Misconduct Around the Globe

Research misconduct is not limited to the developed world, but few countries anywhere are responding adequately.

By Richard Smith and Tracey Koehlmoos | June 1, 2013

DUSAN PETRICICIn 1992, oncologist Werner Bezwoda wowed an audience at a conference in San Diego by describing how 90 percent of women with advanced breast cancer whom he had treated in his South African clinic with high-dose chemotherapy and bone marrow transplantation had achieved complete remission of their cancer. Seven years later he described more good results, but three independent trials of the treatment found no benefit. People became suspicious, and investigators eventually found that the hospital ethics committee had no record of his studies, patients reported as alive had been discharged for terminal care, and many of them had not given consent. Bezwoda eventually confessed to misconduct and disappeared from science. Shortly thereafter, his studies were retracted.

Research misconduct is most often discussed in the context of developed countries, but as this high-profile case illustrates, wherever there is human activity—whether it is politics, sports, religion, or science—there is wrongdoing. Furthermore, as the amount of research in low- and middle-income countries increases, so will research misconduct. But how much is there, what form does it take, and how are countries responding?

In a recent PLOS Medicine article (10:e1001315, 2013), we addressed the “big three” of research misconduct: data fabrication, data falsification, and plagiarism. Increasingly, however, we recognize that a multitude of “questionable research practices,” including selective reporting, redundant publication, hiding conflicts of interest, listing authors on papers who have done little or nothing, and much more, probably does more damage to science than the “big three.”

Unsurprisingly, there are few data on misconduct from the developing world, but studies of article retractions and problems with authorship confirm that misconduct occurs in low- and middle-income countries, and some work suggests that it might even be more common there than in developed regions. A recent systematic review of studies conducted in high-income countries shows frighteningly high levels of misconduct: nearly 2 percent of scientists had themselves fabricated or falsified data, and one-third admitted to questionable research practices, including selective reporting (e.g., “dropping data points based on a gut feeling”) and altering an experiment or its results “in response to pressures from a funding source” (PLOS ONE, 4:e5738, 2009). When asked about other researchers, those surveyed said that they believed as many as 14 percent of their colleagues had fabricated or falsified data and nearly three-quarters were guilty of questionable research practices.

Among low- and middle-income countries, the volume of research is increasing most dramatically in China, and a 2006 article in Science described the country as a “scientific Wild West [where] an unprecedented number of researchers stand accused of cheating—from fudging resumes to fabricating data—to gain fame or plum positions” (312:1464-66). But the article contained no data, and the National Science Foundation of China investigated 542 allegations of misconduct and found positive evidence  in 60 cases—a level of misconduct comparable to that seen in developed countries with similar amounts of research. The main problems were data falsification (40 percent), plagiarism (34 percent), and data fabrication or theft (34 percent).

Unfortunately, it can be difficult to prove or disprove misconduct. In some cases, such as that of R.B. Singh from India, no proper oversight body exists. Singh has published dozens of trials that many suspect are fraudulent, but because he is a private practitioner, there is no institution to investigate
the allegations. He insists he is innocent, but the British Medical Journal and The Lancet have published “expressions of concern” about his research.

Indeed, most low- and middle-income countries have no system for responding to research misconduct—China is one exception, with its Office of Scientific Research Integrity Construction founded in January 2007 to investigate allegations of misconduct—and in many countries, research misconduct is simply not discussed. Even in the developed world, misconduct is often not taken seriously. A paper published in The Lancet recently shows that only two countries in Europe—Norway and Denmark—have misconduct response systems enshrined in law, comparable to the Office of Research Integrity in the United States (381:1097-98, 2013). Most European countries, including many where research has been conducted for centuries, have no national system for responding to misconduct.

We believe that research misconduct is common, and that, although it might be unpleasant to discuss, every country that conducts research needs a national system to provide leadership on preventing, recognizing, investigating, correcting, and punishing wrongdoing in science. At the moment very few countries, rich or poor, have adequate systems.

Richard Smith is director of the United Health Chronic Disease Initiative and former editor of BMJ. Tracey Koehlmoos is the special assistant to the assistant commandant of the Marine Corps and senior program liaison for community health integration for the US Marine Corps. The opinions expressed in this article are her own and in no way reflect the opinions of the US Marine Corps, the Department of Defense, or any other agency.

