You are probably reading the PAAD because it is simply impossible for the busy clinician to keep up with the medical literature, even in a narrowly focused specialty like pediatric anesthesiology. There are simply too many journals, articles, novel medical breakthroughs, important quality improvement initiatives, editorials, and updated clinical guidelines. Over the past 2 + years we’ve been doing our best to honor the memory of the late Dr. Ron Litman and cull and curate these journals and articles to provide you with the best of what ‘s out there. But what if some of these articles from even the most prestigious journals are FAKE? “Last year alone, over 10,000 articles in the medical literature were retracted because of fake research! Indeed a single researcher had over 200 articles retracted!”1 Compounding and fueling this crisis are articles published in “predatory”, paper mills journals. Indeed, we recently published a PAAD: Hemanth A. Baboolal MD, FRCA: The murky world of predatory publishing 06/04/2024 that addressed some of these issues. Although fake data and research is nothing new, the sheer volume and audacity of what is happening in 2024 is new and it’s getting worse. Today’s PAAD, comes from the Washington Post. It’s a short read, probably about the same length as this PAAD, and I would urge all of you to download and read it in its entirety. I suspect you will find it as shocking and disturbing as I did. Myron Yaster MD
Original article from the Washington Post
Marcus, A. and I. Oransky (06/11/2024). An epidemic of scientific fakery threatens to overwhelm publishers. The Washington Post.
https://www.washingtonpost.com/opinions/2024/06/11/scientific-journals-retractions-paper-mills/
Take a moment and just think about this statement: “In the space of a year, the presidents of Harvard and Stanford have both been forced to step down amid allegations of research misconduct or plagiarism, and the Dana-Farber Cancer Institute has requested half a dozen retractions and many more corrections.”1 You read that correctly, Harvard, Stanford, and the Dana Farber Cancer institute, amongst the most prestigious academic institutions in the world. “The 10,000-plus retractions last year were largely the result of paper mill activity overwhelmingly from a single publisher, Hindawi, a subsidiary of Wiley. Paper mills — shadowy companies that operate in places such as China and Latvia and advertise their services on social media — sell entire papers, authorship slots or citations to a researcher’s work to inflate its seeming importance.”1 Indeed, “research misconduct (what we would simply call fraud) clearly is being industrialized on an unprecedented scale.”1
“Paper mills in particular are seizing on the opportunities that a “publish or perish” academic culture provides. Publishers have been aware of, but largely ignored, these schemes for at least a decade, but their thirst for growth and profits — around $2.2 billion last year for Elsevier alone — has led them to tolerate, and even incentivize, such activity.”1
“Only recently, after more mainstream journalists took an interest in paper mills and related dubious endeavors, did Elsevier and other titans such as Springer Nature and Wiley begin acknowledging their existence, while claiming victim status instead of admitting they were complicit in creating business models and incentives that promoted such behavior. In the meantime, paper mills have been bribing journal editors to publish their clients’ work. That and other misconduct continues to plague the literature.”1
As we discussed in the recent PAAD by Dr. Hemanth A. Baboolal MD, FRCA, when you are approached by one of these paper mill journals simply say “NO”! For those of you in academic practices and or are trying to get grants and your research published, we absolutely understand the need to publish for purposes of academic advancement and recognition. The urge to publish in any Pubmed cited journal, and yes to bend the facts, are overwhelming. In the long term though it will ruin your credibility and career. Just say “NO”!
Over the course of our careers, we have been involved in a lot of pharmaceutical, industry sponsored research. Is this type of research tainted and fake? We don’t think so. As Marcus and Oransky point out: “in reality, we see far fewer retractions of papers reporting from industry sponsored work than we do of more purely academic studies. The FDA requires source data verification for all trials submitted as part of drug approval. Monitors visit sites and statisticians carefully look for discrepancies. So, research sponsored by pharmaceutical firms is extremely closely vetted by both sponsors and regulators. In addition, the FDA does their own statistical analyses to verify those submitted by the sponsor. The overall level, of scrutiny tends to give would-be fakers pause. (An entirely different but no less significant issue is drug companies’ habit of burying studies that don’t reflect well on the products they’re testing.)”1
However, pharma studies can be biased in other ways. The questions chosen, the endpoints selected, the comparators employed can all be stacked to favor the sponsor’s drug. As John Ioannidis stated “Maybe sometimes it’s the questions that are biased, not the answers…”2
While outright fraud is of great concern, perhaps even more prevalent is the tsunami of poorly conducted research2, 3 and intentional and unintentional bias introduced by investigators.4 Smyth et al., succinctly summarized the current landscape for biased research. “Outcome reporting bias and publication bias more broadly could be viewed as forms of ‘fabrication,’ according to the definition given by the US Office of Research Integrity. Our study leads us to agree with Martinson et al that “mundane ‘regular’ misbehaviours present greater threats to the scientific enterprise than those caused by high profile misconduct cases such as fraud.” Given the prevalence of outright fraud, that certainly gives reason for concern.
Let us know your thoughts and send your comments to Myron who will post in a Friday reader response.
References
1. Marcus A, Oransky I. An epidemic of scientific fakery threatens to overwhelm publishers. An epidemic of scientific fakery threatens to overwhelm publishers: The Washington Post; 2024.
2. Lies damned lies and medical science. The Atlantic November, 2011. https://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/308269/
3. Al-Shahi Salman R, Beller E, et al. Increasing value and reducing waste in biomedical research regulation and management. Lancet. 2014 Jan 11;383(9912):176-85.
4 Altman DG. The scandal of poor medical research. BMJ. 1994 Jan 29;308(6924):283-4. doi: 10.1136/bmj.308.6924.283.
5. Smyth RM, Kirkham JJ, Jacoby A, Altman DG, Gamble C, Williamson PR. Frequency and reasons for outcome reporting bias in clinical trials: interviews with trialists. BMJ. 2011 Jan 6;342:c7153.