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March 1, 1995

The Appropriateness of Tympanostomy Tubes for Children

Author Affiliations

Editor in Chief The Ear, Nose and Throat Journal Cleveland, Ohio

JAMA. 1995;273(9):700. doi:10.1001/jama.1995.03520330027025

To the Editor.  —As the editor of a medical journal, I recognize the desirability to publish provocative and controversial articles. The article by Dr Kleinman and colleagues1 involves a more significant issue.Before publication, articles in most medical journals are carefully reviewed by experts in the field being discussed to determine the scientific validity, statistical accuracy, and general worth of the communication. This article seems to be deficient on all counts. There is no evidence that any of the authors are trained to perform the procedure themselves nor did they personally collect the data. In addition, by their own admission, the information was obtained from the proprietary database maintained by a utilization review firm (VHS), a for-profit company listed on the New York Stock Exchange whose main interest is to restrict payment for medical care.As a member of the American Medical Association, I feel that it is outrageous

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