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There was more than just heartbreak and recriminations at the New England Journal of Medicine, the world’s most prestigious medical journal, last month after it retracted a key paper on colon cancer, again blaming the new discovery on a lack of sufficient peer review.

But a group of editorial board members held out some hope for future relationships with a journal that has sided with conservatives, long an essential part of its advertising base. The group formed an informal “department”—whose members include long-time journal editors—which will take up more of the administration’s agenda.

The journal’s top editor emeritus, George Annas, was among those who signed the letter urging the journal to endorse the now-retracted paper, co-authored by Rush Holt, the head of the American Association for Cancer Research. He said Tuesday he supports the group’s stance on the story. “I’m pleased that some time now we’re doing something more than just letting those in charge of our side of the debate have an opinion,” Annas said. “And that not only is it more normal but, I think, helps the cause.”

The group, which Annas calls the Left-Right Alliance, signed the letter at a time when a strong majority of Trump voters wanted to see the stories retracted. The failure, some think, to retract the stories has contributed to a growing polarization of views between supporters and opponents of the president. The journal’s page visitors grew by 40 percent in September, to 5.6 million. The group’s motives were less than altruistic: to spur the editorial board to reverse the rejection of the paper, Annas said.

Complicating matters is the fact that many of the group’s members are long-time arch-conservatives who, Annas said, expressed a desire to join the editorial board after realizing it had been frozen out.

Some long-time critics of the journal have pushed for an independent peer review board, and they raised that complaint again in the letter, which was signed by more than 100 doctors, medical researchers and journalists. But Annas said the defectors were independent of those calls. There was not a formal discussion about, or a debate over, those views before members of the Left-Right Alliance signed the letter. Some, Annas said, opposed that idea.

The group still has a ways to go before it can move into the more than 120-year-old journal’s dining room. The group is still working out the details of its protocol, including how to handle contested articles. “This is not about membership, it’s about idea cultivation,” Annas said. For the group to adopt some of the journal’s policies, it must gain a full-time staff member and agree on a policy governing members’ opinions.

The board is working on a policy regarding the role of the editorial board, which one member said controls about 60 percent of its budget, according to a magazine article published by the editors in the California Medical Group Journal. Under that regulation, the board is free to publish papers or reject them.

But when board members disagree with the editorial board, they aren’t allowed to make public statements.

Raeann Lawson, an attorney who wrote the letter, said that in the past, in communications she’s had with board members who opposed admitting the Left-Right Alliance, they told her, “We have responsibilities here” but she’s never read evidence to back up their claim that the board does anything wrong. “They’re way too fancy with this board.” Lawson, who is a Republican, added, “I’m OK with saying, ‘OK, if you don’t like the direction, we can rotate the membership of the editorial board.’”

The ouster of the editorial board members protesting the rejection of the colon cancer study has been met with some outrage among prominent doctors who published that study in the journal. Ivo N. Albers, co-chair of a team of 12 such doctors, said it was “just a shameful moment for the journal that this gushing letter from within is being greeted with so much laughter.”

Another of the group’s members, Igor Waropin, a radiation oncologist at Dana-Farber Cancer Institute, said he would consider re-posting the article in the journal. “The problem with that,” he said, “is the thought that the journal will now keep [a certain kind of] publication away from discussion, and thereby shield it from rational criticism.”

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