Duplicated textual content and strange statistics have been flagged in 130 research by a single physician-researcher and his co-authors.Credit score: Getty
A crew of scientist–sleuths has flagged data-integrity considerations in 130 research authored by the identical biomedical researcher, a specialist in ladies’s well being and gynaecology, and his colleagues. The sleuths printed their findings in a peer-reviewed paper earlier this yr1.
Among the research that have been recognized as doubtlessly problematic have been cited by different researchers or included in analyses that would inform medical apply. The variety of papers being questioned is among the many highest by a still-active life-scientist, say some specialists.
The 130 research have been printed between 2014 and 2023 and report the outcomes of medical trials and different analysis on maternal and girls’s well being. The highlighted issues embody oddities in reported statistics, unfeasible outcomes and textual content that’s similar to different papers. Ahmed Abbas, an obstetrician and gynaecologist at Assiut College in Egypt, is listed as a co-author or corresponding writer for all 130 articles. Abbas didn’t reply to Nature’s request for remark.
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Among the papers stay a part of the literature. Eleven have been retracted. Earlier than it was retracted, a type of 11 was included in a 2019 meta-analysis on a remedy to forestall miscarriage. The retractions of the paper by Abbas and his crew and one other, unrelated paper will in all probability change the conclusion of the evaluation, says one of many 2019 work’s authors.
The inclusion of a doubtlessly unreliable examine in a systematic evaluation can have dangerous penalties, as a result of “it might instantly have an effect on how a surgeon or an [obstetrician–gynaecologist] is doing their job”, says James Heathers, a forensic meta-scientist at Linnaeus College in Växjö, Sweden, who was not concerned with the investigation that recognized the data-integrity considerations.
Girls’s well being specialists are actively growing methods to forestall the publication of questionable knowledge. However they are saying that after these papers are printed, it’s troublesome to purge them from the literature.
Alaa Mohamed Ahmed Attia, the dean of the College of Drugs at Assiut College, with which Abbas is affiliated, didn’t reply to Nature’s request for a touch upon the considerations raised about Abbas’s publications on this yr’s peer-reviewed paper.
Rejection and retraction
The 130 flaggedstudies have been described in a paper printed in Might1 within the Journal of Gynecology Obstetrics and Human Copy by obstetrician and gynaecologist Ben Mol, at Monash College in Clayton, Australia, and his colleagues.
In 2016, Mol peer-reviewed an unpublished manuscript co-authored by Abbas a couple of medical trial of the hormone progesterone to forestall miscarriage. Mol seen discrepancies within the paper and notified the journal, he says. The journal rejected the work by Abbas and his crew. However in 2017, a distinct journal, The Journal of Maternal-Fetal & Neonatal Drugs, printed a model2 of the manuscript that included modifications to the sections that Mol had flagged, he says. The journal finally retracted the paper in December 2019.
In line with the retraction discover, the journal’s editors-in-chief learnt that earlier variations of the manuscript “confirmed vital modifications to the underlying knowledge.” The discover additionally stated that when contacted, the authors couldn’t present the unique knowledge to confirm the outcomes. In line with the journal’s writer, Taylor & Francis, considerations in regards to the paper have been first raised in February 2019. The ensuing investigation led to the article’s retraction later that yr, the writer says. Abbas didn’t reply to Nature’s request for remark in regards to the retraction.
Large database
Mol’s crew determined to survey all papers by Abbas except for literature opinions, case reviews and research achieved as part of a world collaboration. They recognized 263 papers that included Abbas as an writer. These research collectively enrolled greater than 74,000 members between 2009 and 2022.
Of the 263 research analysed within the paper, 130 — virtually half — raised the sleuths’ considerations. Among the papers had statistics that appeared unfeasible. One used wording that was much like that of a beforehand printed paper. The articles that the crew flagged appeared in journals produced by a number of publishers akin to Taylor & Francis and Springer Nature, which additionally publishes Nature. Nature’s information crew is editorially impartial of its writer. When requested for remark by the information crew, Springer Nature didn’t reply.
The sheer variety of research that have been claimed to have been produced in such a brief time period caught the eye of Mol’s crew. In line with the reported registration and publication timeline of the papers, in Might 2017, Abbas would have been conducting 88 simultaneous medical research. Catherine Cluver, a gynaecologist and obstetrician who leads the preeclampsia analysis unit at Stellenbosch College in South Africa, agrees with Mol’s crew that it appears unfeasible to conduct such numerous research at one time. “Doing the entire regulatory work, the ethics approvals, ensuring the trials are being run accurately … I feel there is no such thing as a method you could possibly do greater than 4 or 5, and even then, it’s a push,” she says.
Concern over numbers
A standard problem recognized by Mol and his colleagues was statistical oddities. One paper they flagged, printed within the journal Proceedings in Obstetrics and Gynecology3, evaluated the impact of the treatment esomeprazole in ladies with the being pregnant complication preeclampsia. The sleuths famous that the final digit of 31 of the 32 values in tables 2 and three, together with means and customary deviations, are even numbers (see ‘Even numbers abound’). In scientific knowledge, the digits of such measurements and statistical outcomes are usually extra equally distributed between odd and even numbers, so the prospect of getting so many values ending in even numbers can be low. The numbers are a “concern”, in line with the paper by Mol and his crew.
