclosures in recently published scientific documents. Approximately 8,000 journals, technical reports, dissertations, conference proceedings, and new books, in any of 50 languages, are monitored yearly, as are patent...

, BIOBASE
Elsevier BIOBASE
Not to be confused with BIOBASE , a German publisher of molecular biology databases.Elsevier BIOBASE is a bibliographic database covering all topics pertaining to biological research throughout the world. It was established in the 1950s in print format as Current Awareness in Biological Sciences....

/Current Awareness in Biological Sciences, Current Contents
Current Contents
Current Contents is a rapid alerting service database from the Institute for Scientific Information, now part of Thomson Reuters, that is published online and in several different printed subject sections.-History:...

/Clinical Medicine, Current Contents/Life Sciences, EMBASE
EMBASE
Embase is an online information source of published literature designed to supportinformation managers and pharmacovigilance in complying with the regulatoryrequirements of a licensed drug. Through its unique and comprehensive content coverage,...

/Excerpta Medica
EMBASE
Embase is an online information source of published literature designed to supportinformation managers and pharmacovigilance in complying with the regulatoryrequirements of a licensed drug. Through its unique and comprehensive content coverage,...

, Reference Update, and SciSearch
Science Citation Index
The Science Citation Index is a citation index originally produced by the Institute for Scientific Information and created by Eugene Garfield in 1960, which is now owned by Thomson Reuters. The larger version covers more than 6,500 notable and significant journals, across 150 disciplines, from ...

.

Research

The most widely cited article from Medical Hypotheses was published in 1991 by RS Smith in which he proposed the macrophage
Macrophage
Macrophages are cells produced by the differentiation of monocytes in tissues. Human macrophages are about in diameter. Monocytes and macrophages are phagocytes. Macrophages function in both non-specific defense as well as help initiate specific defense mechanisms of vertebrate animals...

 theory of depression
Depression (mood)
Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, or restless...

 as an alternative to the monoamine theory of depression. In 2007, journalist Roger Dobson published a book in which he collected and described 100 Medical Hypotheses articles called Death Can Be Cured.

The journal chooses one article a year for the David Horrobin Prize, given to the article which best embodies the spirit of the journal. The 2008 judge for the Horrobin Prize was British physician and researcher David Weatherall
David Weatherall
Sir David John Weatherall is a British physician and researcher in molecular genetics, haematology, pathology and clinical medicine....

. The winner of the 2006 prize was psychologist Judith Rich Harris
Judith Rich Harris
Judith Rich Harris is a psychology researcher and the author of The Nurture Assumption, a book criticizing the belief that parents are the most important factor in child development, and presenting evidence which contradicts that belief.Harris has been a resident of Middletown Township, New...

.

In what psychiatrist
Psychiatrist
A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...

 and The Guardian
The Guardian
The Guardian, formerly known as The Manchester Guardian , is a British national daily newspaper in the Berliner format...

columnist Ben Goldacre
Ben Goldacre
Ben Michael Goldacre born 1974 is a British science writer, doctor and psychiatrist. He is the author of The Guardian newspaper's weekly Bad Science column and a book of the same title, published by Fourth Estate in September 2008....

 called an "almost surreally crass paper", two Medical Hypotheses authors posited "mongoloid" as an accurate term for people with Down syndrome
Down syndrome
Down syndrome, or Down's syndrome, trisomy 21, is a chromosomal condition caused by the presence of all or part of an extra 21st chromosome. It is named after John Langdon Down, the British physician who described the syndrome in 1866. The condition was clinically described earlier in the 19th...

 because those with Down's share characteristics with people of Asian
Asian people
Asian people or Asiatic people is a term with multiple meanings that refers to people who descend from a portion of Asia's population.- Central Asia :...

 origin, including a reported interest in crafts, sitting with crossed legs and eating foods containing monosodium glutamate
Monosodium glutamate
Monosodium glutamate, also known as sodium glutamate or MSG, is the sodium salt of glutamic acid, one of the most abundant naturally occurring non-essential amino acids....

 (MSG). Correspondence items have presented masturbation
Masturbation
Masturbation refers to sexual stimulation of a person's own genitals, usually to the point of orgasm. The stimulation can be performed manually, by use of objects or tools, or by some combination of these methods. Masturbation is a common form of autoeroticism...

 as a treatment for nasal congestion
Nasal congestion
Nasal congestion is the blockage of the nasal passages usually due to membranes lining the nose becoming swollen from inflamed blood vessels. It is also known as nasal blockage, nasal obstruction, blocked nose, stuffy nose, or stuffed up nose.Nasal congestion has many causes and can range from a...

. Science reported that a 2009 paper by Georg Steinhauser on navel lint
Navel lint
Navel lint is an accumulation of fluffy fibers in the navel cavity....

 "became an instant classic".

Peer review debate

Horrobin began the journal in response to what he viewed as the limitations of peer review. According to physiologist John Stein
John Stein (physiologist)
John Frederick Stein PhD CBiol FIBiol FRCPath is a Professor and Fellow of Magdalen College, Oxford, a constituent college of Oxford University. He holds a Professorship of Physiology, and has research interests in the neurological basis of dyslexia...

