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Electronic letters published:
![[Read Rapid Response]](/icons/misc/sectionDOWN.gif){kind=icon}
In Response
Fraud and Forgetting
Preventing scientific fraud
Dr Poelhman's research in Canada
Retractions are linked by the Web of Science to original reports.
Research Misconduct, Challenge For Whole Medical Community
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Harold C Sox, MD Annals of Internal Medicine, Drummond Rennie, M.D. Deputy Editor, JAMA
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Hsox{at}acponline.org Harold C Sox, et al.
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To the editor: Dr. Noble feels that journals should do more to prevent scientific fraud. He proposes that journals do an in-depth investigation of randomly chosen articles. Research misconduct is almost always detected inside the institution. In 1988, one of us (DR) proposed, as an experiment, doing such a random audit of accepted manuscripts, the results to be published only in aggregate. (1,2) The idea was to measure the frequency of the grossest forms of misconduct – for example, how often researchers sent in papers based entirely on fabricated patients, as had happened in the cases of Soman and of Darsee (3). I proposed that acceptance for publication would be conditional on the authors allowing the auditors full access to their places of work. The problem with making such a proposal routine is that editors would face insuperable barriers in access to research institutions, and have no power or expertise (nor time or money) to carry out adequate investigations. In addition, the pre-test probability of out-and-out fraud is doubtless very low. Editors’ lack of forensic skills would guarantee that routinely testing for fraud had a low sensitivity) (4), so the probability of detecting fraud would be extremely low, and we would miss many cases. Moreover, the scheme would have costs, starting with Dr. Noble’s proposed fee and the random selection of a target, which would undoubtedly create an atmosphere of distrust. In the end, we agree with Kennedy that routinely auditing a random selection of all papers is a bad plan (4)). In fact, most journals investigate the validity of articles that they intend to publish. Both JAMA and Annals do a detailed evaluation of the statistical methods and often ask for the study protocol. However, we see no workable alternative to starting with the assumption that, however misguided, authors are trying to offer a faithful depiction of the facts. We see our main mission being to present research reports in a form that makes it easy for scientific peers to evaluate them and try to reproduce the findings, which is the best , and is certainly the most practical, way to detect results that are wrong for whatever reason. The true test of any discovery begins with publication. We thank Dr. Garfield for reminding all of us that the Science Citation Index is another way to find articles that have been retracted. We agree that present-day authors have no excuse for citing a retracted article. Still, they do. Dr. Garrel has informed the research community that his university has investigated the six articles written by Dr. Poehlman during his tenure at the University of Montreal. The university has fulfilled its obligation, and we have fulfilled ours by publishing their findings. May all universities and journals take their responsibilities so seriously. Harold C. Sox, M.D. Editor, Annals of Internal Medicine Drummond Rennie, M.D. Deputy Editor, JAMA References 1) Rennie, D. The Editor: Mark, Dupe, Patsy, Accessory, Weasel, and Flatfoot. (Presentation before the Conference on Ethics and Policy in Scientific Publication. October 1988. National Academy of Sciences, Washington, DC.); In ‘Ethics and Policy in Scientific Publication’, Council of Biology Editors, Inc. Bethseda . 1990 2) Rennie, D. How much fraud? Let's do an experimental audit. The AAAS Observer. 1989;Jan 6:4. 3) Rennie, D. Editors and Auditors. JAMA. 1989;261:2543-2545. 4) Broad W, Wade N. Betrayers of the Truth – Fraud and Deceit in the Halls of Science. New York, NY: Simon and Schuster; 1982. 5) Kennedy D. Good news – and bad. Science. 2006;311:145. Conflict of Interest:None declared |
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Howard M. Spiro, MD Yale Medical School
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howard.spiro{at}yale.edu Howard M. Spiro
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Fraud and Forgetting Editors Sox and Rennie once again have condemned fraud in the last issue of the Annals (144:609). As usual they are correct and, moreover, publish details that will teach physicians reading their lament more than just another statement of principles. The editors want to change the culture in which research misconduct happens, but ignore the minatory value of the past. Unless medical institutions rehearse over and over again, particularly for those entering the profession, the errors many of us have made in the past, it seems unlikely that fraud in medicine will very much diminish. Medical ethics is much vaunted, but physicans need continuous reminders of specific cases: we learn from case study, whether called narrative or casuistry. To be sure, it seems only decent to let our erring colleagues retreat in silence, at least at memorial services where encomiums makes everyone appear another Osler. But Osler too had his faults though they are rarely catalogued Most academics will know of too many problems that have quickly been forgotten/buried. For example, some years ago, a brilliant scholar not too far from New Haven finally atoned for his errors of judgement by giving up his position at a world-famous medical school, to some the greatest fall since Lucifer. To repeat that story to several generations of students and residents would seem mean-spirited. Yet not to discuss it, along with its implications for the much praised “peer review” system, does nothing to prevent others from the same mistakes. Academic physicians and their students would learn more from that sad story than from the more distant sagas, like the stem cell imbroglio, that made the headlines. Even if medical scientists and clinicians are forthcoming about such problems, fraud will continue to flourish. The very obliquity of my commentary suggests the difficulty in being more forthright but also its necessity. Howard Spiro M.D. Emeritus Professor of Medicine Yale Medical School howard.spiro@yale.edu Conflict of Interest:None declared |
