This Week in PLOS Medicine: Disruptive Publishing, Pneumococcal Vaccine, Acupuncture & Depression, & Medical Devices
This week PLOS Medicine publishes the following new articles:
In her final editorial as the Chief Editor of PLOS Medicine, Virginia Barbour reflects on the ways the journal has sought to constructively disrupt medical publishing over its history. She highlights disruptive PLOS Medicine papers from lethal injection to the role of “big” industries – pharma, tobacco, alcohol – in health. She identifies key issues for medical journals to address in the future, including open access and journals’ relationship with the pharmaceutical industry.
According to a pooled analysis of disease surveillance data by Daniel Feikin and colleagues, vaccination with the pneumococcal conjugate vaccine-7 (PCV7, a vaccine that covers 7 strains or serotypes of Streptococcus pneumonia) is linked to overall decreases in the rate of serious infections caused by this bacterium (such as pneumonia and meningitis, referred to as invasive pneumococcal disease or IPD). The authors also report small increases in IPD caused by serotypes of Streptococcus pneumoniae not covered by the vaccine (referred to as non-vaccine type IPD). These results are important as they suggest rapid and sustained reductions in pneumococcal disease after vaccine introduction, especially in children under 5 years of age. The study does show that serotypes causing IPD covered by PCV-7 have been partially replaced by types not covered by PCV-7 (a phenomenon referred to as serotype replacement), which has implications for the surveillance of newer pneumococcal conjugate vaccines (such as PCV10 and PCV13, which cover more serotypes).
Many patients with depression are interested in receiving non-drug therapies, however, there is limited evidence to support the use of acupuncture for depression. In a randomized controlled trial, Hugh MacPherson and colleagues report that acupuncture or counseling, provided alongside usual care in primary care settings, could benefit patients with recurring depression. The authors conclude that this is the first study to rigorously evaluate the clinical and economic impact of acupuncture and counseling for patients in primary care. Although these findings are encouraging, this study does not identify which aspects of acupuncture and counseling are likely to be most beneficial to patients with mild depression.
Daniel Kramer and colleagues compare current practices in the EU, the US, China, and Japan for monitoring the safety and effectiveness of medical devices already on the market, to identify strategies that might improve postmarket surveillance of medical devices. Based on their comparison of current practices, the authors call for greater system transparency, regular reexamination of the safety and effectiveness of select devices, and improved balance of central and local control.