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Antibiotics for chronic bronchitis: a meta-analysis that speaks only four languages

¹ Dept of Pneumology, Institut Clínic del Tòrax (IDIBAPS), Hospital Clínic, Barcelona, Spain. ² St Elizabeth's Medical Center, Brighton, MA. ³ Health Science Center, University of Texas, San Antonio, TX, USA.

To the Editors:

We have read with interest the meta-analysis by Siempos et al. 1 evaluating the use of different antibiotics for exacerbations of chronic bronchitis. We are puzzled by the criteria used to select the studies that were included in the analysis. The authors utilised a well-established methodology and quality criteria for the selection of randomised clinical trials, but only studies written in English, French, German or Italian were included in the analysis 1. English is now accepted as the most common language in scientific literature; however, there is an increasing number of peer-reviewed scientific journals written in languages other than English that have published clinical studies with data relevant to the issue of this meta-analysis. In fact, among the top 25 respiratory journals ranked by impact factor there is one published in Spanish with an impact factor of 1.401 2.

It is not clear to us why Siempos et al. 1 have reviewed articles written in French, German and Italian and excluded the others. Most of the indexed non-English journals include English abstracts with information that may help verify the quality of the study. If the study proved to be scientifically important, there are individuals, organisations and companies that provide translation services that would help make the overall goals more accurate.

In the article by Siempos et al. 1, five studies were excluded due to language selection. Considering that in one of the comparisons, conclusions were drawn based on only four studies, the inclusion of one or more of the excluded studies could have impacted on the final results. Furthermore, the authors did not provide references for the publications that were excluded. Provided with this information, the interested reader could compare the results of the excluded works with those of the studies included in the meta-analysis and verify whether this arbitrary exclusion could have potentially biased the results.

Therefore, we believe that the European Respiratory Journal should not accept exclusion criteria beyond those that are strictly based on science. The exclusion of studies based on the language of publication is simply unacceptable.

REFERENCES

1. Siempos II, Dimopoulos G, Korbila IP, Manta K, Falagas ME. Macrolides, quinolones and amoxicillin/clavulanate for chronic bronchitis: a meta-analysis. Eur Respir J 2007;29:1127–1137.[Abstract/Free Full Text]
2. ISI Web of Knowledge. Journal citation reports. http://portal.isiknowledge.com/portal.cgi. Date last accessed: June 12, 2007

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