The annual scientific sessions of the American College of Cardiology have now come and gone. Several subspecialty meetings are still planned for later this spring, but then there will be a hiatus in U.S. meetings until early fall, when the Heart Failure Society of America, Transcatheter Cardiovascular Therapeutics, and American Heart Association meetings, to name but a few, are scheduled.
Dr. Sidney Goldstein recently wrote a column about “Dwindling Relevance of Annual Meetings" but I do not think he could have anticipated the attack launched by John P.A. Ioannidis in a Viewpoint entitled “Are Medical Conferences Useful? And for Whom?” (JAMA 2012;307;1257-8) https://jama.ama-assn.org/content/307/12/1257.extract.
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Let’s start out by foot now and head to the American Heart Association meeting in November 2012. We’ll make it to Los Angeles in time if we head out by early May.
I encourage you to read it.
Dr. Ioannidis begins by asking rhetorically “Do medical conferences serve any purpose?” and then states that “there is virtually no evidence supporting the utility of most conferences” and in fact suggests that they “may be harmful to medicine and healthcare.” More on this later.
The writer’s number one reason cited for this complaint? The high carbon footprint associated with the travel required to attend meetings. Now, putting aside the fact that airlines will still fly to Chicago and other cities hosting the ACC or that I rode a Prius taxi from the airport and shared the ride with a colleague and that, well, the owners of the hotels and restaurants and my cabbie, too, were delighted to have us in town, an environmentally based argument cannot win the day.
More concerns?
Dr. Ioannidis believes that these meetings lead to “mediocre curriculum vita building.” He raises concern that abstracts have “sentimental value” because reviewers screen on the basis of the name and affiliations of the authors. Presumably he has not been an abstract reviewer in the recent past since the process has been blinded for years. He criticizes the fact that most abstracts do not end up as peer-reviewed full length manuscripts, but this is not a surprise nor is it the intent. Preliminary findings are “the name of the game” and usually do not meet the standard of conventional peer review. So what? They do permit exchange of sometimes novel ideas (and sometimes not); they provide our trainees and junior colleagues a chance to learn about and contribute to the scientific exchange of ideas; and they can create controversy and debate. But that is not on Dr. Ioannidis’s radar screen. He is more concerned with the “herding after elevated prestigious opinion leaders,” “lush expositions,” and the promotion of the “massive sovietization of medical disciplines.” And all along I thought that the Berlin Wall was dismantled in 1989.
His solutions are vague. He advocates small meetings and workshops with “specific, well-defined aims.” Of course, these meetings occur all the time already. He thinks that investigators with any ties to industry in the previous 3 years should not be allowed on organizing committees. As a scientist, he wants a randomized trial of different types of meetings. Aside from the fact that I have no idea how to define the end points of such trials, one thing is for sure: Dr. Ioannides is unlikely to present the findings of his “trial” in abstract form at a meeting.
Now, I am not an apologist for national meetings. It’s not all perfection. About 20 years ago, I recall a display that was designed to evaluate the attendee’s golf swing. And indeed, smaller meetings are here to stay, web-based resources are exploding, and the “meeting culture” is organically evolving, if only because few of us can afford to attend multiple meetings over multiple days throughout the year.
Still, meetings like the ACC accomplish a lot: the scientific exchange of kernels of ideas, social and professional interaction, academic networking, a brief reprieve from daily work, training of our fellows and junior faculty, and more. Many of my research ideas have developed after attending poster sessions, and collaborations have been enriched by in-person meetings with colleagues.
So is there a point to this anti-meeting argument besides another attack on our profession?
Here’s my solution: Let’s start out now and head to the American Heart Association meeting in November 2012. We’ll make it to Los Angeles in time if we head out by early May. We will leave no carbon footprint, submit no abstracts, and declare no conflicts of interest for at least 6 months (while we are walking on the highways and byways of America). Then we can have a real meeting that satisfies Dr. Ioannides without even having to stage a randomized trial. So if you are driving West this summer and happen upon a cardiologist with a sign that reads “L.A. or Bust,” show some compassion and hand out some generic medicated foot powder. I’ll need it!