Peer reviewers can sometimes help identify questionable findings. Francis Collins, MD, PhD, director of the NIH, retracted five papers published in 1995 and 1996 about a possible genetic cause of leukemia when Amitav Hajra, a graduate student working in his laboratory, first at the University of Michigan and then at the NIH, admitted to having fabricated the results. The fraud was discovered by a reviewer of a paper that Hajra had submitted to the journal Oncogene. The incident changed the way that Dr. Collins oversees his research group. “It caused me to become more skeptical, which is something I am not entirely happy about,” he says. “I always had a skeptical eye in terms of looking at the technical aspects of data, but until this awful experience, that did not include a concern about whether the data were real or fabricated. Now it does.”11
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The behavioral economists have proposed another solution. Many written forms required by businesses and governments rely on honest reporting. For example, proof of honest intent is typically provided through signature at the end of tax returns or government-issued forms. Still, people sometimes cheat to advance their financial self-interests—at great cost to society. These authors tested an easy-to-implement method to discourage dishonesty: signing at the beginning rather than at the end of a self-report, thereby reversing the order of the current practice.12 Using laboratory and field experiments, they observed that signing before, rather than after the opportunity to cheat, makes ethics salient when they are needed most and significantly reduces dishonesty.
At the time of publication, the final season of Breaking Bad is about to start. Walter White’s fate remains a mystery. “Cooking meth” or cooking research data may both provide the user with a short-lived euphoria, but the long-term effects of each can be tragic.
Dr. Helfgott is physician editor of The Rheumatologist and associate professor of medicine in the division of rheumatology, immunology, and allergy at Harvard Medical School in Boston.
Research Hall of Shame
Here are a few of the more shameful examples of falsified medical research.
- In 1974, while working in the laboratory of the famed immunologist Robert Good at the Memorial Sloan Kettering Institute in New York City, researcher William Summerlin, MD, observed that the success of skin transplants between genetically unrelated rodents was enhanced by culturing the skin in special medium for several weeks. If confirmed, his findings had major implications as an antirejection therapy. However, attempts to reproduce his original results failed. Since the experiment involved a transfer of melanocytes between black and white mice, the outcome of each experiment could be readily observed. Fortuitously, one of the animal-care technicians discovered Dr. Summerlin’s ruse. He had been using a black-tipped felt pen to achieve the desired results. When the technician accidently removed one of the black patches with alcohol, he thought that he had committed a serious error and reported it to his superiors. That led to the end of Dr. Summerlin’s career in medical science.
- John Darsee, MD, was a rising star in the division of cardiology at Brigham and Women’s Hospital (BWH) in Boston. A prolific investigator, he had already published well over 70 abstracts and articles during his medical residency at Emory University in Atlanta and as a cardiology fellow at BWH.13 Wait a second. Seventy publications over seven years of training. This must have been a world record for trainee productivity! Was anybody paying attention to this glaring statistical anomaly? When I arrived at BWH, the word was already out. Dr. Darsee had been frequently seen after hours at the copying machine “working” with a stack of canine electrocardiograms. Many of his fellow trainees were aware that he was fabricating data, but somehow, his superiors were blind to the outrageous reality. Subsequently, it was discovered that most, if not all, of his previous work at Harvard and Emory, including studies of purported HLA gene associations with certain cardiac anomalies, had all been fabricated. Most of the patients did not even exist. Somehow, this did not prevent Dr. Darsee from finding many coauthors for most of his papers.
- With over 500 peer-reviewed publications, Don Poldermans, MD, a noted researcher at the Erasmus Medical Center in The Netherlands, heavily influenced the clinical practice of perioperative medicine.14 His work in the area of beta-blockers and statins in noncardiac surgery helped to shape guidelines and national policies on the use of these treatments. In just one day, all this data was called into question. An official press release from the hospital cited concerns including “carelessness in collecting the data for his research, using patient data without written permission, using fictitious data, and submitting two reports to conferences which included knowingly unreliable data.” Sadly, warning signs were missed before this avalanche of allegations. A 2005 systematic review of randomized trials that were stopped early for benefit isolated a prematurelyhalted Poldermans study, finding that “the very large treatment effect is likely too good to be true. It is inconsistent with the researchers’ expectations; with the magnitude of effect of beta-blockers in tens of thousands of patients with acute myocardial infarction or chronic management of congestive heart failure; with results in day-to-day clinical practice; and with results of other trials.”14
- Brown L. In Conversation: Vince Gilligan on the end of Breaking Bad. New York Magazine. May 20, 2013. Available at www.vulture.com/2013/05/vince-gilligan-on-breaking-bad.html?utm_content=buffer7bfc1. Accessed June 6, 2013.
- Gruley B, Voreacos D. Harvard doctor turns felon after lure of insider trading. Bloomberg. Nov. 27, 2012. Available at www.bloomberg.com/news/2012-11-27/harvard-doctor-turns-felon-after-lure-of-insider-trading.html. Accessed June 6, 2013.
- Gross C. Disgrace: On Marc Hauser: A case of scientific misconduct at Harvard. The Nation. Dec. 21, 2011. Available at www.thenation.com/article/165313/disgrace-marc-hauser#. Accessed June 6, 2013.
- Geison, GL. The Private Science of Louis Pasteur. Princeton, NJ: Princeton University; 1996.
- Martinson BC, Anderson MS, deVries R. Scientists behaving badly. Nature. 2005;435:737-738.
- Long TC, Errami M, George AC, Sun Z, Garner HR. Scientific integrity: Responding to possible plagiarism. Science. 2009;323:1293-1294.
- Suspend disbelief. Nature. 2012;492:7-8.
- Yang Y, Raine A, Narr KL, et al. Localisation of increased prefrontal white matter in pathological liars. Br J Psychiatry. 2007;190:174-175.
- von Hippel W, Trivers R. The evolution and psychology of self-deception. Behav Brain Sci. 2011;34:1-56.
- DuBois J. Remediating misconduct. The Scientist. May 14, 2013. Available at www.the-scientist.com/?articles.view/articleNo/35544/title/Opinion–Remediating-Misconduct. Accessed June 6, 2013.
- Bonetta L. The aftermath of scientific fraud. Cell. 2006;124:873-875.
- Shu LL, Mazer N, Gino F, et al. Signing at the beginning makes ethics salient and decreases dishonest self-reports in comparison to signing at the end. Proc Natl Acad Sci USA. 2012;109: 15197-15200.
- Relman AS. Lessons from the Darsee affair. N Engl J Med. 1983;308:1415-1418.
- Chopra V, Eagle, KA. Perioperative mischief: The price of academic misconduct. Am J Med. 2012;125:953-955.