Features
The evil impact of medical research misconduct
BY Dr B. J. C. Perera
MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed),
MRCP(UK), FRCP(Edin), FRCP(Lon), FRCPCH(UK), FSLCPaed, FCCP, Hony FRCPCH(UK), Hony. FCGP(SL)
Specialist Consultant Paediatrician and Honorary Senior Fellow, Postgraduate Institute of Medicine, University of Colombo, Sri Lanka.
Joint Editor, Sri Lanka Journal of Child Health
Section Editor, Ceylon Medical Journal
The scholarly eye-opening article ‘Retracted research ~ 1’ by Amal Mandal, a former Associate Professor of Political Science from West Bengal, India, published in The Island Newspaper on 01-03-2024, and the follow-up article ‘Retracted research ~ 2’ by the same author, published on the following day, would have sent shock-waves and shivers down the spines of all involved in scientific publishing. Those newspaper items were primarily based on an index article titled “More than 10,000 research papers were retracted in 2023 — a new record.” published in the reputed scientific journal Nature on 12th December 2023(1). It reported on the unbelievable and gut-wrenching situation in 2023 when implausible numbers of so-called original research articles published in many journals, including those of tremendous pedagogic repute, were retracted (withdrawn) following publication, for a variety of reasons.
Amongst the whys and wherefores for retractions, academic research misconduct comes up pretty high in the ranking order. It has been known for quite a while but now it has really been put out into the open and the cat is most definitely out of the bag. As reproduced almost verbatim here from a communique from Imperial College London, UK(2), “research misconduct has been characterised as actions or questionable research practices that fall short of the standards of ethics, research and scholarship required to ensure that the integrity of research is upheld. It can cause harm to people and the environment, waste resources, undermine the research record and damage the credibility of research. It is often defined by ‘falsification, fabrication and plagiarism’ and can include making up data or results, incorrectly attributing authorship, gift authorship, manipulating research data, materials, equipment, or processes, or changing or omitting data, graphs, images, or results.”
In the main, many of those papers that have been retracted have published results and material that are not perfectly authentic and tenable from the point of view of a rigorous scientific appraisal. In other words, to put it in perspective and even to state rather bluntly, they are fraudulent attempts at securing scientific publications, even at the price of sacrificing intellectual honesty. All kinds of misdemeanours are known to occur in the many strata of people involved in the scholastic publishing industry. Amongst these, unscrupulous authors of so-called original research articles, which are of doubtful validity, take pride of place; certainly not a situation to be proud of, but only fit to be relegated into a contemptible bin of disgrace. The main worry of all these aspects is the fact that the inadequacy of scientific precision in many of these articles has been detected only after they had been accepted and published in the journals concerned. The articles had got into the published public record by the time the problems had been detected.
Bio-medical scientific publications are so very important because they attempt to provide the precise technical basis and erudite reasons for the causation of, as well as the accepted management strategies for human disease. Medical journals have an abiding impact on the diagnosis and treatment of human illnesses and the way we provide essential healthcare to unfortunate patients. They are the pivotal foundations of current knowledge on which up-to-date treatment of diseases and disorders affecting humans are based.
There is no room for two words or give-and-take provisions in that endeavour. Medicine and healthcare that are evidence-based should undoubtedly be the cardinal principles on which diagnosis, treatment and further management are unequivocally based. However, sadly for sure, if the fundamental principles of reliability in good quality research which ultimately percolates as benefits to sick humans are faulty and leaves a lot to be desired, there is no hope at all for progress in medicine.
The terrible consequences of research misconduct can be extremely severe and ever so grave. Such aftermath effects would include causation and propagation of preventable illnesses, the loss of human life due to misinformation in the literature as well as continued citing and usage of retracted work. It can also result in wasted resources, both human and financial when newer research processes or clinical work are based on previous flawed or fraudulent research. Deceitful research is the pits of the world and is fit only for guttersnipes.
Funding agencies often require that cases of research misconduct be reported to them which can be damaging to the careers of those who commit transgressions and there is a financial cost to the institution in investigating allegations as well. The retraction of papers and reputational risks of misconduct can be damaging to the research careers of those who commit misconduct as well as their academic institutions.
