Analysis

Report of the independent panel considering the retraction of two articles in The BMJ

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5176 (Published 15 August 2014) Cite this as: BMJ 2014;349:g5176

This article has corrections. Please see:

  1. Iona Heath, panel chair and past president, Royal College of General Practitioners,
  2. Stephen Evans, professor of pharmacoepidemiology, London School of Hygiene and Tropical Medicine,
  3. Curt Furberg, professor emeritus of public health sciences, Wake Forest University School of Medicine,
  4. Julia Hippisley-Cox, professor of epidemiology and general practice, University of Nottingham,
  5. Harlan Krumholz, Harold H Hines Jr professor of medicine (cardiology) and professor of investigative medicine and of public health, Yale School of Medicine,
  6. Cynthia Mulrow, senior deputy editor, Annals of Internal Medicine,
  7. Paul Wicks, vice president of innovation, Patients Like Me

In May The BMJ corrected an error relating to adverse effects of statins in two articles but was asked to retract the articles. The editor referred the decision to an expert panel. Here, we publish its findings

In October 2013 The BMJ published an Analysis article by Abramson et al1 arguing that cholesterol lowering guidelines should not be widened to include statin therapy for low risk individuals (five year risk <10%) and an Observations article by Malhotra2 suggesting that saturated fat is not the main cause of cardiovascular disease. The Abramson et al article1 questioned the balance of risk and benefit presented in the recently updated Cochrane review3 and the 2012 Cholesterol Treatment Trialists’ (CTT) Collaboration meta-analysis4 (on which the updates to the 2013 Cochrane review3 are largely based). Both articles quoted an article by Zhang et al5 to claim that the rate of side effects with statins was around 20%. This was an error. In fact, Zhang et al5 referred to “statin-related clinical events that may be interpreted as adverse reactions by patients or their clinicians.” As Zhang et al themselves pointed out in a rapid response to Abramson et al’s article, “implicit in this definition is the recognition that the causative association between each identified event and statin use was unknown.”6

This error of interpretation was first suggested in a rapid response from Takhar7 immediately after publication of the Abramson et al article1 and subsequently clarified by Zhang et al themselves in a letter published in June 2014.8 Numerous rapid responses were posted, reflecting a vigorous debate on the merits and limitations of statins for those at low risk of cardiovascular disease.

On 30 October 2013, a few days after publication, Rory Collins, professor of medicine …

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