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David W Noble, BMedBiol, FRCA Aberdeen Royal Infirmary
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d.noble{at}nhs.net David W Noble
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The recent examples of research misconduct highlight a continuing problem [1, 2]. Being a medical scientist does not make a person immune to human frailties. Indeed, far worse crimes have been committed by doctors [3]. Medical publishers also have their frailties perhaps striving too hard to publish medical investigations with greatest impact or controversy. This may inadvertently encourage fraud. While accepting that institutions play their role to ensure the integrity of research conducted under their umbrella, journals and journal editors too must accept responsibility to ensure truthful reporting of results. Paying subscribers and non-paying readers deserve quality assurance measures in this regard. This requires time, effort and resource for journals and their peer review processes. Given the importance to patients and health care providers of employing best practice, greater acknowledgement of those already contributing to peer review and quality assurance is warranted. However even greater scrutiny of research data is required. This could and should be provided by journals. For a minimum modest fee, of say $10 per author of papers accepted for publication, further checks could be made to a proportion of articles. Sponsored studies might attract a higher fee for journal publication. This could be invested to promote quality assurance. For example, one paper in 20 might receive additional scrutiny and one in 200 receive extensive scrutiny of all relevant data. The real possibility of misconduct being identified coupled with the imposition adequate sanctions would be a powerful disincentive. Surely patients and health care providers deserve no less. Prevention is better than retraction. References [1]. Sox HC, Rennie D. Research misconduct, retraction, and cleansing the medical literature: lessons from the Poehlman case. Ann Intern Med 2006; 144: 609-13. [2]. Abbott A. Science comes to terms with the lessons of fraud. Nature 1999; 398: 13-7. [3]. Spitz V. Doctors from hell. Boulder, Sentient Publications: 2005. Conflict of Interest:None declared |
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Dominique R Garrel, M.D. University of Montreal, Remi Rabasa-Lorhet, Pierre Boyle
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dominique.garrel{at}umontreal.ca Dominique R Garrel, et al.
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We read the article entitled “Research misconduct, retraction and cleansing the medical literature: lessons from the Poehlman case” with great interest. Eric Poehlman was hired by the University of Montreal and obtained a senior Canadian Chair position from the Canadian Institute for Health Research in 2002. He held a professorship position in the department of nutrition of our university and was dismissed when we learned of his misconduct at the University of Vermont. The news of Dr Poehlman’s scientific fraud was a devastating blow to all Canadian scientists and students who worked with him. The possibility that scientific misconduct by Dr Poehlman had continued in our institution prompted us to perform a full review of all data from the CIHR- funded projects collected under his supervision. This included the verification of all electronically stored data as well as raw data from subjects records. All student and research assistants testified that no data entry had ever been purposefully altered. In addition, the results of one study funded by a private company were audited by an independent external committee which found no evidence of fraud. This evidence convinced the research committee of our university to allow us to continue Dr Poehlman’s projects after his dismissal, and the CIHR to resume funding of all projects. We are therefore confident that the data reported in the 6 following scientific papers published by Dr Poehlman while working in our institution are untampered. As per our university standard requirements, all raw data are available for examination 5 years after publication. 1. Karelis AD, Henry JF, Malita F, St-Pierre DH, Vigneault I, Poehlman ET, Rabasa-Lhoret R.: Comparison of insulin sensitivity values using the hyperinsulinemic euglycemic clamp: 2 vs 3 hours. Diabetes Metab. 2004 30:413-4. 2. St-Pierre DH, Karelis AD, Cianflone K, Conus F, Mignault D, Rabasa- Lhoret R, St-Onge M, Tremblay-Lebeau A, Poehlman ET.Relationship between ghrelin and energy expenditure in healthy young women. J Clin Endocrinol Metab. 2004 89:5993-7. 3. Karelis AD, Brochu M, Rabasa-Lhoret R, Garrel D, Poehlman ET.Clinical markers for the identification of metabolically healthy but obese individuals. Diabetes Obes Metab. 2004, 6:456-7. 4. Conus F, Allison DB, Rabasa-Lhoret R, St-Onge M, St-Pierre DH, Tremblay -Lebeau A, Poehlman ET.Metabolic and behavioral characteristics of metabolically obese but normal-weight women. J Clin Endocrinol Metab. 2004 89:5013-20. 5. Karelis AD, St-Pierre DH, Conus F, Rabasa-Lhoret R, Poehlman ET.Metabolic and body composition factors in subgroups of obesity: what do we know? J Clin Endocrinol Metab. 2004, 89:2569-75. 6. St-Pierre DH, George V, Rabasa-Lhoret R, Poehlman ET. Genetic variation and statistical considerations in relation to overfeeding and underfeeding in humans. Nutrition. 2004, 20:145-54. Conflict of Interest:None declared |
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Eugene Garfield, Ph.D. Thomson ISI, Marie McVeigh and Marion Muff
Send rapid response to journal:
garfield{at}codex.cis.upenn.edu Eugene Garfield, et al.
