Research misconduct is widespread and harms patients

BMJ 2012; 344 doi: (Published 5 January 2012)
Cite this as: BMJ 2012;344:e14

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Re: Editor's Choice: Research misconduct is widespread and harms patients
or What did you do for the Learning organization Mum?

Dear Editor. Your editor's choice on 6th January said that the best writing transforms the writer as well as the reader. Yes - and moreover if you replace the word writing with communicating this is in fact a part of aiming to behave like a loyal member of a Learning organization. You mention some direct effects. In addition an important side effect of not fighting misconduct is loss of general thrust within the research community as well as from the society at large. This greatly hinders the business of knowledge development and should motivate us to go for the very best medical teacher staff culture as the response on 13th January from Professor John H Noble Jr. advocates.

The concepts of Learning Organizations and Participatory Learning and Action have different origins but yet their partly different practical tools are based on the same principles. Adhering to these principles one creates a cooperative culture which in one case may last a one hour in a small meeting to other cases of more "direct democracy" for several years for the people in a large area, an institution or a business. The fundamental premise is acknowledging the dignity of any other person and consequently resisting any actions violating the dignities of others. My deep wish is that academic research units will recognize that values are hierarchically related. Then most likely after internal dialogues they will place the dignity as their top value. This is in fact the composite sum of all the Human Rights.

Specifying single factors and their laboratory measured outcome variables is often overused because of the feasibility to get hold of them. Adding such effects is seldom appropriate because of their interactions in our complex body with mind. Factorial RCTs have long been underused perhaps because of the difficulty of getting interaction effects significant (may be confirmed be simulations). But they at least will estimate the effect of another factor. (As for a single issue we often as individual stakeholders weight its outcome differently. But in the real complex world we ought to consider several issues at the same time. Then collective decision based on several issues - with such carefully facilitated decision processes as hinted - we experience this regularly achievable.

The culture of effective positive cooperative behavior in a research group will increase its benefit/cost impact. The simplest added kind of teamwork benefit is that other team members will make the main researcher conscious about one or more facts she/he knows if reminded about it. The cost of research is so great that to improve the communication within the teams may become a major step forward. We then have to rely more on our positive physiology as well as identifying and fighting a bundle of prejudices - stemming from early childhood up to and including teacher cultures in universities.

This response accords very well with your 27th January article on Shared decision making.

Another world is possible by moving away from solid faith in bureaucratic measures and romanticizing competition towards more voluntary cooperation in local and other practices.

Competing interests: None declared

Truls W Gedde-Dahl, retired reseacher

Foundation for Local health trials , Hoegaasveien 68, N-1259 Oslo

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This report is disturbing and, I believe, generalizes to the US. See: Martinson BC, Anderson MS and deVries R. Scientists behaving badly. Nature, 435(7045), 2005, 737-738.
It's not just the fact that it is happening but that it reflects a culture within which new researchers are socialized. Prior research indicates the motivators for dishonesty include a high-pressure achievement-oriented environment, where "if everybody else is doing it, it must be OK." See: Vedantam S. Cheating is an awful thing for other people to do. Washington Post, August 21, 2006, p. A2.
The problem also underscores how important are reanalysis and replication of reported research, a recent topic on the US IRB Forum. BUT get this, "Ginny Barbour, a senior editor with the PLoS group of journals, said one-third of authors could not find the original data to back up figures in scientific papers when these were questioned." I wonder how many journal editors seek to discover and reject such authors?! I wonder how meticulous the US FDA is in policing the input it receives in support of marketing approval for new drugs and medical devices.
These behaviors are beyond the reach of IRB/REB surveillance and indicate the need for a new end-product quality control system. The simplifying assumptions about the efficacy of peer review and professional ethics and responsibility fail miserably when the emperor is discovered marching around buck naked.

Competing interests: None declared

John H Noble Jr, Emeritus Professor

SUNY/Buffalo, 508 Rio Grande Loop, Georgetown, Texas, USA

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