When publication is too slow?

This story at cnn.com is of the kind that usually makes me cringe because it clearly provides advertising for a new healthcare technology that has not been widely tested and uses a truly dire personal circumstance to illustrate that the new technology can almost magically save the day. This is a technique that has been repeatedly used to hype several drugs or devices or alternative medicines that ultimately have not proven to be helpful (or worse). Yet in this instance, it seems that it is the real deal, a brain tumor that was effectively inoperable and there was a newly available technology that could do the job. And it was applied in the nick of time. Let's assume that this case in fact represents the appropriate application of technology. It might be interesting to view it as an opportunity to ask some questions of the current peer review and publication process in order to meet the following goal: timely communication of the best globally acquired knowledge for state-of-the-art treatment.

• Where can we find an authoritative system for timely reviews of new healthcare treatments on which patients with experience or physicians (in this instance, parents of children with an intracranial teratoma and neurosurgeons).



• How do we minimize the "gaming" of such an authoritative system?



• Is there a mechanism in the current academic publication pipeline that would support such a system or should we look to electronic social networks, mass media and word-of-mouth to provide the solution?



• Can we represent the degree of certainty we have about efficacy of a new treatment in a way that is both intuitive (i.e. actionable by the lay public) and that has solid statistical or evidentiary support?



• If we do not support timely dissemination of potentially useful technologies, is our ethical position suboptimal? Alternatively, does any premature knowledge dissemination fly in the face of the time-tested admonition to first do no harm.



• Can the federal government provide a transparent and timely vehicle of expert opinion in this regard?