BMJ  2003;327:1113 (8 November), doi:10.1136/bmj.327.7423.1113

reviews

Journals

Have editors got their priorities right?

Whistleblower claims they are more worried about being sued for libel than about ensuring research is valid

Journal editors are much more frightened of being sued for libel by academics or drug companies than they are of publishing fraudulent research, the whistleblower Peter Wilmshurst claimed last week.

And he should know. He has spent the last 25 years of his life trying to expose cases of research misconduct (reporting more than 20 doctors to the General Medical Council), and has found it an uphill struggle. His career has suffered and he has received many brickbats and few bouquets.

Dr Wilmshurst, a consultant cardiologist at the Royal Shrewsbury Hospital NHS Trust, was describing his experiences to the annual meeting of HealthWatch, an organisation set up to campaign against health fraud. Television presenter Nick Ross presented him with the organisation's annual award for his courage in challenging misconduct in medical research.

Dr Wilmshurst explained how he knew that journal editors were more worried by libel than dubious research. He said that every time that he submitted an article highlighting research fraud, every word was scrutinised by an army of libel lawyers and the article was frequently rejected. This was in stark contrast to the reception he received when he submitted research articles.

"I have submitted many scientific articles for publication and many had implications for survival of patients, but no journal has ever asked me to prove that I got the results claimed. This might suggest that medical journal editors are more concerned with the reputations of academics and their institutions than the lives of patients.

"The simple truth is that editors are most concerned with money. Journals are never sued for publishing false results no matter how many patients died. In scientific research they can have the best of both worlds. They are absolved from blame if a study is wrong and gain an improved impact rating if the research is an important advance...

"I would like to see whether the policies at journals changed if some were sued by patients harmed by implementation of treatments based on their publications."

Moreover, journals and academic institutions failed to recognise the venality of some researchers, for whom getting their research published was worth a great deal of money. The gains from dishonest research were great "but institutions and journals trust researchers not to fall prey to these."

He offered the following solution. "We need to put in place robust checks on research. I believe that there should be random checks of raw data of work in progress and of submitted work. We know that the use of performance enhancing drugs is common in competitive sports because of enforced drug checks without warning at sporting events and between events.

"If we did not have these checks we might mistakenly conclude that doping was not common in sport. I believe that the checks reduce the dishonesty in sport.

"We need a similar approach to research. The raw data could be demanded at a routine check during a visit to the research institution or when the research is submitted for publication.

"Failure to produce the raw data should be considered the equivalent of failing the inspection and should result in a ban on future research for a specified period and a review of previous research published.

"A finding that a department in an institution had falsified research should be a negative factor when assigning ratings in the research assessment exercise. In this setting justified whistle-blowing would be welcomed by institutions."

As well as describing the problems that he had had in exposing fraudulent research, Dr Wilmshurst also told his audience why some researchers conducted dishonest research in the first place. He listed the following obstacles to honesty:

• Personal ambition for promotion, advancement, money, kudos, and power.
  
• Those who achieve success by becoming heads of departments or institutions can only maintain their position if their institution continues to succeed. Success is judged largely by the balance sheet. Department heads are expected to pull in research grants.
  
• The code of silence that pervades the medical profession and the research establishment. There is still considerable reluctance to shop another doctor, no matter how dishonest he or she is.
  

Dr Wilmshurst described how his own career in medicine had flourished until he tried to get a specialist medical journal to retract a paper, whose results he knew had been falsified. The postgraduate dean of his hospital advised him "to stop upsetting influential people." He was then (the mid-1980s) senior registrar at St Thomas' Hospital, London. "After that for the first time in my career I had difficulty getting a job. I stopped counting the rejections after the 42nd," he said.

A fuller version of Dr Wilmshurst's paper will be published in the next edition of the HealthWatch newsletter. Information can be found at www.healthwatch-uk.org

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BMJ aferriman{at}bmj.com

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This article has been cited by other articles:

• Goodman, N. W (2004). The policing of science. JRSM 97: 259-261 [Full text]  
• Garrow, J. S (2004). Editors and their priorities about libel and fraud: We need whistleblowers. BMJ 328: 230-230 [Full text]  
• Wilmshurst, P. (2004). Editors and their priorities about libel and fraud: External checks must be imposed to protect the public. BMJ 328: 230-230 [Full text]  
• Lange, J. H (2004). Editors and their priorities about libel and fraud: Everyone in science must be active in its process. BMJ 328: 230-230 [Full text]  

Rapid Responses:

Read all Rapid Responses

Keep blowing your whistle....

Iain D Beardsell
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Research should be monitored by “local research approval committees”

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Local monitoring? Why not a demand for internet data?

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