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EDITORIALS: Charles Young and Fiona Godlee Managing suspected research misconduct BMJ 2007; 334: 378-379 [Full text]

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Finally, whose responsibility is it to protect the public from unsound research?

E.S Prakash   (18 March 2007)

Research misconduct in Complementary Medicine

Edzard Ernst   (27 March 2007)

Finally, whose responsibility is it to protect the public from unsound research? 18 March 2007
E.S Prakash, Senior Lecturer, School of Medicine, Asian Institute of Medicine, Science & Technology 2 Persiaran Cempaka, Amanjaya Campus, 08000 Sungai Petani, Kedah Darul Aman, Malaysia Send response to journal: Re: Finally, whose responsibility is it to protect the public from unsound research?	In an insightful editorial [1] on a very useful publication by Roberts and colleagues [2], Young and Godlee point out the role authors, editors and systematic reviewers have in protecting the public from unsound research data. In concluding this editorial they state: "in the interim, clinicians treating patients with head injuries should approach these data with caution". One major implication of the publication of "Doubts over head injury studies" by Roberts and colleagues [2] is that it serves to warn readers at large of risks that are implied in the use of biomedical literature in the care of patients. There are perhaps a million pages (or even more) of published peer reviewed biomedical literature that healthcare professionals use to determine how they will care for their patients. While we may discuss about measures that may be taken at different levels to minimize the occurrence of research misconduct in the future, it is virtually impossible to go back over all published literature and set all records straight. This simply means that the most important thing would be for readers to look at all published literature (whether peer reviewed or not) as critically as possible before they use such information in the care of patients. In a certain sense, all readers have the responsibility of acting as “reviewers”. We have the "duty" of responding quickly to published literature (whether primary research or syntheses of primary research) especially when we have concerns about any aspect (hypotheses, design, methods, ethics, results, their interpretation, conclusions) of a study or any article published in a journal. Journals allow this to happen by publishing “letters to the editor”. In this context, I would encourage all journals (since most journals go online) to at least experiment with a “Rapid Response” feature like the BMJ does. Furthermore, I think all journals should print their "disclaimers" (for example, the disclaimer published by the BMJ can be accessed from the URL http://www.bmj.com/terms, accessed 18 March 2007) prominently in every print issue of the journal; perhaps, the declaration that editors, reviewers, and publishers are not directly responsible for the accuracy of the information contained in articles should always be included before articles in online journals are displayed and / or downloaded. It is probably insufficient to state this very important information in the "Web site terms & conditions", a link at the bottom of a long page that most people will miss. This way, journal editors and reviewers can avoid “severe anxieties” (a phrase that Richard Smith is said to have used in the course of investigations of suspected research fraud [3]) that can occur when they suspect but cannot verify that the trust that underpins the peer review process has been breached. References: [1] Young C and Godlee F. Managing suspected research misconduct. BMJ 2007; 334; 378-379; doi:10.1136/bmj.39129.611516.80. [2] Roberts I, Smith R and Evans S. Doubts over head injury studies. BMJ 2007; 334; 392-394; doi:10.1136/bmj.39118.480023.BE. [3] White C. Suspected research fraud: difficulties of getting at the truth. BMJ 2005;331:281-288; doi:10.1136/bmj.331.7511.281; article accessed from the URL http://www.bmj.com/cgi/content/full/331/7511/281 on 18 March 2007. Competing interests: None declared
Research misconduct in Complementary Medicine 27 March 2007
Edzard Ernst, Director of Complementary Medicine, Peninsula Medical School, 25 Victoria Park Road, Exeter, Devon EX2 4NT Send response to journal: Re: Research misconduct in Complementary Medicine	Your timely editorial[1] points out the responsibility of journal Editors vis a vis suspected fraud. In my field, complementary and alternative medicine (CAM), there seems to be one fairly clear-cut and intriguing case of research fraud. Daniel P. Wirth has authored more than 20 studies of spiritual healing, most in “Complementary Therapies in Medicine”. In the course of conducting systematic reviews of healing, 8 years ago, we repeatedly attempted to contact Wirth - invariably without success. An ‘‘absence of adequate documentation that the healing studies took place as described’’ was recently noted by his former supervisor.[2] Moreover ‘‘the possibility that these foundational studies are without scientific basis’’ was noted.[2] Meanwhile, Wirth has been convicted of an unrelated crime; in 2004 he pleaded guilty to mail and bank fraud.[2] Wirth’s coauthor and long-time collaborator (J.S. Horvath) was convicted of identity theft and other crimes.[3] Solfvin et al. described in detail how some of Wirth’s and Horvath’s activities imply that these data are fabricated.[3] So far, none of the editors who published Wirth’s research has withdrawn these articles. About a year ago, I wrote to the Editor of “Complementary Therapies in Medicine" alerting him to the possibility that this journal may have published around a dozen of fraudulent studies (published under a previous editor). To the best of my knowledge, the articles have not been retracted, but the Editor did subsequently publish an editorial on research misconduct in which he promised “to gauge the views of other editors of CAM journals on the matter of how to deal with this issue, on a synergistic basis”.[4] It is usually assumed that research misconduct is prompted by the desire of recognition or financial gain – not much of either in CAM, some may think. This may be so but there is a third, perhaps even more powerful motivator: evangelic belief. And in CAM we certainly have plenty of that. References 1. Young C,.Godlee F. Managing suspected research misconduct. BMJ 2007;334:378-9. 2. Solfvin J, Leskowitz E, Benor DJ. Questions concerning the work of Daniel P. Wirth. J Altern Complement Med. 2005;11:949-50. 3. Solfvin J, Leskowitz E, Benor DJ. Questions concerning the scientific credibility of wound healing studies authored by Daniel P. Wirth. Online document, http://www.wholistichealingresearch.com/WirthQ.html . 2006;accessed 8th February. 4. Van Haselen R. Misconduct in CAM research: Does it occur? Compl Ther Med 2006;14:89-90. Competing interests: None declared