The editor of medical journal the Lancet has launched a scathing attack on NHS hospital league tables.

Richard Horton said the NHS star ratings - published last week - could undermine confidence by using "untrustworthy" methods for assessing standards

Dr Horton accused the Healthcare Commission, the government body responsible for compiling the tables, of basing its conclusions on research methods that were "obscure, unrepresentativem unreproducible, unaccountable, anti-scientific, misinformed, tendentious and unjustified".

The system, introduced by Alan Milburn when he was health secretary, has long provoked outrage in some parts of the health service. But this year four foundation hospitals lost their three-star status and 10 of the 31 seeking similar independence where stripped of their top ranking in the 0-3 star system.

Sir Ian Kennedy, the chairman of the commission, has promised to change the system in 2005-06 , to allow "a broader, richer picture". However, writing in SocietyGuardian last week he said the star ratings were useful and had provided a "wake-up call" to the health service.

Dr Horton, in an open letter to Sir Ian in his own journal, said changes would not resolve concerns over fairness or validity.

"It is, and will remain, a star chamber and not a star system you preside over," the letter says.

Dr Horton said only two of the 14 commissioners had daily frontline responsibility for patient care.

"It is hard to respect your commission's judgments when you have a board of such limited ongoing clinical service experience," he said. "Indeed your commission's dubious methods are creating a culture of waste, deception and fear among NHS staff."

The letter continues: "The perverse incentives your commission has introduced encourage manipulation of figures to meet targets that may bear little relation to local priorities. And the power that you wield has inculcated an environment of prejudice, anxiety and resignation into the workplace."