I would not be much of an actor. Acting seems to require the ability to shed the self-consciousness you collect in adolescence at least momentarily and let rip with an unfiltered version of humanity. To do less strikes a viewer immediately as all too artificial or false. Once you spot the lie, the whole mirror is cracked. That takes chutzpah, and I’ll happily confess that I couldn’t remove myself beyond the inhibiting “I am ridiculous right about now” mindset, the feeling of selling a lie. I’d be living in constant fear that I’d be pointed at for my mimicry.
Mimicry in Research
Research is not without its mimics. As a pretty fresh PhD type I have some of the zeal of the born again convert but anyone can see that fraud and research misconduct is all around with anaesthesia particularly blessed with the dodgy attempting to mimic good researchers. I’m not quite sure if I should be astonished people do this or that there isn’t more of it being called out.
The case study provided by Yoshitaka Fujii is one of the more recent impressive examples. Fujii’s area of research centred around approaches to decrease nausea and vomiting after anaesthesia (a noble cause worthy of pursuit). In 2011 an episode of plagiarism emerged and an investigation ensued. This eventually revealed that not only had ethics approval not been a feature for much of his work, data had been falsified in 172 of 212 papers (there’s a good summary in Retraction Watch here and a superb effort to look at it with even more rigour by Dr John Carlisle here). For his trouble he was sacked.
While there’s plenty that’s disturbing about that tale, at least post-operative nausea and vomiting is a bit of a niche. Maybe as long as prevailing views are appropriately updated and there’s little harm, that’s enough. What if the potential harm is more though?
The Heart of It
Don Poldermans was heavily involved in research promoting a particular class of drugs, beta-blockers, to prevent cardiovascular events around the time of surgery. Another noble cause. His work in the DECREASE trial was a big deal when I was training in anaesthesia. Finally anaesthesia had made it to the big stage of medical research. He ended up helping draft the guidelines on managing peri-operative risk.
His findings weren’t matched by others. Then it emerged that there were issues with his data, starting with issues of consent, potential data fabrication and submission of papers based on false data. Poldermans was sacked although he states his problem was only one of sloppiness, particularly in an underling, and disputes the accusations relating to data. His former employer reached the conclusion that no one was harmed.
Well as this article explains, there’s potential that lots were harmed because bad research presented as an authoritative source can change medical care. In removing Poldermans’ work from the meta-analysis, the risk of death was 27% higher if you got the treatment compared to those on placebo. If given as per guidelines, up to 10 000 patients in the UK alone may have died. So where do you draw the line as to when research misconduct resulting in real world badness elicits more than sacking?
Nobody Expects the Research Police
If you’re a Monty Python fan, those words will trigger a fond recollection. One of the contributing factors (covered here, as an example) might just be that no one expects to get caught. That would be because it’s hard to see the real penalties flowing from the discovery of the misconduct. Is sacking and embarrassment enough?
The journal Anaesthesia has laid out the approach both to prevention by automatic plagiarism checking and the steps involved in the response. They list the following steps:
* Seek an explanation from the author
* Correct or reject manuscripts.
* Contact the researcher’s institution where things look egregious and ask for an investigation.
It is noted that the last of these doesn’t always do much (indeed Fujii had been flagged as far back as 2000). Where publication has already happened, there can be corrections or retractions. All in all, it pretty much amounts to writing some letters. It’s not even clear if they get a particularly grumpy pensioner to draft the missive.
Should there be more than this? One earlier example in anaesthesia, involving Scott Reuben, resulted in 6 months jail time but not for the ills of the research. It was for fraud relating to the use of federal grant money.
So here’s my question: where are the research police? Where’s the squad wearing the tricked out white coats brandishing particularly scary scientific calculators and especially pointy clicky pens? Because until there’s more than letters to the editor, is there really enough incentive for the otherwise tempted to stay on the straight and narrow?