Transcript Document

Ethics of Medical Writing:
Problems and Solutions
Fikri M Abu-Zidan, MD, FRCS, PhD, DipApplStats
Statistics Editor, Emirates Medical Journal,
Associate Professor, Head, Trauma Group,
Faculty of Medicine and Health Sciences, UAE University
Why to publish? Fame and Fun
Egoistic motives
Seeing your own name
in print
Promotion
Financial gain
Improve knowledge
Contacts
Atruistic motives
Generate knowledge
Research misconduct
Fabrication, falsification, plagiarism
[FFP], or other practices that seriously
deviate from those that are commonly
accepted within the scientific community
for proposing, conducting, or reporting
research. It does not include honest error
or honest differences in interpretations or
judgments of data
Us Office of Research Integrity
Nature 1999; 398: 13-17
When Captain Cook arrived in
Australia, he was in the
company of a local Aboriginal
chieftain when he saw his first
kangaroo. He asked the man,
“What is that?” The chieftain,
not understanding English,
replied “Kangaroo?” which
meant” What did he say?” in
his native tongue.
Work
Bias
Falsification
Author
Dual
Salami
Honorary
Plagiarism
Ghost
Bias
• Fitting a question for the results
• Details of methods
• Breaking the code
• Interim analysis
• Commercial bias
• Political bias
• Reviewers’ bias
• Editors’ bias
Reporting bias
More than half of 111 papers about
non steriodal anti-inflammatory
drugs trials omitted references that
do not agree with them.
Gotzche PC
Br Med J 1987; 295: 654
Editor’s bias
Studies with statistically significant results
were more likely to:
be published than those with negative
results ( [OR] 2.32 [CI] 1.2-4.28).
be published in journals with a high impact
factor.
lead to a greater number of publications
Easterbrook et al,
Lancet1991; 337: 867
Political Bias
At 0815 h Chicago time last
Friday Jan 15, George Lundberg
was dismissed as editor-in-chief
of JAMA during a brief
telephone call to his home from
the executive vice-president of
the American Medical
Association (AMA), E Ratcliffe
Anderson , Jr.
It was this conjunction of a sex
survey with President Clinton’s
impeachment that infuriated
Anderson. He accused Lundberg
of dealing in “sensationalism
here, not science.”
Ann Oncol
BMJ
Lancet
Falsification
Mendel's published figures on the
genetics of peas were so closed to
the expected ratio of 3:1 that it
would have taken 'an absolute
miracle of chance' to produce them.
Hamblin TJ
Br Med J 1981; 283: 1671
Rober A Slutsky, 1985
Radiology resident and Associate Clinical Professor
137 articles
48 questionable University of California, San Diego
12 fraudulent
Experiments that had never been performed
Radiology 1985; 154:733-5.
J Am Coll Cardiol 1985; 5: 1132-7.
Reported statistical analysis that was not performed
J Am Coll Cardiol 1985; 5: 273-9.
Multiple authorship in surgical journals
Br J Surg
1969-2001
F Abu-Zidan & S. Shaban
Honorary authors
Over the last 20 years the number of BMJ
authors of original articles increased,
mainly because of the rise of authorship
among professors and department
chairpersons.
Drenth JP
JAMA 1998; 280: 219
Authorship
Authorship credit should be based on substantial
contributors to:
(a) Conception and design or analysis and
interpretation of data; and to
(b) Drafting the article or revising it critically for
important intellectual content; and on
(c) Final approval of the version to be published
Conditions (a), (b) and (c) must all be met.
Ann Intern Med 1997; 126: 36-47
Participation solely in the acquisition
of funding or the collection of data
does not justify authorship.
General supervision of the research
group is also not sufficient for
authorship.
Ann Intern Med 1997; 126: 36-47
Salami publications
Even the best salami loses flavor at its
cut edges. The more it is sliced into
tiny pieces, the more of its original
taste you lose.
Schein et al Br J Surg 2000; 87: 1610.
Dual publication
Multiple publication of a given piece of
work in different scientific journals is
dishonest and adds nothing to the
literature and progress of science.
The author wants to be paid twice for the
same job
Ghost authors
Individuals not named as
authors but who contribute
substantially to the
preparation of an article.
William Gosset published under the name
of Student because Guinness Brewery in
Dublin would not let him publish under his
own name (1908).
11% of articles published in six peer reviewed
journals involved the use of ghost authors.
19% had evidence of honorary authorship.
"The practice is well –known, scandalous, and
outrageous. It is a perfect illustration of
deceptive authorship practices for commercial
reasons.
Flanagin et al
JAMA; 1998: 280: 222
Plagiarism
Latin word plagiarius:
kidnapper, literary thief.
To take (ideas, writing etc) from
(another) and pass them off as
one's own"
Easily detected
Br J Cancer
1977; 36: 550
J Surg Oncol
1979; 11: 129
Br Med J
1980; 5th July
‘If you copy from one author it’s
plagiarism. If you copy from two, it’s
research.’
Wilson Mizner
The best antidote to plagiarism is always
to cite your sources.
Schein et al
BJS 2000, 87: 1610
Causes of research misconduct
Rotten apple theory
Rotten system theory
How is fraud detected?
Peer review
Replication
Does not always work
Victims of fraud
• Quality of medical care
• Research fund misdirection
• Scientific community
• Co-author reputation
A search of Medline from 1996 to
August 1997 revealed that 235
articles had been retracted, 86 of
which were deemed to be due to
misconduct. These 235 article had
been cited 2034 times after the
retraction notice had appeared .
Farthing MJ
Lancet 1998; 352(Supp IV): 11
Failure of scientific community
Early independence
Excessive publication
Journal's responsibility
Failure to report suspicion
Failure to retain data
Prevention of research misconduct
Education
• Research Training
• Research ethics
• Publication ethics
Farthing M
Br Med J 2000; 87: 1605
The Research
• Protocol driven
• Establish contributors
• Define methodology
• Ethical approval
• Project and personal license
• Supervision
Farthing M
Br Med J 2000; 87: 1605
The Publication
•
•
•
•
•
Disclose conflict of interest
Disclose previous publication
Approval by all contributors
Submit to one journal at a time
Assume research data audit.
Farthing M
Br Med J 2000; 87: 1605
NIH committee guidelines:
Faculties must present work frequently inside and
outside the hospital.
All coauthors must be prepared to back the published
work.
Head of Departments must take responsibility for
work presented.
A committee should be set up to prevent misconduct
in research.