, Horrobin believed from his days as an undergraduate that peer review encourages adherence to currently accepted ideas at the expense of innovation.

Medical Hypotheses has been both criticised and mentioned favorably for its lack of peer review. Neuroscientist Vilayanur Ramachandran, who is on the journal's editorial review board, told Science
Science (journal)
Science is the academic journal of the American Association for the Advancement of Science and is one of the world's top scientific journals....

: "There are ideas that may seem implausible but which are very important if true. This is the only place you can get them published."

AIDS denialism papers and fallout

In 2009, the journal's publisher, Elsevier, withdrew two articles written by AIDS denialists that had been accepted for publication. One of the withdrawn articles, written by Peter Duesberg
Peter Duesberg
Peter H. Duesberg is a member of the United States National Academy of Sciences and a professor of molecular and cell biology at the University of California, Berkeley...

 and David Rasnick
David Rasnick
David Rasnick is a chemist and biologist known for his work in the area of HIV/AIDS denial.-Education and views:David Rasnick received a Ph.D. in chemistry from Georgia Tech in 1978. In a 1998 interview, Rasnick stated that he had studied proteases and their inhibitors for twenty years...

, claimed that there is "yet no proof that HIV causes AIDS" and was not responsible for deaths in South Africa that another paper had attributed to it and misrepresented the results of medical research on antiretroviral drug
Antiretroviral drug
Antiretroviral drugs are medications for the treatment of infection by retroviruses, primarily HIV. When several such drugs, typically three or four, are taken in combination, the approach is known as Highly Active Antiretroviral Therapy, or HAART...

s. The publisher stated that the articles "could potentially be damaging to global public health. Concern has also been expressed that the article contains potentially libelous material. Given these important signals of concern, we judge it correct to investigate the circumstances in which this article came to be published online."

The withdrawal followed a campaign by scientists who criticised the articles' factual accuracy and the process behind their acceptance. A group of 20 HIV scientists and advocates contacted the National Library of Medicine to request that the journal be removed from the MEDLINE
MEDLINE
MEDLINE is a bibliographic database of life sciences and biomedical information. It includes bibliographic information for articles from academic journals covering medicine, nursing, pharmacy, dentistry, veterinary medicine, and health care...

 database alleging that the journal lacked scientific rigor and had become a "tool for the legitimization of at least one pseudoscientific movement [AIDS denialism]." Economist Nicoli Nattrass wrote in an article in AIDS and Behavior that "Medical Hypotheses has long been a source of concern in the scientific community because the articles are not peer-reviewed," and that the National Library of Medicine had been requested to review the journal "for de-selection from PubMed on the grounds that it was not peer-reviewed and had a disturbing track record of publishing pseudo-science."

As a result of the controversy, Science
Science (journal)
Science is the academic journal of the American Association for the Advancement of Science and is one of the world's top scientific journals....

reported that Elsevier had asked that the journal's editor either raise the standards of review or resign. A review panel convened by Elsevier recommended that Medical Hypotheses adopt some form of peer review to avoid publication of "baseless, speculative, non-testable and potentially harmful ideas". Editor Bruce Charlton said that peer review went against the journal's 30-year history and is not supported by either him or the journal's editorial board. Elsevier reportedly told Charlton that his position would not be renewed at the end of the year, and Charlton said he would not resign. On May 11, 2010 Bruce Charlton announced on his blog that he "was sacked" by Elsevier.

Of the journal's 19 editorial board members, 13 wrote to Elsevier to protest the decision to change the journal's editorial policies. The group of scientists wrote that not having peer review "is an integral part of our identity, indeed our very raison d'être," and they would resign their positions if it was instituted. One of the members, David Healy
David Healy (psychiatrist)
David Healy is an Irish psychiatrist who is currently a professor in Psychological Medicine at Cardiff University School of Medicine, Wales. He is also the director of North Wales School of Psychological Medicine. He became the centre of controversy concerning the influence of the pharmaceutical...

 of the University of Cardiff School of Medicine, said that the review board members' letter was "a defense of Bruce, not of the Duesberg paper." In contrast, board member António Damásio
Antonio Damasio
Antonio Damasio is David Dornsife Professor of Neuroscience at the University of Southern California, where he heads USC's Brain and Creativity Institute and Adjunct Professor at the Salk Institute. Prior to taking up his posts at USC, in 2005, Damasio was M.W...

 said that the paper should not have been published on the journal's website.

In June 2010, Elsevier announced the appointment of Mehar Manku as the new editor, and stated that "(s)ubmitted manuscripts will be reviewed by the Editor and external reviewers to ensure their scientific merit. All reviewers will be fully aware of the Aims and Scope of the journal and will be judging the premise, originality and plausibility of the hypotheses submitted." Manku was previously the Editor of Prostaglandins, Leukotrienes and Essential Fatty Acids, another journal founded by Horrobin.
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