Richard D. Smith

Bio: Richard D. Smith is an academic researcher from University of Exeter. The author has contributed to research in topics: Health care & Health policy. The author has an hindex of 74, co-authored 502 publications receiving 19108 citations. Previous affiliations of Richard D. Smith include University of Bristol & University of London.

Peer review: a flawed process at the heart of science and journals

Abstract: Peer review is at the heart of the processes of not just medical journals but of all of science. It is the method by which grants are allocated, papers published, academics promoted, and Nobel prizes won. Yet it is hard to define. It has until recently been unstudied. And its defects are easier to identify than its attributes. Yet it shows no sign of going away. Famously, it is compared with democracy: a system full of problems but the least worst we have. When something is peer reviewed it is in some sense blessed. Even journalists recognize this. When the BMJ published a highly controversial paper that argued that a new `disease', female sexual dysfunction, was in some ways being created by pharmaceutical companies, a friend who is a journalist was very excited—not least because reporting it gave him a chance to get sex onto the front page of a highly respectable but somewhat priggish newspaper (the Financial Times). `But,' the news editor wanted to know, `was this paper peer reviewed?'. The implication was that if it had been it was good enough for the front page and if it had not been it was not. Well, had it been? I had read it much more carefully than I read many papers and had asked the author, who happened to be a journalist, to revise the paper and produce more evidence. But this was not peer review, even though I was a peer of the author and had reviewed the paper. Or was it? (I told my friend that it had not been peer reviewed, but it was too late to pull the story from the front page.)

Joining together to combat poverty: Everybody welcome and needed

Abstract: The International Poverty and Health Network was created in December 1997 following a series of conferences organised by the World Health Organisation with the aim of integrating health into plans to eradicate poverty. Its formation was a response to the evidence of the persistent and growing burden of human suffering due to poverty. The more people who join the greater the likely impact of the network. Around 1.3 billion people live in absolute, grinding poverty on less than $1 per day.1 This is despite the overall growth of the world economy, which doubled in the 25 years before 1998 to $24 trillion. Of the 4.4 billion people in developing countries nearly three fifths lack access to sanitation, a third don't have clean water, about a fifth have no health care, and a fifth do not have enough dietary energy and protein. Economic disparities both within and between countries have grown, and in about 100 countries incomes are lower in real terms than they were a decade ago.2 By 1995 the richest fifth of the world's population had 82 times the income of the poorest fifth. The world's 225 richest people have combined wealth equivalent to the annual income of the poorest 2.5 billion (nearly half of the world's population).1 At the same time the world faces a growing scarcity of renewable resources from deforestation, soil erosion, water depletion, declining fish stocks, and lost biodiversity. The poor will be hit hardest by these problems. Despite overall dramatic increases in life …

Medical journals are an extension of the marketing arm of pharmaceutical companies.

Abstract: Medical journals have become dependent on the pharmaceutical industry for their survival, which can have a corrupting influence on their content, argues Smith, the former editor of the BMJ.

The true cost of antimicrobial resistance

Abstract: Richard Smith and Joanna Coast argue that current estimates of the cost of antibiotic resistance are misleading and may result in inadequate investment in tackling the problem

The European commission

Abstract: 2 1 The innovative transport systems and the CityMobil project 10 1.1 The research questions 10 2 The state of art in the field of automatic transport systems 12 2.1 Case studies and demand studies for innovative transport systems 12 3 The design and implementation of surveys 14 3.1 Definition of experimental design 14 3.2 Questionnaire design and delivery 16 3.3 First analyses on the collected sample 18 4 Calibration of Logit Multionomial demand models 21 4.1 Methodology 21 4.2 Calibration of the “full” model. 22 4.3 Calibration of the “final” model 24 4.4 The demand analysis through the final Multinomial Logit model 25 5 The analysis of interaction between the demand and socioeconomic attributes 31 5.1 Methodology 31 5.2 Application of Mixed Logit models to the demand 31 5.3 Analysis of the interactions between demand and socioeconomic attributes through Mixed Logit models 32 5.4 Mixed Logit model and interaction between age and the demand for the CTS 38 5.5 Demand analysis with Mixed Logit model 39 6 Final analyses and conclusions 45 6.1 Comparison between the results of the analyses 45 6.2 Conclusions 48 6.3 Answers to the research questions and future developments 52

What is agency

Abstract: This article aims (1) to analytically disaggregate agency into its several component elements (though these are interrelated empirically), (2) to demonstrate the ways in which these agentic dimensions interpenetrate with forms of structure, and (3) to point out the implications of such a conception of agency for empirical research. The authors conceptualize agency as a temporally embedded process of social engagement, informed by the past (in its “iterational” or habitual aspect) but also oriented toward the future (as a “projective” capacity to imagine alternative possibilities) and toward the present (as a “practical‐evaluative” capacity to contextualize past habits and future projects within the contingencies of the moment).

Antibiotic resistance—the need for global solutions

Abstract: The causes of antibiotic resistance are complex and include human behaviour at many levels of society; the consequences affect everybody in the world. Similarities with climate change are evident. Many efforts have been made to describe the many different facets of antibiotic resistance and the interventions needed to meet the challenge. However, coordinated action is largely absent, especially at the political level, both nationally and internationally. Antibiotics paved the way for unprecedented medical and societal developments, and are today indispensible in all health systems. Achievements in modern medicine, such as major surgery, organ transplantation, treatment of preterm babies, and cancer chemotherapy, which we today take for granted, would not be possible without access to effective treatment for bacterial infections. Within just a few years, we might be faced with dire setbacks, medically, socially, and economically, unless real and unprecedented global coordinated actions are immediately taken. Here, we describe the global situation of antibiotic resistance, its major causes and consequences, and identify key areas in which action is urgently needed.