I believe less and less of what I read in medical journals. Sad but true. This state of disbelief may simply be because I can now look back on much more of my life than there is left to go and realise from my own experience what others have long known to be true: with hindsight most science turns out to be wrong. And, as I age and become more experienced and quicker in critical appraisal, I also realise that so much in the medical literature is just so awful that it is unlikely to be right.

But the really sad thing is that I no longer trust the authors as I used to. I constantly worry that they may have been influenced too much, or even corrupted by financial, professional and personal interests which distort their science—and review articles of the sort that we publish in Practical Neurology. Presumably it was ever thus, but I have no idea whether this is an increasing problem or not. I just know it is a very big one, and so do many editors of other medical journals. What are we to make of articles which are followed by a competing interest statement which includes a huge list of consultancies, lecture fees and grants from industry to the authors? Exactly how much money is involved, and how much difference …