The astonishing death toll of scientific lies

You may not have heard of cardiologist Don Polderman, but experts who study scientific misconduct believe that Thousands of people could die Because of that

Poldermans was a distinguished medical researcher at the Erasmus Medical Center in the Netherlands, where he analyzed the quality of care in cardiac surgery, publishing a series of definitive studies from 1999 to the early 2010s.

An important question he studied: Should you give patients a beta blocker, which lowers blood pressure, before certain heart surgeries? Polderman’s research says yes. European medical guidelines (and to a lesser extent US guidelines) It is recommended accordingly.

problem? Polderman information known fake. A 2012 investigation of his employer Erasmus Medical School into allegations of misconduct He was found to have “used patient data without written permission, used fictitious data and… submitted to conferences. [reports] which included notoriously unreliable data.” Poldermans Apologized by accepting the complaintIt is emphasized that the use of fictitious information was accidental.

After publication, a new meta-analysis was published in 2014 evaluating whether beta blockers should be used before cardiac surgery. It is found A course of beta blockers made it 27 percent more likely that someone would die within 30 days of their heart surgery. That is, the policy that Polderman recommended based on his research using falsified data adopted in Europe, was actually dramatically increasing the likelihood of people dying from heart surgery.

Millions Heart surgeries were performed across the US and Europe from 2009 to 2013 when those misleading guidelines were in place. A provocative analysis by cardiologists Graham Cole and Darrell Francis hypothesized that there was 800,000 deaths Compared to if best practices were established five years ago. Although this exact number is hotly contested, a 27 percent increase in mortality for a common procedure over the years may add up to an extraordinary death toll.

I learned about the Poldermans case when I reached out to some scientific misconduct researchers, asking them a provocative question: Should scientific fraud be prosecuted?

Unfortunately, fraud and misconduct in the scientific community is not nearly as rare as one would like to believe. We also know that the consequences of getting caught are often unpleasant. A bad paper can take years to retract, even if the errors are readily apparent. Sometimes, scientists who complain that they falsified their data make frivolous lawsuits against peers who point it out, further silencing anyone who would speak out about bad data. And we know that this behavior can have high risks and can dramatically affect patients’ treatment options.

In cases where research dishonesty is literally killing people, isn’t it appropriate to resort to the criminal justice system?

Questions have been raised as to whether research fraud should be a crime

In some cases, research misconduct can be difficult to distinguish from carelessness.

If a researcher fails to apply the appropriate statistical correction for multiple hypothesis testing, they will likely get some false results. In some cases, researchers are strongly incentivized to be careless in this way by an academic culture that places non-null results above all else (that is, researchers are rewarded for finding an effect, albeit reluctantly correct, even if not methodologically correct). to publish research if it finds no effect).

But I would argue that judging such behavior is a bad idea. This would create a serious chilling effect on research, and perhaps make the scientific process slower and more legalistic – leading to more deaths that could be avoided if science could flow more freely.

So the conversation about whether to criminalize research fraud focuses on the most clear-cut cases: the deliberate falsification of data. Elizabeth Bick, a scientific researcher who studies fraud, Made a name for himself Photographs of test results in many medical journals clearly demonstrate the change. It’s not something that could be an innocent mistake, so it represents something of a baseline for how often manipulated data is released.

While technically some scientific fraud may fall under existing laws that prohibit lying in, say, a grant application, in practice scientific fraud is almost never prosecuted. Polderman eventually lost his job in 2011, but most of his papers were not even revoked, and he faced no further consequences.

But responding to the growing awareness of fraud frequency And to its detriment, there are some scientists and scientific-fraud watchdogs That proposed change. A new law, tailored narrowly to scientific fraud, could clarify where to draw the line between carelessness and fraud.

The question is whether legal consequences will actually help our fraud problem. I asked Bick what he thought of the proposal to criminalize the misconduct he studied.

His response was that, although it is not clear whether criminalization is the right approach, people should understand that currently there are almost no consequences for wrongdoers. “It’s crazy when you see people cheating,” he told me, “and even if it involves grant money from the NIH, there are very few penalties.” Even with those who have been defrauded, the punishment is very light. You are not eligible to apply for new grants for the next year or sometimes three years. It’s very rare that people lose their jobs over it.”

Why did this happen? Fundamentally, it is a problem of incentives. It’s embarrassing for institutions when one of their researchers misbehaves, so they’d rather impose a light penalty and not continue digging. There is little incentive for anyone to get to the bottom of misconduct. “If the most serious consequence for speeding is a police officer saying ‘don’t do that again,’ everyone will be speeding,” Bick told me. “This is our situation in science. Do whatever you want. If you are caught, it will take years to investigate.”

In some ways, a legal statute is not the ideal solution. Courts are also guilty of taking years to adjudicate complex cases. They are also ill-suited to answering detailed scientific questions, and will almost certainly depend on the scientific institutions conducting the investigation—so what matters is those institutions, not whether they are affiliated with a court, a nonprofit, or an organization. NIH.

But in serious enough cases of misconduct, it seems to me that having an institution outside of academia to get to the bottom of these areas would be a great advantage. If well-designed, a law that allows prosecution for scientific fraud can change the overwhelming incentive to go unpunished and proceed with misconduct.

If an investigation conducted by an external body (such as a prosecutor) were ongoing, it would no longer be easy for institutions to shake off cases of fraud and maintain their reputation. But the outside agency doesn’t actually have to be a prosecutor; An independent scientific review board would probably be sufficient, Bick said.

Ultimately, prosecution is a blunt instrument. It can help provide accountability in cases where no one is incentivized to provide it — and I think in cases of misconduct that lead to thousands of deaths, it would be a matter of justice. But this is not the only way, or necessarily the best way, to solve our fraud problem.

But so far, efforts to build institutions within the scientific community that address police misconduct have met with limited success. At this point, I would consider it a positive if there is an effort to allow external institutions to also police misconduct.

Source link