The end-of-year edition of the Journal of Evaluation in Clinical Practice published “Maternal kisses are not effective in alleviating minor childhood injuries (boo-boos): a randomized, controlled and blinded study” (also available here) on behalf of the Study of Maternal and Child Kissing (SMACK) Working Group, a group funded by a (fake) device company that sells ointments and bandaids.
In a flurry of critique reminiscent of China’s People’s Daily Online taking seriously the Onion’s satiric declaration that North Korean leader Kim Jong Un is the “sexiest man alive for 2012,” several prominent online publications missed the satire in the boo-boo kiss trial.
The Federalist site, for example, stated “An esteemed scientific journal appears to have been conned into publishing what appears to be a fake study on the effects of mommy kisses on their children’s boo-boos,” to which the Journal’s Editor-in-Chief replied that the article “is very clearly ironic and published with reference to the time of year, much as the [British Medical Journal] BMJ does with its own Christmas edition. (You remember the BMJ RCT of parachutes?!)”
Another site, noting that the findings were presented as real by “a number of online news outlets”, stated it was unethical to run the article without a disclaimer, and quoted an ethicist as saying “The Internet is already a source of confusion. I would expect a scholarly journal to not contribute to the confusion.” One of my favorite blogs, the Incidental Economist, even critiqued the absence of a warning, and stated “Am I missing the joke?”
The large number of sites that miss the joke reminds me that research humor is an inside joke. Although there are numerous humorous references in the piece, the aspects that I found satirical (i.e., using irony to critique shortcomings) include
- by performing a randomized controlled trial (including sham kissing in the control arm), this satirizes the commonly argued stance that observational studies are too weak to use as medical evidence
- by inflicting injury (they randomized kids to get boo-boos by luring them under tables with candy) they satirize human subjects research protections, especially related to restricting research on “vulnerable populations” such as children
- the authors’ funding by a fake device company satirizes the bias common in industry-funded health research (the authors promote their funders shamelessly: “reliance on ineffective therapies may delay or prevent the delivery of proven and appropriate medical care, such as Bac-Be-Gone® antibacterial ointment and Steri-Aids® self-adhesive bandages”)
- the self-congratulatory tone (“Although brilliant in its simplicity and robust in its design, our study …”) satirizes the exaggerated conclusions some authors draw from their studies, often to attract the type of media attention garnered by this piece
- a satire of over-achieving parents: “maternal resources are very limited, and time spent on delivering ineffective kisses to boo-boos means that maternal attention is not devoted to other activities that have clearly been shown to be beneficial to toddlers, such as the introduction of algebraic functions and the teaching of conversational Mandarin [8].”
What do you think? Do you have favorite examples of health research satire?
Marion R. Sills, MD, MPH 
