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Medically Clear: Fake News Thrives in Medicine

Ballard, Dustin MD

doi: 10.1097/01.EEM.0000512763.92882.b9
Medically Clear

Dr. Ballardis an emergency physician at San Rafael Kaiser, co-chair of the KP CREST (Clinical Research on Emergency Services and Treatments) Network, and the medical director for Marin County Emergency Medical Services. He is also the creator of the Medically Clear podcast on iTunes or at Follow him on Twitter @dballard30. Read his past articles at



I recently received a promising email invitation. Perhaps you have received something similar? “Dear Dr. Ballard, I hope this email finds you well. My colleague asked if I could get in touch with you about a paper you authored entitled, ‘Does primary stroke center certification change ED diagnosis, utilization, and disposition of patients with acute stroke?’ I am hoping to discuss with you having a short follow-up article or perhaps a review article published in one of the next issues of the Internal Medicine Review.”

If you have received a letter like this, you may have had a reaction like mine: “I had no idea that anyone actually read that paper!” Perusing on, you discover that it gets better: “I think our readers would be interested in a paper with information from any continued research or new data since this was published. It would not have to be a long article, but if you don't have time for this, perhaps you could ask one of your co-authors or students to collaborate or contribute instead.”

This sounds promising, I thought. It doesn't have to be a long article, and I can have someone else write it! But there's more: “If you have any questions about whether or not a certain subject fits our scope I can put you in contact with Dr. Chadwick Prodromos from our editorial board.”

I was curious, so I looked up the impact factor for Internal Medicine Review and the h-index of Dr. Prodomos. Sadly, life is full of disappointments. Research unearths relevant facts: Internal Medicine Review has no impact factor, it does not appear anywhere on Google Scholar or PubMed, it has no subscribers, and it charges researchers money to publish their work.

The real story? The principles of fake news are thriving in evidence-based medicine.

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The Nothing Sphere

Here's how it works. Anyone who has published in the literature receives a complimentary email with an invitation, and they prepare and submit an article. They are then advised that there is a charge for publication ($3000 or more in some cases). After payment is received, the work is published into the nothing sphere!

In our post-factual world of scams, manufactured stories, and flush bank accounts in Nigeria, such predatory activity shouldn't be unexpected. Nonetheless, the language and targeting are disquieting.

Luckily, Jeffrey Beall, an associate professor and an academic librarian at the University of Colorado-Denver and the curator of “Beall's List of Predatory Publishers,” is paying attention to this and tracking the leeches. His interest in this began in 2009 while working toward tenure and looking for publications to bolster his resume. He discovered and reviewed a new open source publisher, Bentham Open for The Charleston Advisor. What he found was the tip of an iceberg. Bentham Open, a company founded in 2007 in the United Arab Emirates, provided admittance to, at the time, more than 200 open access online journals of dubious quality. In fact, Prof. Beall noted that many of those journals had only a few articles in them and that many articles were of questionable quality and not publishable in mainstream journals. He also found that the author fees were high: $450 just to publish a book review, for example.

Concerned about the implications of what he found, Prof. Beall created the watchdog Scholarly Open Access. ( The site includes a list of “potential, possible or probable” predatory publishers. Since Prof. Beall first started keeping count in 2011, the list of such publishers has grown from 18 to 923.

Fortunately, thanks to Prof. Beall and others, the federal government is starting to pay attention to this threat to science. The U.S. Federal Trade Commission filed suit in August against an offshore open access publisher called OMICS Group that recently took over several respected Canadian medical journals. The FTC complaint alleges that the company is “deceiving academics and researchers about the nature of its publications” and falsely claiming that its journals follow rigorous peer-review protocols. OMICS Group, Prof. Beall reported, follows the paradigm of purchasing and converting “respected journals into rubbish journals, trading on their good reputations to profit from researchers unaware of the change in ownership.”

We'll have to see whether the FTC's action is effective in slowing the deceptive activity of OMICS and its ilk. Some in academic publishing are hopeful, including Michael Callaham, MD, the editor of Annals of Emergency Medicine and a past president of the World Association of Medical Editors. Dr. Callaham said three salutary effects could come of the FTC action: regulatory and legal charges, a reduction in these infractions by “unethical pseudopublishers,” and education of the public and scientists previously unaware of these operations.

Prof. Beall, however, is not as optimistic. “Unfortunately,” he said, “there's no evidence that the FTC lawsuit has had any effect on the growth of predatory publishers. I am not optimistic that it will have any broad effect in the coming years.”

Sadly, it seems that fake publishing isn't going away soon, and researchers and readers should educate themselves on how to distinguish the real from the rubbish. After all, there are only so many hours in the day, and there's an opportunity cost associated with each study one takes precious minutes to read.

Dr. Callaham advised physicians to be selective in their reading. “There is so much out there in traditional publications and blogs. If the study has merit of some kind, it probably wouldn't have wound up in a journal you've never heard of. Or it will be discussed or replicated in some more reliable journal or discussed on a reliable blog. Before that, I would not waste any time on it.”

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Money to Nigeria

Most fake “invitations” are easy to spot and often humorous. My friend and colleague David Vinson, MD, received an email addressed to me asking me to review his article. Another solicitation from Diabetes & Metabolism (David does not study diabetes) began its pitch with “We pray for your brilliance and accomplishments.”

Nonetheless, Internal Medicine Review did not immediately set off my radar, so I decided to have a little fun with them. “I would love to publish with your Review,” I wrote back. “I understand from your colleagues that you have a thriving distribution and subscription base. I do feel like I should probably also financially contribute to your cause in the process. Please confirm your bank account and wiring number, and I will wire you $1,250 from my bank account. Look for an origination in Nigeria.”

Interestingly, these scammers don't seem to follow the “takes one to know one” maxim. I was promptly sent a bank account number and swift code. I am happy to share this with anyone who would like to make a donation to this worthy cause. We all know fake news is more fun than the real thing.

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