There are well-organised systematic initiatives such as “Paper Mills” that undertake certain nefarious academic activities for filthy lucre(3). These are money-making unethical commercial ventures which specialise in producing fake or fraudulent research papers. Very often the main parent organisations are in one country, the customers who pay a lot of money for these dubious services are in another country and the ‘ghostwriters’ who produce the papers for pretty high payments but are totally behind the scenes, are perhaps even in yet another country. It is extremely difficult to track down these miserable goings-on and bring the perpetrators to book.
There is also the distasteful spectre of Predatory Journals, also known as fraudulent, deceptive, or pseudo-journals(4) looming on the horizon. They are a mushrooming plethora of journals with questionable and scientifically unsatisfactory review, assessment and publication practices. They tend to play on the personal susceptibilities of authors such as securing publications to satisfy academic requirements of scholastic institutions where they work for considerable sums of money.
From a different perspective, one has to acknowledge that the current vogue of Artificial Intelligence (AI) has revolutionized various sectors, including biomedical research, bringing about promising breakthroughs in disease diagnosis, drug discovery, and treatment optimization. It is an undeniable truth that AI is here to stay. However, beneath the veil of optimism lies a darker reality; AI’s negative and even ugly effects on biomedical research. To all these things that are taking place now in the publication portals of biomedical research, if we add the potentially deleterious effects of AI, say even to enterprises such as Paper Mills, one would shudder at the likely consequences. The possibilities and the deleterious potential of the harmful usages of AI are suspected and somewhat known at present and are established to be quite disastrous.
The way things have panned out, while AI offers tremendous potential, its integration into this field has raised ethical, social, and practical concerns that cannot be overlooked. One of the foremost concerns is the perpetuation of biases. AI systems learn from data, and if this data is biased, the AI models will reflect and perpetuate these biases. In biomedical research, biased data could lead to skewed results, misdiagnoses, and unequal treatment. Moreover, the opaque nature of AI algorithms poses a challenge to transparency and reproducibility in research. Unlike traditional research methods where processes are transparent and results can be scrutinized, AI models often operate as ‘black boxes’, making it difficult to understand how decisions are made. This lack of transparency undermines the scientific method and hampers the ability of researchers to validate findings or identify errors, potentially leading to misguided conclusions and wasted resources.
Furthermore, overreliance on AI may diminish the role of human expertise and intuition in biomedical research. While AI algorithms can analyse vast amounts of data and identify patterns, they lack the contextual understanding and creativity that human researchers possess. This could lead to the neglect of valuable insights that cannot be quantified or captured by algorithms alone, thereby stifling innovation and limiting the potential for groundbreaking discoveries.
All the foregoing details and statements have a direct bearing on the work of editors of medical journals in the publishing industry. The author of this communique is very conscious of, and, in fact, seriously worried about, these implications concerning his work with editorial duties in two esteemed medical journals of Sri Lanka. Some of these potential consequences strike at the very core of the heart of medical publishing endeavours; namely the authenticity, veracity and unabridged reliability of the research material that is published in medical journals.
It has to be acknowledged that most medical journals have peer review systems in place which assess the different features, scientific quality, and many other components as well as implications of articles of research that are submitted to the journals. The research papers in medical journals are published after a rigorous process of such intense appraisal. However, as evidenced by the alarmingly increasing numbers of retractions, this system has perhaps most unfortunately not been all that successful in maintaining the very best standards of medical publications. It is getting progressively difficult to separate the grain from the chaff, especially for the editors of medical journals. This editor at least is well aware of the likely problems and constraints that would be placed on the venture of publishing well-tested and reliable scientific papers in the not-too-distant future.
References
1. Van Noorden R. More than 10,000 research papers were retracted in 2023 — a new record. Nature 2023;624:479-481.
2. What is research misconduct? Available from https://www.imperial.ac.uk/research-and-innovation/research-office/research-governance-and-integrity/research-integrity/what-is-research-integrity/what-is-research-misconduct/ Accessed on 01-03-2024.
3. Perera BJC. ‘Paper mills’: a detestable blot like no other. Sri Lanka Journal of Child Health 2021;50(2):185-187.
4. Elmore SA, Weston EH. Predatory Journals: What They Are and How to Avoid Them. Toxicologic Pathology 2020;48(4):607-10