Supply: Ref. 1
The tables additionally characteristic quite a few pairs of numbers which have similar digits after the decimal level — for instance, 0.76. Among the repetitious values are in the identical desk; some are break up throughout the tables. This, too, is regarding, says the paper by Mol and his crew.
These uncommon numbers ought to compel the authors to current their uncooked knowledge, says Nicholas Brown, a psychologist and research-integrity specialist at Linnaeus College.
The editor-in-chief of Proceedings in Obstetrics and Gynecology, Donna Santillan, stated in a press release that each one inquiries about analysis or publication misconduct are investigated by the journal. Santillan, a reproductive sciences researcher on the College of Iowa in Iowa Metropolis, declined to touch upon whether or not this examine is at present being investigated, citing privateness considerations.
Persevering with investigation
Different research flagged by Mol’s crew describe apparently inconceivable outcomes. In a 2020 survey4 in The European Journal of Contraception & Reproductive Well being Care that assessed the attitudes of obstetricians and gynaecologists in Egypt in the direction of abortion, for instance, the imply age of physicians surveyed was 42.6, and their imply variety of years in apply was 26.4. For these numbers to be appropriate, the imply age at which these physicians began practising can be 16.2. The identical paper comprises phrases which are similar to these of a examine5 printed in 2009 by totally different authors (see ‘Textual echo’).
Supply: Ref. 1
The journal’s writer, Taylor & Francis, says that it’s at present investigating the paper, after considerations have been raised in December 2023. Abbas didn’t reply to a request for remark in regards to the investigation.
Mol says that he’s not accusing the authors of information fabrication and it’s potential that the discrepancies are a results of unintentional errors. “We’re simply presenting the details after which different folks can draw a conclusion.”
Scientific-trial guidelines
Some publications specializing in ladies’s well being informed Nature that they’re actively working to maintain problematic analysis from being printed. For instance, a bunch of journal editors are combating in opposition to knowledge falsification within the subject of obstetrics and gynaecology by sharing details about doubtlessly flawed papers. The group additionally drew up a guidelines of seven necessities that randomized managed trials should meet to be printed, akin to ethics-committee approval. If a trial’s authors don’t fulfil these necessities, “we’re not going to publish it”, says Vincenzo Berghella, editor-in-chief of the American Journal of Obstetrics & Gynecology Maternal-Fetal Drugs and a maternal-fetal specialist at Thomas Jefferson College in Philadelphia, Pennsylvania.
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If problematic research do find yourself in journals, investigating them post-publication is usually a “painstakingly troublesome” course of, says Žarko Alfirević, a specialist in fetal and maternal drugs on the College of Liverpool, UK. “The burden of proof must be enormously excessive” for journals to confess that fraud has been dedicated, he says.
To mitigate the injury of problematic research within the medical literature, Alfirević, who’s an editor at Cochrane, a bunch that opinions medical proof, is pushing for the adoption of trustworthiness assessments of randomized managed trials as a situation for authors to incorporate them in systematic opinions.
Downstream impact
The chance of flawed papers affecting medical care is actual, says Mol. One instance is the 2017 examine by Abbas and his colleagues on the usage of progesterone to forestall miscarriage and the 2019 systematic evaluation during which the examine was included. That very same evaluation by Cochrane additionally integrated a second examine, authored by a distinct group, that was additionally subsequently retracted. Each papers contributed to the evaluation’s conclusion that progesterone dietary supplements may scale back the danger of miscarriage in ladies who’ve skilled recurrent miscarriages. The evaluation has been cited in ten medical pointers.
Now it’s clear that, regardless of what the retracted research urged, the dietary supplements usually are not efficient for all ladies who’ve skilled recurrent miscarriages6. The evaluation’s corresponding writer, David Haas, an obstetrician and gynaecologist at Indiana College in Indianapolis, says that it’s “extremely seemingly” that the 2 retractions will change the evaluation’s conclusion. He and his colleagues at the moment are working to publish an up to date model of the evaluation during which the retracted research have been eliminated. A discover on the present on-line model of the evaluation says that the evaluation authors have been suggested that the examine by Abbas and his colleagues is the topic of investigation and the evaluation crew has moved the examine from ‘included research’ to ‘research awaiting classification’.
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One other evaluation that included a paper authored by Abbas and his colleagues can also be being up to date. The meta-analysis7, printed in 2023, analysed papers on a technique combining progesterone and a process on the cervix to forestall pre-term delivery and concluded that the mix could possibly be profitable. Among the many papers analysed was a examine8 by Abbas and his co-authors, which was printed within the Worldwide Journal of Gynecology & Obstetrics in 2020.
The journal retracted the paper in late 2023, noting that “inconsistencies have been discovered throughout the dataset … which name into query the validity of the info.” The authors of the meta-analysis say they’re conscious that Abbas’s paper has been retracted and they’re about to submit an amended model that excludes the retracted work. “Luckily, eradicating this paper from our meta-analysis has not influenced the first consequence,” says corresponding writer Craig Pennell, an obstetrician and gynaecologist on the College of Newcastle in Australia.