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In response to: Harold C. Sox, and Drummond Rennie “Research Misconduct, Retraction, and Cleansing the Medical Literature: Lessons from the Poehlman Case” Annals of Internal Medicine (18 April 2006 Volume 144 Issue 8) Dear Editor: The recent article about the importance of integrating retraction notices with their original reports noted their treatment in PubMed, but failed to take into account the procedures followed in the Science Citation Index (SCI) the electronic version of which is included in the Web of Science. Ever since the SCI was launched in the sixties, published retractions have been indexed by SCI. In each case a citation link was established between the retraction, that is “correction,” and the original source article. To find retractions, like all other corrections, all one had to do was conduct a cited reference search based on the author, journal and year of the retracted paper. You would then see a list of all items that cited the original work including the retractions, which like all other corrections would be coded as such. However, since 1996 the treatment of retractions was amplified by including the notation for the retraction together with the bibliographic citation for the source item. If one does a search on a subject or an author and finds a paper which has been retracted, the retraction can be seen immediately adjacent to the source entry. Thus, the retraction entry for WS Hwang’s paper on “Patient- specific embryonic stem cells derived from human SCNT blastocyst (Retraction of vol 308, pg 1777, 2005) is followed by SCIENCE 311 (5759): 335-335 JAN 20 2006. When you conduct a cited reference search on the original paper at Hwang HS, Science, 2005, you immediately see the statement that “this article was retracted see Science 311, 335, Jan. 20, 2006” In previous generations authors often unwittingly cited retracted research because they did not or could check citation indexes. Today there is no excuse since access to PubMed and Web of Science is widely available. Eugene Garfield, Chairman Emeritus Marie McVeigh, Senior Manager, JCR & Bibliographic Policy Marion Muff, Bibliographic Policy Manager Institute for Scientific Information Thomson Scientific 3501 Market Street Philadelphia, PA 19104 Conflict of Interest:The authors are all connected to the purveyor of the Science Citation Index and Web of Science. |
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Ahmad, A Sabri, M.B.B.S final year student Punjab Medical College, Faisalabad, Pakistan, Mohammad Ahad Qayyum
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ayaz153{at}hotmail.com Ahmad, A Sabri, et al.
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Office of Research Integrity (ORI) receives 30 to 40 new cases of research misconduct per year [1]. It is a matter of great concern and medical community as a whole shares the responsibility of solving this grave issue. The problem can be eliminated only by joint efforts of investigating authorities, concerned institutions, International Committee of Medical Journal Editors, journal editors, authors and readers. No society is free of crime but well directed efforts can minimize the damage done. Swift drastic steps are essential if we really want to get rid of this menace. Following measures may prove helpful besides the steps mentioned in original article [1]. A code of conduct must be formulated which binds all editors of journals to treat all such issues with uniformity and severity. Thus, leaving no room for the fraudulent author to pollute the fresh spring of medical research. Once fraudulent nature of an article is proven, all medical journals must unanimously condemn such an act in their next issue. There should be encouragement for journals and institutions for acting against it along with the condemnation of an editor unwilling to retract the article. Journals must devise a system to screen the submitted articles for citation of retracted articles before publication. Any article with citation of retracted article must be returned for correction along with explanation of rejection. All journals must be bound not to publish any article with citation of fake article. Electronic and print media can play a pivotal role by properly projecting such issue to create public awareness. Everyone has a responsibility to promote a culture in which research misconduct does not happen [1]. References: 1. Sox H.C, Rennie.D, Research misconduct, retraction and cleansing the medical literature: lessons from the Poehlman case. Ann Intern Med. 2006 Mar 6 PMID: 16522625 Conflict of Interest:None declared |
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