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Avatar of: Bruce St.

Bruce St.

Posts: 1

June 14, 2013

This is by far the most politically motivated article by scientists discussing scientific issues. The basic arguement was, don't look at us, everybody else is cheating too. That, does not make your cheating any more ethical. You named researchers from three countries for misconduct: South Afirca, India and China. You dragged in China even if you can not find any single case of misconduct. You just quote a seven-year-old ariticle from Science to imply that a lot of people there are cheating. Then you cited some real data and admit it is not so bad compared to the US/Europe. Had you mentioned the biggest cheating scientist in the developed countries, it would have made the whole article pointless. Remeber Jan Hendrik Schon: 17 papers in Science and Nature in two years. Yeah, because everybody else was cheating too.

Avatar of: Kathy Barker

Kathy Barker

Posts: 44

June 18, 2013

Very interesting but odd article...."Misconduct around the globe" sounds like a discussion of a human failing , but "Research misconduct is most often discussed in the context of developed countries" ("Discussed?"  It is done!) is the start of the insinuation that the U.S. has this problem all wrapped up with ORI.  What studies ("some work") suggest misconconduct is higher in the developing world? Are there studies that suggest that Norway, Denmark, and the U.S. have less research misconduct?

Avatar of: FJScientist


Posts: 30

June 20, 2013

I would disagree with the notion that scientific misconduct is not discussed.

What the article does highlight though is the wide variation in the ways to report suspected irregularities. That may vary with country but, as indicated below, the variation is much more pronounced at a local level since that is the level at which investigations are conducted.

First, if you see something odd, always to bring it to the attention of the editor of the journal in which the suspect article was published. That can be done by anybody, anywhere at anytime. You have to document what the irregularity is. A simple 'I think that's bogus' will not suffice. I've had the privilege in the past of seeing such reports from the community and I must say that I was pretty impressed by what some readers pick up. 

You must recognize that the editors at most journals do not have the resources or the authority to conduct an investigation. If presented with reasonable evidence that something needs to be looked into, the editor typically will forward your allegation (name redacted) to the author and ask for a response. If unsatisfactory, the allegation and supporting evidence will be forwarded to the home institution(s) of the authors. The editor can not make findings by him/herself since any allegation has serious consequences to the author and to the scienfitic public. It needs a thorough investigation and in today's system, that rests with the authors' institutions.

However, each institution's response is very different from another. This has little to do with differences amongst countries, etc. It has everything to do with whether an institution is equipped with some type of standing committee constituted to receive and investigate those allegations. So, we need some international agreement that every institution has such a committee?? But, that does not help in those cases where the committee itself may be tainted by the embarassing allegations (for example, when the institution has a vested interest in not looking too deeply). And, as the article noted, what do you do with a private researcher who has no institution?

What's the solution? I'm not sure, but I bet that if you put together a group of editors, they'll come up with a good solution. Does one create some sort of central, perhaps international arbitration system that evaluates reports of potential misconduc?. Should allegations of misconduct be heard by a body NOT at the investigator's institution? That can be difficult though if the investigatory panel is not near to where the researcher in question resides. That researcher must have every opportunity to evaluate and defend him/herself against serious and, let's face it, sometimes wacko allegations. The need to involve the accused is why the home institutions run the investigations currently.

If not the home institutions, what bodies are local, independent and equipped to evaluate fraud? The judicial system? Fraud is fraud. Shouldn't it be prosecuted? The burden of proof in the courts is high (there must be the knowing intent to deceive), which is exactly what we are after in scientific fraud (incompetence needs to be handled in other ways). Why not prosecute in the courts? Well, at least where I live, the criminal courts can not handle the additional work load. Does one pursue in civil court? There needs to be incentives for law firms to investigate because they're not going to do this for free. Do civil courts even exist in all countries (probably not)? So, we're back to the general question of how you pursue scientific fraud in a way that is consistent across all countries. Again, I don't know.

But maybe we need to brainstorm the possibilities, which is what I think the authors are trying to germinate. I wish them well with that. However, I have one overarching plea. Whatever we do, please no time-wasting mechanisms that just wind up punishing the practitioner of science with burdensome paperwork. We are being swamped right now (at least in the US) with all sorts of burdens such that I sometimes fail to get the time to conduct my work.

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