Is a mechanism such as the NCI's Clinical Alert ever an appropriate alternative to journal peer review?

Responsibly handled, a mechanism such as a Clinical Alert can provide physicians with enough information to deal with the early release of data to the public. The journal peer review system was established primarily as an academic tool to allow publication of scientific work for the purpose of communicating information among scientists and physicians. Since both the number of papers published by an investigator and the quality of the journal publishing them are important to academic advancement, bypassing this system naturally threatens many physicians and scientists. The Clinical Alert, however, served its purpose and was well received by the majority of practicing physicians and the public. In fact, a second Alert was issued by NCI in October 1989 when data became available on the effectiveness of a new adjuvant drug therapy for a common stage of colon cancer (Appendix B) and, at a workshop convened by the National Cancer Advisory Board, where the mechanism of the Clinical Alerts was discussed, it was apparent that most participants felt that maintaining this process was important. In light of the current revolution in biology, the public's interest in receiving the benefits of its financial support of the national research enterprise, and access by the press to both scientific literature and meetings, it seems appropriate for public officials, especially when mandated by Congress, to take the responsibility of releasing some types of data to the public before traditional peer review. Some visible public decision-making process must, however, be used where the pros and cons of early release of a particular data set can be discussed, as was done with the original NCI Clinical Alert.(ABSTRACT TRUNCATED AT 250 WORDS)