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Single maintenance and reliever therapy (SMART) of asthma
  1. Helen K Reddel1,2,
  2. Kwok Y Yan2
  1. 1Woolcock Institute of Medical Research, Sydney, Australia
  2. 2Royal Prince Alfred Hospital, Camperdown, Australia
  1. Correspondence to Helen Reddel, Associate Professor, Woolcock Institute of Medical Research, P O Box M77, Missenden Rd Post Office, NSW 2050, Australia; hkr{at}

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We write to raise concerns about the recent paper by Chapman et al on single maintenance and reliever therapy (SMART) of asthma,1 on the basis that it misrepresents published scientific evidence. The errors include:

  1. Reporting outcome measures for one treatment arm from several double-blind studies (table 1 and accompanying text), but omitting the published data2 for comparator arms from the same studies which would have been highly relevant to the authors' conclusions.

  2. Selective omission of data from a peer-reviewed study3 that would have avoided the authors' doubts about the validity of double-blind double-dummy methodology.

  3. Selective citing of text from one Cochrane review,4 with juxtaposition of text to imply that its conclusions were relevant to the studies described immediately before, and failure to cite a more relevant Cochrane review.5

  4. Criticism of peer-reviewed publications on the basis of the use of outcome measures which were standard for other randomised controlled trials in asthma at the time (eg, criteria for exacerbations), or on the basis of omission of outcome measures which were either not available (eg, the adherence device used in a 1994 publication) or which have already been reported in a peer-reviewed publication (eg, a composite measure of asthma control2).

Misrepresentation of scientific evidence, whether in a data paper or a review, damages the scientific credibility of a journal. It is difficult to understand how the above errors could have passed through the usually rigorous Thorax peer review system, and this should be a matter of concern to the Editorial Board. The errors in the article, given their number and nature, cannot be addressed by simply publishing an erratum. We call on Thorax to respond appropriately.


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  • Linked articles 150219, 151167, 149633

  • Competing interests HR has received research funding from GlaxoSmithKline and AstraZeneca and honoraria for consulting, participation on advisory boards and/or continuing medical education presentations from AstraZeneca, GlaxoSmithKline, Merck, Getz, Novartis, Biota and Boehringer Ingelheim. KY has received honoraria from GlaxoSmithKline, AstraZeneca, Nycomed and Schering Plough for lectures and participation on advisory boards.

  • Provenance and peer review Not commissioned; not externally peer reviewed.

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